• Anne Biringer, Dara Abells, Jordana Boro, Joanne A Permaul, Sucheta Sinha, and Lisa Graves.
• Family physician in the Ray D. Wolfe Department of Family Medicine at Mount Sinai Hospital in the Sinai Health System, the Ada Slaight and Slaight Family Director of Family Medicine Maternity Care in the Sinai Health System, and Associate Professor in the Department of Family and Community Medicine at the University of Toronto in Ontario. anne.biringer@sinaihealthsystem.ca.
• Can Fam Physician. 2019 Dec 1; 65 (12): e531-e537.

ObjectiveTo describe the experiences of participants in Canadian family medicine maternity care enhanced skills programs: their current practice situation with respect to maternity care; the reasons they pursued enhanced maternity care training; and their perceptions of competencies attained during the program.DesignCross-sectional questionnaire.SettingCanada.ParticipantsGraduates of family medicine enhanced skills programs in maternity care in Canada between 2004 and 2014.Main Outcome MeasuresParticipants' current engagement in intrapartum care; reasons for participating in the enhanced skills programs; interest in obstetrics at different points in training; and development of maternity care competencies during both core residency and the enhanced skills program.ResultsEighty-seven graduates (response rate of 44%) participated. At an average of 5 years in practice, 77% of enhanced skills graduates were providing intrapartum care. Sixty-nine percent of respondents took the enhanced skills program because they did not feel ready to practise obstetrics without supervision. More than half (55%) of respondents had intended to include obstetrics in their future practices when they were in medical school. By the end of residency, 99% intended to practise obstetrics; however, this percentage decreased to 87% by the end of fellowship. There was a statistically significant increase in graduates' perceptions of various maternity care competencies (eg, vacuum-assisted birth, perineal repair) following enhanced skills training. Eighty-two percent of respondents indicated that the ability to access enhanced skills training supported their decision to provide obstetrics care.ConclusionThis is the first evaluation of graduates of enhanced skills programs in maternity care in Canada. Enhanced skills programs appear to support the education of family medicine maternity care providers; however, these programs might be compensating for residents' lack of confidence in providing maternity care independently rather than providing truly enhanced skills. This study also confirms that some medical students and family medicine residents change their minds in the direction of wanting to provide full-scope maternity care during the course of their education.Copyright© the College of Family Physicians of Canada.

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