PC fellows are inadequately prepared to provide SRH care to AYA with CHD, and there is a need for curricular reform within PC fellowship programs.
Key Findings
Results
Approximately half of pediatric cardiology fellows reported that fellowship training had not prepared them to counsel patients on contraceptive options or provide preconception counseling.
52% of participants indicated that training received during fellowship has not prepared them to counsel patients with heart and/or vascular disease on contraceptive options
49% indicated fellowship training had not prepared them to provide preconception counseling to their patients
Survey collected data on training program characteristics, attitudes, practices, experiences, and knowledge related to SRH for AYA with CHD
Results
Fewer than half of pediatric cardiology fellows reported feeling comfortable discussing sexual and reproductive health with cardiology patients.
Only 43% of participants indicated feeling comfortable discussing SRH with cardiology patients during fellowship
This suggests a majority (57%) do not feel comfortable with SRH discussions in their clinical practice
The study used a national survey design of ACGME-accredited fellowship programs
Results
The majority of pediatric cardiology fellows do not regularly discuss or initiate discussions about sexual and reproductive health with their cardiology patients.
79% of participants reported that they do not regularly discuss or initiate discussions about SRH with cardiology patients
This finding reflects a gap between the recognized need for SRH counseling and actual clinical practice
The patient population in question—AYA with CHD—is described as an expanding population with specific SRH needs
Results
Nearly all pediatric cardiology fellows surveyed indicated that additional training resources for SRH counseling would be helpful.
The paper describes near-universal endorsement of additional training resources among respondents
This finding was identified as supporting the need for curricular reform within PC fellowship programs
The survey collected data on attitudes and experiences in addition to practices and knowledge
Methods
This national survey of pediatric cardiology fellows achieved an estimated response rate of 20% with 97 responses submitted.
There were 97 responses submitted out of an estimated 466 PC fellows, resulting in an estimated response rate of 20%
The survey targeted ACGME-accredited fellowship programs across the United States
Bivariate logistic regression was performed to assess associations between categorical variables of interest
Demographic data and data related to participant training programs were collected alongside attitudinal and knowledge measures
What This Means
This research suggests that doctors training to become pediatric cardiologists are not being adequately prepared to talk with their teenage and young adult patients about sexual and reproductive health (SRH). The study surveyed nearly 100 pediatric cardiology fellows across the United States and found that about half felt their training had not prepared them to counsel patients about contraception or pregnancy planning, and fewer than half felt comfortable having these conversations at all. The vast majority—nearly 8 in 10—reported that they do not routinely bring up sexual and reproductive health topics with their patients.
This matters because young people with congenital heart disease (heart defects present from birth) face unique risks related to pregnancy and contraception, and their cardiologists are well-positioned to provide or coordinate this care. As medical advances have allowed more people with congenital heart disease to survive into adulthood, this population is growing, making the gap in training increasingly important to address.
Almost all of the fellows surveyed agreed that additional training resources would be helpful, suggesting broad recognition of the problem among trainees themselves. This research suggests that formal training programs for pediatric cardiology fellows need to be updated to include sexual and reproductive health education, so that future cardiologists can better serve the needs of their adolescent and young adult patients.
Hirschbaum J, Kung G, Tanaka D, Williams R, Gal D. (2025). Assessment of Sexual and Reproductive Health Care Training During Pediatric Cardiology Fellowship.. The Journal of adolescent health : official publication of the Society for Adolescent Medicine. https://doi.org/10.1016/j.jadohealth.2025.05.013