Abortion training in family practice residency programs

Abstract

Background: Despite a relatively fixed demand for services, access to abortion services has become increasingly limited, in part due to fewer training opportunities for OB-GYN residents. The recommended core educational guidelines for family practice residents include voluntary interruption of pregnancy up to 10 weeks gestation, but the availability of and interest in such training have not been reported.

Methods: A survey questionnaire assessing availability of abortion training, percentage of residents participating, program demographics, and resident interest in training was sent to all US family practice residency program directors and randomly selected third-year residents during the 1993-1994 academic year: A total of 301 of 399 (75%) program directors and 253 of 399 (63%) third-year residents completed the questionnaire.

Results: Twelve percent of programs nationwide offered abortion training during 1993-1994. Western programs were more likely to offer training (18 of 50 or 36%) than Northeastern (7 of 55 or 12%), Midwestern (6 of 98 or 6%), or Southern programs (4 of 98 or 4%). When available, 45% of trainees chose to participate. Training was primarily in suction curettage up to 12 weeks gestational age. The median duration of training was 4 weeks. Training was provided in both freestanding clinics and hospitals. Religious hospitals were less likely to offer training.

Conclusions: About one of eight family practice residency programs nationwide offer training in abortion. When offered, nearly half of family practice residents choose to participate in this training. Interested family practice residents could be trained to fill an increasing need for physicians willing and able to perform first-trimester abortions.

PIP: In the fall of 1993, 399 family practice residency program directors were asked to complete a questionnaire so researchers could determine the current status of abortion training in family practice residency programs in the US. 301 program directors completed the questionnaire. Only 35 (12%) residency programs provided abortion training to residents. Program directors estimated that 45% of residents from these programs participated in abortion training. Abortion training lasted a median of 4 weeks. Residents performed a median of 10 abortions. They performed them up to 12 weeks gestation (range, 10-20). 30 programs taught suction curettage. Family practice residency programs in the west were more likely to provide this training than the other regions (36% vs. 4% for the south, 6% for the midwest, and 12% for the northeast; p 0.0001). Abortion training takes place primarily in clinics and hospitals (46%, 41%, respectively; 13% for both). Residency programs affiliated with a religious hospital were less likely to offer abortion training than nonaffiliated programs (3.9% vs. 15.7%; p = 0.0335). Religion was the main reason residents refused abortion training. At programs with no abortion training, 46% of senior residents did not know that family practice residents elsewhere received training in first trimester abortions. Only 24% of senior residents who did not know that family practice residents elsewhere received abortion training were interested in receiving abortion training. These findings show that few family practice residents are being trained in performing abortions, particularly in the midwest and the south, which are also the regions with the lowest access to abortion services. North Dakota has only 1 clinic that provides abortions and its physicians come from other states.