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堕胎研究生医学教育与培训中的新差距与迫切需求

New Gaps and Urgent Needs in Graduate Medical Education and Training in Abortion.

作者信息

Beasley Anitra D, Olatunde Aishat, Cahill Erica P, Shaw Kate A

机构信息

A.D. Beasley is director, Ryan Residency Program in Family Planning, associate professor, Baylor College of Medicine, and associate residency program director and assistant dean, academic and faculty affairs, Ben Taub Hospital, Houston, Texas.

A. Olatunde is director, Ryan Residency Program in Family Planning, and clinical lead, Complex Family Planning Center, Paley Clinic at Einstein Medical Center, Philadelphia, Pennsylvania.

出版信息

Acad Med. 2023 Apr 1;98(4):436-439. doi: 10.1097/ACM.0000000000005154. Epub 2023 Jan 16.

Abstract

Abortion is essential health care, and abortion training and education are essential at all levels of medical education. Among the most common procedures performed in obstetrics and gynecology (OB/GYN), abortion is a core competency for OB/GYN residency programs. For nearly 50 years, the procedure was federally protected by the U.S. Supreme Court's January 22, 1973, Roe v Wade decision. On June 24, 2022, amidst increasing state restrictions limiting abortion access, the Court's decision on Dobbs v Jackson Women's Health Organization effectively reversed Roe . As a result, immediate bans on abortion went into effect across the country, removing access to abortion for millions of people and newly limiting training and education in this core competency for many medical residents. As of June 2022, nearly half of U.S. OB/GYN residency programs and more than 40% of residents are located in states that have banned or are likely to ban abortion. In states where abortion is restricted or illegal, states must adapt quickly to ensure their residents meet training requirements. This adaptation may include developing and leveraging relationships with programs in states where access is protected, depending on simulation, and placing greater emphasis on education and training in pregnancy loss management and postabortion care. None of these is a comprehensive solution and even all together, they are insufficient to train residents and medical students. Ultimately, many future physicians will not receive the training they need to provide full reproductive health care to their pregnant patients. Legal and other systems of support are needed to ensure that current and future physicians can provide compassionate, evidence-based reproductive health care, including essential abortion care.

摘要

堕胎是基本医疗保健,堕胎培训和教育在医学教育的各个层面都至关重要。在妇产科最常见的手术中,堕胎是妇产科住院医师培训项目的一项核心能力。近50年来,该手术受到美国最高法院1973年1月22日罗诉韦德案判决的联邦保护。2022年6月24日,在各州对堕胎限制日益增多的情况下,最高法院对多布斯诉杰克逊妇女健康组织案的判决实际上推翻了罗诉韦德案。结果,全国各地立即实施了堕胎禁令,数百万人无法堕胎,许多医学住院医师在这一核心能力方面的培训和教育也受到了新的限制。截至2022年6月,美国近一半的妇产科住院医师培训项目以及超过40%的住院医师所在的州已经禁止或可能禁止堕胎。在堕胎受到限制或非法的州,各州必须迅速做出调整,以确保其居民满足培训要求。这种调整可能包括与堕胎合法州的项目建立并利用合作关系、依靠模拟培训,并更加重视流产管理和堕胎后护理方面的教育和培训。这些都不是全面的解决方案,即使综合起来,也不足以培训住院医师和医学生。最终,许多未来的医生将无法获得为怀孕患者提供全面生殖健康护理所需的培训。需要法律和其他支持体系来确保当前和未来的医生能够提供富有同情心的、基于证据的生殖健康护理,包括基本的堕胎护理。

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