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Complex Family Planning Qualifying Exam Preparation

The content of the Qualifying Examination will be based on the blueprint for Complex Family Planning. The major categories and subcategories are shown below, including the percentages of the categories. The questions will be in a multiple-choice, one best answer format.


Provide contraceptive counseling, provision, and surveillance to patients and contraceptive consultation to other health care providers

  • Engage in person-centered counseling to identify reproductive life goals
  • Screen patients for contraceptive coercion
  • Implement practices to improve access to contraception (e.g., same-day IUD insertion, quick start)

Demonstrate advanced knowledge of pharmacology (mechanism of action, dosing, route of administration/absorption, contraindications, metabolism, excretion), effectiveness, potential side effects, and complications of all contraception methods

  • Coitally-dependent
  • Short-acting
  • Long-acting
  • Permanent
  • Emergency contraception

Provide care for patients with specialized contraceptive needs (e.g., limited access or medical considerations)

  • Adolescent patients
  • Perimenopausal patients
  • LGBTQIA patients
  • Patients with substance and alcohol use disorder
  • Patients with disabilities
  • Patients experiencing intimate partner violence and sexual assault
  • Patients who are incarcerated
  • Postpartum or post-abortal patients (including immediate LARC)

Provide contraceptive counseling, provision, and surveillance for patients with pre-existing medical or anatomical conditions

  • Evaluate and manage interactions between contraception and medications
  • Evaluate and manage interaction between medical conditions and contraception (e.g., HIV infection, renal disease, hepatic disease, hematologic disorders, thromboembolic disorders, cardiac disease, mental health disorders, connective tissue disorders, STIs, PID)
  • Provide care for patients with reproductive tract anomalies (e.g., uterine anomalies, leiomyomata)
  • Perform complex placement of contraceptive devices [e.g., patients with anatomic challenges (e.g., stenotic cervix, leiomyomata, reproductive tract anomalies) or physical or mental conditions impacting insertion (e.g., contractures, developmental delay)]
  • Utilize contraception for non-contraceptive benefits (e.g., management of uterine bleeding, catamenial seizures, perimenopausal)

Evaluate and manage side effects related to contraception

  • Evaluate reported side effect(s) with respect for patient autonomy (e.g., modeling non-coercive practice)
  • Counsel patients about alternative methods of contraception based on side effect history
  • Offer management options for method side effects

Evaluate and manage complications related to contraception

  • Identify severe adverse complications and refer for management (e.g., stroke, DVT, myocardial infarction)
  • Evaluate and manage if intrauterine pregnancy occurs with contraceptive methods

Evaluate and manage complicated contraceptive removals, including malpositioned or broken devices, with use of imaging if needed

  • IUD (e.g., missing strings, embedded, uterine perforation)
  • Implants (e.g., nonpalpable implants, broken devices)
  • Use of hysteroscopy and laparoscopy for removal of devices
  • Determine when additional expertise and/or facilities are needed (e.g., interventional radiology, other surgical specialties, and specialty laboraties)

Evaluate early pregnancy

  • Determine pregnancy location (e.g., intrauterine, extrauterine, cesarean scar, cervical, cornual)
  • Evaluate intrauterine pregnancy (e.g., solution of ultrasonographic landmarks, gestational age, etc.)
  • Demonstrate knowledge of ectopic risk factors (e.g., IUD in situ, prior tubal ligation, prior ectopic)

Manage early pregnancy

  • Provide pregnancy options counseling
  • Provide counseling about options for management of pregnancy of unknown location (PUL), early pregnancy loss (EPL), and ectopic pregnancy (e.g., intrasac injections, laparoscopy, uterine aspiration, multi-modal approach)
  • Use uterine aspiration for diagnosis and treatment of PUL and EPL
  • Use of mifepristone and/or misoprostol for PUL
  • Use of mifepristone and/or misoprostol for EPL

Manage and surveil gestational trophoblastic disease with other subspecialties

  • Procedurally manage gestational trophoblastic disease (e.g., second-trimester uterine evacuation)
  • Identify the consequences of gestational trophoblastic disease (e.g., thyroid storm and hypertension)
  • Provide counseling for and manage contraception after treatment of gestational trophoblastic disease
  • Diagnose gestational trophoblastic disease and refer patients

Provide comprehensive counseling to patients about abortion and consultation to other health care providers

  • Provide comprehensive options counseling to patients
  • Screen patients for interpersonal reproductive coercion
  • Facilitate identification of patient-led reproductive goals (e.g., post-abortion contraception, general contraception, general contraception, reproductive life planning)
  • Incorporate comprehensive knowledge of local laws and regulations into counseling
  • Describe methods of abortion to patients (e.g., medication, procedure, induction, feticidal injection, third-trimester options)

Provide abortion counseling for patients with special reproductive needs

  • Adolescent patients
  • LGBTQIA patients
  • Patients with substance and/or alcohol use disorder
  • Patients experiencing intimate partner violence and/or sexual assault
  • Patients who are incarcerated
  • Patients with disabilities

Perform a pre-abortion evaluation

  • Identify patients at risk or abortion complications (e.g., prior uterine surgery, uterine anomalies, cervical anomalies)
  • Identify comorbidities that influence abortion care (e.g., cardiac disease, seizure disorders, renal disorders, coagulopathies, fetal demise)
  • Evaluate the results of laboratory studies (e.g., Rh typing, CBC, CMP)
  • Perform ultrasound as needed (e.g., to determine pregnancy location, determine gestational age, diagnose uterine anomalies, diagnose multiple gestations, identify placental location, and recognize signs of abnormal placentation)
  • Determine the need for additional imaging studies (e.g., MRI, CT scan, ultrasound)
  • Determine the need for consultations from other health care specialties (e.g., hematology, cardiology, anesthesiology)
  • Determine an appropriate location for completion of abortion (e.g., at home, free-standing clinic, hospital-based clinic, operating room) based on patient risk factors (e.g., gestational age, comorbidities, fetal demise)
  • Determine options for abortion method including feticidal injections
  • Counsel patients on available genetic testing options
  • Determine need for peri-abortal medications (e.g., Rh immunoglobulin, antibiotics, antiemetics, uterotonics)
  • Provide a multi-modal plan for pain management during and after abortion

Provide medication abortion

  • Demonstrate advanced knowledge of pharmacology (mechanism of action, dosing, route of administration/absorption, contraindications, metabolism, excretion) for medication abortion at various gestational ages (e.g., mifepristone, misoprostol, methotrexate, oxytocin)
  • Counsel regarding risks and benefits of treatment regimen for medication abortion at any gestational age
  • Determine medication regimen based on patient factors (e.g., gestational age, prior uterine scar)
  • Surveil patients to assess abortion completion (e.g., laboratory, ultrasound, clinical)
  • Provide complex labor inductions for second and/or third-trimester abortion (e.g., history of cesarean deliveries, leiomyomatous uterus, prolonged induction)

Perform procedural abortion

  • Perform abortions for patients with comorbidities (e.g., prior surgery, fibroids, vascular malformations, multi-gestation, emergent uterine evacuation)
  • Provide cervical preparation to patients, including those with comorbidities (e.g., cervical anomalies, previous uterine surgery, advanced gestational age, urgent uterine evacuation)
  • Provide pain management and/or anesthesia (e.g., paracervical block, sedation, non-pharmacological pain management)
  • Utilize ultrasound guidance during procedural abortion
  • Perform abortion via electric or manual uterine aspiration
  • Perform abortion via dilation and evacuation
  • Perform abortion via dilation and extraction
  • Assess for abortion completion (e.g., tissue examination, laboratory studies, ultrasound)

Evaluate, diagnose, and manage abortion complications

  • Hemorrhage
  • Retained products of conception
  • Hematometra
  • Uterine perforation and initial management of resulting injuries (e.g., genitourinary, gastrointestinal, vascular)
  • Cervical lacerations
  • Amniotic fluid embolism (AFE)
  • Thrombotic event
  • Anesthesia complications
  • Undiagnosed placenta site abnormalities
  • Infection
  • Septic abortion
  • Heterotopic pregnancy (initially manage)
  • Vasovagal response
  • Continuing pregnancy after abortion
  • Unplanned delivery prior to scheduled procedure
  • Disseminated intravascular coagulopathy
  • Uterine rupture


  • Demonstrate knowledge of basic research methodology (e.g., study design, sample size)
  • Critically analyze published studies
  • Determine the proper biostatistical test based on data type and study questions
  • Demonstrate knowledge of research ethics (e.g., informed consent, vulnerable populations)

Public health and reproductive health policy

  • Understand how reproductive health impacts public health and health policy
  • Identify disparities in reproductive health, including access, care quality, patient experience, and outcomes
  • Identify professional organizations that advocate for and influence policy in reproductive health
  • Demonstrate knowledge of social and structural determinants that create reproductive health inequities in marginalized groups


  • Engage with stakeholders (e.g., public, other healthcare providers, policymakers) about the role of family planning in public health and health policy
  • Engage with the work of professional organizations that advocate for health policy in contraception and abortion
  • Demonstrate the knowledge and skills to advocate for equitable access to reproductive health services

Ethics and professionalism

  • Systematically engage in practice review to identify health disparities
  • When engaged in shared clinical decision making, incorporate patient, family, and cultural consideration in making treatment recommendations
  • When providing care for patients, consider psychological, sexual, and social implications of various treatment options

Patient safety

  • Systematically analyze the practice for safety improvements (e.g., root cause analysis)
  • Systematically engage in practice reviews for safety improvements (e.g., root cause analysis)
  • Incorporate the standard use of procedural briefings, "time outs," and debriefings in clinical practice
  • Participate in the review of sentinel events, reportable events, and near misses
  • Implement universal protocols (e.g., bundles, checklists) to help ensure patient safety

Interpersonal and communication skills

  • Communicate to patient and family regarding adverse outcomes and medical errors
  • Demonstrate sensitivity and responsiveness when communicating with a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation
  • Provide comprehensive information when referring patients to other professionals

Systems-based practice

  • Incorporate considerations of cost awareness and risk-benefit analysis in patient care
  • Provide care with multidisciplinary teams to promote patient safety and optimize patient outcomes

Practice-based learning and improvement

  • Design or participate in practice or hospital quality improvement activities

Evidence-based medicine

  • Incorporate evidence-based practices and national guidelines to improve practice patterns and outcomes
  • Implement evidence-based protocols to enhance recovery after surgery (ERAS)