A descriptive analysis of abortion training in family medicine residency programs (original) (raw)
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Integrating abortion training into family medicine residency programs
Family medicine, 2007
Family physicians provide many office-based procedures in primary care settings. While first-trimester abortion is a procedure appropriate for and performed by family physicians, few residency programs offer routine training in this skill. This study explored the experience of residency programs that have initiated or are in the process of initiating required abortion training. Faculty members responsible for abortion training curricula in identified programs completed questionnaires and semi-structured interviews. Faculty members from nine programs with required training and seven programs interested in initiating this training were included in the study. Factors that assisted in curriculum development included the support of family medicine and obstetrician-gynecologist faculty. Commonly encountered challenges included the need for dedicated resources, inter-specialty conflict, and limited access to training sites. Family medicine programs can be successful at developing required ...
Initiating abortion training in residency programs: issues and obstacles
Family medicine, 2006
Early abortion is a common outpatient procedure, but few family medicine residencies provide abortion training. We wished to assess experiences and obstacles among residency programs that have worked to establish early abortion services. From 2001-2004, 14 faculty participated in a collaborative program to initiate abortion training at seven family medicine residencies. Ten focus groups with all trainees were followed by individual semi-structured interviews with a smaller group (n=9) that explored the progress and obstacles they experienced. Individual interviews were recorded and analyzed to identify major themes and sub-themes related to initiating abortion training. Five of seven sites established abortion training. Five major themes were identified: (1) establishing support, (2) administration, (3) finance, (4) legal matters, and (5) security/demonstrators. Faculty from sites where training was ultimately established rated the sub-themes of billing/reimbursement, obtaining staf...
Abortion Training in U.S. Obstetrics and Gynecology Residency Programs, 1998
Family Planning Perspectives, 2000
Context: Since the late 1970s, the number of obstetrics and gynecology residency programs providing abortion training in the United States has steadily decreased. Given the documented shortage of abortion providers, assessing and ensuring the availability of abortion training in graduate medical education is critical. Methods: In 1998, the National Abortion Federation surveyed the 261 accredited U.S. residency programs in obstetrics and gynecology, and analyzed the availability of first- and second-trimester abortion training. Results: Of the 179 programs that responded to the survey, 81% reported that they offer first-trimester abortion training—46% routinely and 34% as an elective. Seventy-four percent of programs offer second-trimester training—44% routinely and 29% as an elective. Some programs that do not offer training give residents the option of obtaining it elsewhere. While 26% of programs indicated that all residents in their programs receive abortion training, 40% said that fewer than half are trained, including 14% that train no residents. The operating room is the most common training site: Fifty-nine percent of programs reported that abortion training takes place in the operating room. Conclusions: After a decades-long decline in the availability of abortion training, opportunities for abortion training have increased. However, there is reason to be cautious in interpreting these results, including possible response bias and pressure to report the availability of abortion training because of new guidelines from the Accreditation Council for Graduate Medical Education.
Contraception, 2010
Background: Abortion is one of the most contested, yet common surgical procedures in the United States and a required component of obstetrics and gynecology resident education. Approaches to abortion training are variable. Study Design: We conducted in-depth interviews with 30 physicians who had graduated 5-10 years prior from four US residency programs with routine abortion training. Interviews focused on their experiences with abortion during training and in practice. Results: Graduates' positive and negative experiences demonstrated that many valued teaching about the social issues surrounding abortion as well as training in surgical skills. Respondents found training rewarding when attending physicians openly discussed their personal commitment to abortion practice, respected differences of opinions about abortion and demonstrated high regard for abortion training. Some residents who opted out of surgical training for abortion valued partially participating in the rotation. Conclusions: Many physicians-in-training consider didactics related to the social context of care and respect for moral boundaries important components of abortion training.
2014
Objective: To assess the availability and characteristics of abortion training in US ob-gyn residency programs. Methods: We surveyed fourth-year residents at US residency programs by email regarding availability and type of abortion training, procedural experience and self-assessed competence in abortion skills. We conducted multivariable, ordinal logistic regression with general estimating equations to determine individual-level and resident-reported, program-level correlates of quantity of uterine evacuation procedures done during residency. Results: Three hundred sixty-two residents provided data, representing 161 of the 240 residency programs contacted. Access to training in elective abortion was available to most respondents: 54% reported routine training-where abortion training was routinely scheduled; 30% reported opt-in training-where training was available but not routinely integrated; and 16% reported that elective abortion training was not available. Residents in programs with routine elective abortion training and those who intended to do abortions before residency did a greater number of first-trimester manual uterine aspiration and second-trimester dilation and evacuation procedures than those without routine training. Similarly, routine, integrated training, even for indications other than elective abortion, correlated with more clinical experience (all pb.01, odds ratio and confidence interval shown below). Conclusion: There is a strong independent relationship between routine training and greater clinical experience with uterine aspiration procedures.
The effect of training on the provision of elective abortion: A survey of five residency programs
American Journal of Obstetrics and Gynecology, 2003
Abortion is one of the most common surgical procedures in the United States, more common than hysterectomy, sterilization, or cesarean delivery. 1 Over the last 15 years, abortion access has decreased, largely because of a falling number of abortion providers. We surveyed recently graduated physicians to determine what variables correlate with abortion provision, including residency training.
Abortion education in medical schools: A national survey
American Journal of Obstetrics and Gynecology, 2005
This survey was performed to examine the inclusion and extent of abortion education in US medical schools. Study design: A 3-item confidential survey requesting information about abortion education throughout the 4 years of medical school was mailed to the OB-GYN clerkship directors of the 126 accredited US medical schools. Results: Seventy-eight surveys were returned, for a response rate of 62%. Overall, 17% of clerkship directors reported no formal education about abortion either in the preclinical or clinical years. In the third-year OB-GYN rotation, 23% reported no formal education, whereas 32% offered a lecture specifically about abortion. While 45% of third-year rotations offered a clinical experience, participation was generally low. About half of schools offered a fourth-year reproductive health elective, but few students participated. Conclusion: Abortion education is limited in US medical schools. As an integral part of women's reproductive health services, abortion education deserves a place in the curricula of all medical schools.
Obstacles to the Integration of Abortion Into Obstetrics and Gynecology Practice
Perspectives on Sexual and Reproductive Health, 2010
CONTEXT: Obstetrics and gynecology residents who are trained in family planning and intend to provide abortions after residency often do not ultimately do so. The extent of the professional barriers physicians face trying to integrate abortion into their practice is unknown.
Attitudes and Intentions of Future Health Care Providers Toward Abortion Provision
Perspectives on Sexual and Reproductive Health, 2004
Perspectives on Sexual and Reproductive Health attending the University of Washington and their intention to provide abortion services in their practices. The primary outcome of this study was students' intention to incorporate abortion into their practice. Secondary outcomes were willingness to seek abortion training and attitudes toward advanced clinical practitioner provision of abortion services. On the basis of previous work, we hypothesized that students in medical programs, those in women's health-oriented programs and those who spent their first 15 years of life in an urban area would be more likely than others to intend to provide abortions, once age, sex and religion are controlled for. Also, we predicted that students would be more willing to perform medical abortions than surgical abortions, because medical abortions are limited to first-trimester terminations of pregnancy.