Incorporating abortion and family planning into Ob-Gyn resident education in the United States 

Incorporating abortion and family planning into Ob-Gyn resident

education in the United States 

U. Landy, J. Steinauer, R. Lewis, P. Darney 

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of

California, San Francisco, USA 

Introduction: Abortion in the United States was

legalized in 1973. Since that time, elective abortion has become one of the most

common surgical procedures in the United States, with an estimated 1.3 million

elective abortions performed in 2000. Despite the high volume of pregnancy

terminations, abortion is not a routine component of graduate medical education

in many departments of Obstetrics and Gynecology (Ob-Gyn). According to a survey

conducted in 1992, only 12% of Ob-Gyn residency programs require first trimester

abortion training for residents, and 7% offer training in second trimester

abortions. In 1996, the Accreditation Council for Graduate Medical Education (ACGME)

created a mandate for Ob-Gyn residency programs to increase abortion training. 

Aims and Methods: The Kenneth J. Ryan Residency Training Program in Abortion and

Family Planning (Ryan Program) was founded in 1999 in response to the ACGME

mandate. The Ryan Program provides technical expertise and funding to assist

Ob-Gyn residency programs in efforts to ensure that abortion and contraception

become a routine aspect of resident education. 

Results: Since 1999, the Ryan

Program has established twenty training rotations throughout the United States.

Program sites have integrated abortion into the Ob-Gyn residency curriculum

using a variety of approaches and settings. Training occurs in high volume,

outpatient, hospital-based services or in collaboration with free-standing

reproductive health clinics. Rotations range in length from 4 to 10 weeks, take

place most commonly in the first, second and/or third year of residency, with a

minimum of 1 dedicated abortion training day per week. In addition to the

clinical training component, Ryan Program sites employ a variety of strategies

to integrate didactic teaching in abortion and contraception into the core

residency curriculum. Initial evaluation has shown that all Ob-Gyn departments

to implement a Ryan Training Program have experienced an increase in the number

of residents who report knowledge of and clinical competency in methods of

pregnancy termination when compared to baseline. 

Conclusions: The Ryan Program

has been successful in assisting selected departments of obstetrics and

gynecology in fulfilling their professional mandate of incorporating abortion

education in the residency curriculum.

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