Almeling R, Tews L, Dudley S
Access Initiative, National Abortion Federation, Washington, DC, USA.
Fam Plann Perspect. 2000 Nov-Dec;32(6):268-71, 320.
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.
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.
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.
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.
自20世纪70年代末以来,美国提供堕胎培训的妇产科住院医师培训项目数量一直在稳步下降。鉴于已记录的堕胎服务提供者短缺的情况,评估并确保研究生医学教育中堕胎培训的可获得性至关重要。
1998年,美国国家堕胎联合会对美国261个经认可的妇产科住院医师培训项目进行了调查,并分析了孕早期和孕中期堕胎培训的可获得性。
在回复调查的179个项目中,81%报告称提供孕早期堕胎培训——46%为常规培训,34%为选修培训。74%的项目提供孕中期培训——44%为常规培训,29%为选修培训。一些不提供培训的项目让住院医师可以选择在其他地方获得培训。虽然26%的项目表示其项目中的所有住院医师都接受堕胎培训,但40%的项目称接受培训的住院医师不到一半,其中14%的项目没有培训任何住院医师。手术室是最常见的培训地点:59%的项目报告称堕胎培训在手术室进行。
在堕胎培训的可获得性经历了数十年的下降之后,堕胎培训的机会有所增加。然而,在解释这些结果时仍有理由保持谨慎,包括可能存在的回应偏差以及由于研究生医学教育认证委员会的新指南而产生的报告堕胎培训可获得性的压力。