Our study is an exploratory mixed methods study with a convergent parallel design. We will administer a cross-sectional survey of fourth year residents in obstetrics and gynecology training at Ryan Residency Program sites to quantify the number of tubal ligations or salpingectomies after vaginal delivery (PPBTL) performed during residency and residents’ perceived competency with this procedure. A subsample of respondents will also participate in qualitative in-depth interviews to gather data on facilitators and barriers to achieving competency. We hypothesize that most graduating residents will have completed fewer than 10 PPBTLs (the lowest minimum procedure number of all required surgical categories tracked by the ACGME), most residents will not feel competent performing this procedure, and there will be regional variation in the number of procedures performed and perceived competency.