Dilation and evacuation training in maternal-fetal medicine fellowships

Abstract

Objective: Many maternal-fetal medicine (MFM) specialists provide dilation and evacuation (D&E) procedures for their patients with fetal or obstetric complications. Our study describes the D&E training opportunities that are available to MFM trainees during their fellowship.

Study design: National surveys of MFM fellows and fellowship program directors assessed the availability of D&E training in fellowship. Univariate and multivariate comparisons of correlates of D&E training and provision were performed.

Results: Of the 270 MFM fellows and 79 fellowship directors who were contacted, 92 (34%) and 44 (56%) responded, respectively. More than one-half of fellows (60/92) and almost one-half of fellowship programs (20/44) report organized training opportunities for D&E. Three-quarters of fellows who were surveyed believe that D&E training should be part of MFM fellowship, and one-third of fellows who have not yet been trained would like training opportunities. Being at a fellowship that offers D&E training is associated with 7.5 times higher odds of intending to provide D&E after graduation (P = .005; 95% confidence interval, 1.8-30).

Conclusion: MFM physicians are in a unique position to provide termination services for their patients with pregnancy complications. Many MFM subspecialists provide D&E services during fellowship and plan to continue after graduation. MFM fellows express a strong interest in D&E training; therefore, D&E training opportunities should be offered as a part of MFM fellowship.

Keywords: dilation and evacuation; maternal-fetal medicine training; second-trimester abortion.

Figure 1

Dilation and evacuation (D&E) training opportunities according to maternal-fetal medicine (MFM) Fellows. The figure displays the percentage of fellows who report routine or optional D&E training available at their fellowship and the percentage of fellows who think that routine or optional D&E training should be available.