Abortion training in family medicine residency programs

Abstract

Introduction: Although clearly within the scope of practice of family physicians, abortion training is not consistently integrated into family medicine residency programs. Family physicians have a potentially important role in increasing abortion access in this country. The aims of this study were to describe the status of medication and suction abortion training for family physicians and to document the process of creating such training.Materials and Methods: Surveys and semistructured interviews were conducted with third-year residents and faculty at nine American family medicine residency programs that offer integrated abortion training.Results: The average number of suction abortion procedures provided by residents in integrated training programs was 37, with the average resident performing 10 medication abortions. Five of the nine integrated programs offered onsite medication abortion training, with only three providing onsite suction abortion training. Most programs (5/9) exclusively used family physician trainers. Overall, 91% of the residents were satisfied with their training. Thematic analysis highlights the challenges facing programs offering abortion training, including community and departmental politics, soliciting the support of clinic staff, funding and ensuring dedicated faculty time. Residents exposed to training perceive increased competence in gynecologic procedures. Residents consistently valued nonprocedural aspects of the curriculum such as options counseling, values clarification and debriefing sessions.Discussion: Although family medicine residents exposed to abortion training overall are satisfied, there are opportunities for improvement.Conclusion: Programs interested in offering integrated abortion training continue to face multiple challenges in implementation and maintenance but can build upon the experiences of dedicated faculty in preexisting programs. Introduction: Although clearly within the scope of practice of family physicians, abortion training is not consistently integrated into family medicine residency programs. Family physicians have a potentially important role in increasing abortion access in this country. The aims of this study were to describe the status of medication and suction abortion training for family physicians and to document the process of creating such training. Materials and Methods: Surveys and semistructured interviews were conducted with third-year residents and faculty at nine American family medicine residency programs that offer integrated abortion training. Results: The average number of suction abortion procedures provided by residents in integrated training programs was 37, with the average resident performing 10 medication abortions. Five of the nine integrated programs offered onsite medication abortion training, with only three providing onsite suction abortion training. Most programs (5/9) exclusively used family physician trainers. Overall, 91% of the residents were satisfied with their training. Thematic analysis highlights the challenges facing programs offering abortion training, including community and departmental politics, soliciting the support of clinic staff, funding and ensuring dedicated faculty time. Residents exposed to training perceive increased competence in gynecologic procedures. Residents consistently valued nonprocedural aspects of the curriculum such as options counseling, values clarification and debriefing sessions. Discussion: Although family medicine residents exposed to abortion training overall are satisfied, there are opportunities for improvement. Conclusion: Programs interested in offering integrated abortion training continue to face multiple challenges in implementation and maintenance but can build upon the experiences of dedicated faculty in preexisting programs.