Abortion Training in Canadian Obstetrics and Gynaecology Residency Programmes
ESC Congress Library. Costescu D. May 4, 2016; 126957; A-131
Dr. Dustin Costescu
Dr. Dustin Costescu
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Abstract
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Objectives: It is an accreditation standard that graduating obstetricians/gynaecologists be able to independently perform a dilation and curettage, a dilation and evacuation in the early second trimester, and with supervision, a dilation and evacuation of a pregnancy greater than 14 weeks gestation. Beyond this, no further direction is provided in terms of the necessary components of abortion training, despite the fact that one third of women in Canada experience abortion in a lifetime. In order to develop a national abortion training curriculum, we first set out to quantify what training is available across the country.

Methods: Residents and program directors at all 16 residency training programmes in Canada were surveyed using a web-based or paper-based questionnaire. We assessed both whether training for specific abortion procedures is available, and whether residents expected to be competent in performing these procedures. We compared results from a similar study performed in senior OB/GYN residents in 2004.

Results: 301 residents (55% response rate) and 15 program directors (94%) responded. Half of the residency programs offer 'opt-out' (training occurs unless the resident declines) training, and half offer 'opt-in' (residents use electives or selective to obtain training). 88% of residents had access to surgical abortion in the operating room, but only 71% had access to abortion training in an ambulatory setting (where most abortions take place). While 90% of residents and 87% of program directors felt that they would be competent in first trimester surgical abortion in the OR, only 35% of residents and one program director felt that residents would be competent in second trimester abortion. Compared to 2004, residents are less likely to report having access to abortion training. 69% of residents would like more abortion training during residency.

Conclusions: Canadian residency programs do not meet the current accreditation standard for abortion training, and most residents expressed desire for more training. In fact, abortion training opportunities have decreased in the past 10 years. There is a need for a structured, evidence-based national abortion training curriculum to supplement the currently-available training opportunities.

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