Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA.
Kenneth J. Ryan Residency Training Program, University of California, San Francisco, San Francisco, CA.
Am J Obstet Gynecol. 2018 Jul;219(1):86.e1-86.e6. doi: 10.1016/j.ajog.2018.04.011. Epub 2018 Apr 12.
Nearly 15 years ago, 51% of US obstetrics and gynecology residency training program directors reported that abortion training was routine, 39% reported training was optional, and 10% did not have training. The status of abortion training now is unknown.
We sought to determine the current status of abortion training in obstetrics and gynecology residency programs.
Through surveying program directors of US obstetrics and gynecology residency training programs, we conducted a cross-sectional study on the availability and characteristics of abortion training. Training was defined as routine if included in residents' schedules with individuals permitted to opt out, optional as not in the residents' schedules but available for individuals to arrange, and not available. Findings were compared between types of programs using bivariate analyses.
In all, 190 residency program directors (79%) responded. A total of 64% reported routine training with dedicated time, 31% optional, and 5% not available. Routine, scheduled training was correlated with higher median numbers of uterine evacuation procedures. While the majority believed their graduates to be competent in first-trimester aspiration (71%), medication abortion (66%), and induction termination (67%), only 22% thought graduates were competent in dilation and evacuation. Abortion procedures varied by clinical indication, with some programs limiting cases to pregnancy complication, fetal anomaly, or demise.
Abortion training in obstetrics and gynecology residency training programs has increased since 2004, yet many programs graduate residents without sufficient training to provide abortions for any indication, as well as dilation and evacuation. Professional training standards and support for family planning training have coincided with improved training, but there are still barriers to understand and overcome.
大约 15 年前，51%的美国妇产科住院医师培训项目主任报告说，堕胎培训是常规的，39%的人报告说培训是可选的，10%的人没有培训。目前堕胎培训的情况尚不清楚。
我们旨在确定妇产科住院医师培训项目中堕胎培训的现状。
通过调查美国妇产科住院医师培训项目的主任，我们对堕胎培训的可用性和特点进行了横断面研究。如果培训包括在住院医师的日程中，并允许个人选择退出，则将其定义为常规培训；如果不在住院医师的日程中，但可供个人安排，则将其定义为可选培训；如果无法安排，则将其定义为不可用。使用双变量分析比较不同类型项目之间的培训情况。
共有 190 名住院医师培训项目主任（79%）做出了回应。64%的人报告说有常规的、有时间安排的培训，31%的人报告说有可选的培训，5%的人报告说没有培训。常规、有时间安排的培训与更多的子宫排空手术数量相关。虽然大多数人认为他们的毕业生在第一孕期抽吸术（71%）、药物流产（66%）和引产终止（67%）方面有能力，但只有 22%的人认为毕业生在扩张和排空方面有能力。堕胎程序因临床指征而异，一些项目将病例限制在妊娠并发症、胎儿异常或胎儿死亡。
自 2004 年以来，妇产科住院医师培训项目中的堕胎培训有所增加，但许多项目的毕业生在提供任何指征的堕胎以及扩张和排空方面都没有得到足够的培训。专业培训标准和计划生育培训的支持与培训的改善是一致的，但仍存在需要理解和克服的障碍。
