Department of Obstetrics and Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, 833 Chestnut Street, Philadelphia, PA 19107, United States.
Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095, United States.
Contraception. 2024 Feb;130:110291. doi: 10.1016/j.contraception.2023.110291. Epub 2023 Sep 18.
The Accreditation Council for Graduate Medical Education requires all obstetrics and gynecology residents have access to abortion training. The impact of Dobbs on training remains unknown. We aimed to describe residency programs affected by abortion bans and those lacking abortion training despite permissive state policies. We considered demographic data to understand the impacts on residents under-represented in medicine.
We used residency databases and websites to abstract data. We identified programs offering routine abortion training as either those with Ryan Programs or those with website or email acknowledgment of training. We defined states with abortion bans as those with either complete or 6-week bans as of December 2022. We used χ and Student's t tests in descriptive analyses and performed a logistic regression to adjust for demographic and program-specific variables.
Of 286 residency programs included, 140 (49%) offered routine abortion training prior to Dobbs. As of December 2022, 19 of these (14%) had lost the ability to provide routine in-state abortion training. Of 223 residency programs in states with legal abortion, 102 (46%) programs lacked routine abortion training. These sites were more likely to be community or community-university programs, with graduates more likely to practice as generalists. Resident race/ethnicity did not differ between residents in states with legal abortion vs abortion bans.
Nearly half of obstetrics and gynecology residency programs in states with legal abortion do not appear to provide routine abortion training. Further work is needed to understand this paucity of training and maximize access in legislatively permissible environments.
Following Dobbs, 14% of residency programs lost in-state abortion training. Notably, in states with legal abortion, 46% of programs lack routine abortion training despite permissive legislation. This presents a window of opportunity for expansion of abortion training, particularly at community and community-university hybrid residency sites.
美国毕业后医学教育认证委员会要求所有妇产科住院医师接受堕胎培训。多布斯案对培训的影响仍不清楚。我们旨在描述受到堕胎禁令影响以及尽管所在州政策允许但缺乏堕胎培训的住院医师培训计划。我们考虑了人口统计学数据，以了解对医学领域代表性不足的居民的影响。
我们使用住院医师数据库和网站来提取数据。我们将提供常规堕胎培训的计划定义为那些提供瑞安计划的计划或那些在网站或电子邮件中确认培训的计划。我们将在 2022 年 12 月之前有完全或 6 周堕胎禁令的州定义为堕胎禁令州。我们在描述性分析中使用 χ 和学生 t 检验，并进行逻辑回归以调整人口统计学和计划特定变量。
在纳入的 286 个住院医师培训计划中，有 140 个（49%）在多布斯案之前提供常规堕胎培训。截至 2022 年 12 月，其中 19 个（14%）已经失去了在州内提供常规堕胎培训的能力。在有合法堕胎的 223 个住院医师培训计划中，有 102 个（46%）计划缺乏常规堕胎培训。这些地点更有可能是社区或社区-大学计划，其毕业生更有可能作为全科医生执业。在有合法堕胎的州和有堕胎禁令的州，居民的种族/族裔差异无统计学意义。
在有合法堕胎的州，近一半的妇产科住院医师培训计划似乎没有提供常规堕胎培训。需要进一步努力了解这种培训的不足，并在立法允许的环境中最大限度地扩大堕胎培训。
在多布斯案之后，14%的住院医师培训计划失去了州内堕胎培训。值得注意的是，在有合法堕胎的州，尽管立法允许，但 46%的计划缺乏常规堕胎培训。这为扩大堕胎培训提供了一个机会，特别是在社区和社区-大学混合住院医师培训基地。
