Abstract
Objectives: The Kenneth J. Ryan Residency Training Program in Abortion and Family Planning (Ryan Program) provides support for residency programs to comply with the Accreditation Council for Graduate Medical Education (ACGME) mandate to integrate abortion into training and enhance training in abortion and contraception. Since 1999, some 84 programs have been established in 33 states and two Canadian provinces. Our objective is to describe the impact on residents' clinical competence and the departments overall. Methods: All Ryan Programs are systematically reviewed through postrotation surveys completed by residents and through annual reports, site reviews and yearly surveys completed by Ryan Program directors, department chairs and residency program directors. Results: In 2015, a total of 254 (94%) residents completed postrotation surveys. In the same year, 22 of 23 (96%) directors, chairs and residency program directors of actively funded Ryan Programs completed their annual surveys. On average, residents spend 17 days in clinics providing abortion or contraception care. During the rotation, residents offer complex contraceptive services, first-trimester manual and electric uterine aspirations, medication abortions and second-trimester dilation and evacuation procedures. Directors, department chairs and residency program directors described a variety of benefits including residents' increased skills in counseling, contraception, ultrasound, abortion and outpatient surgery. In addition to improved clinical competence, departments reported better continuity of care for patients and increased appeal of the residency programs to medical student applicants. Conclusions: The Ryan Program has been successful in integrating abortion and family planning into 34% of all ob-gyn residency programs. These rotations have led to approximately 2750 ob-gyns graduating with proficiency in abortion and contraception care.
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