Abortion training: Hard to get?

Most professional and academic leaders say doctors who want instruction get it, but some residents say finding someone to teach them is easier said than done.

By Myrle Croasdale, AMNews staff. Oct. 24/31, 2005.

Family physician Jules Marsh, MD, did a year in emergency medicine before switching to family medicine. During both residencies, she set up month-long electives to learn how to perform abortions. Otherwise, she said, she would not have even heard it discussed.

"The status of abortion training in the United States is disturbing," said Dr. Marsh, who finished her training in Tacoma, Wash., this year. "As far as I can remember, not a word about abortion was brought up in medical school and nothing during residency. ... It's like never having heard of a colonoscopy."

Family physician Debra Stulberg, MD, said she had an equally difficult time seeking out training she wanted. She ultimately set up an elective at a Planned Parenthood clinic in Chicago during her family medicine residency. But it wasn't easy.

"I came in knowing I wanted to be trained in the full scope of women's health, so I began setting this up very early," Dr. Stulberg said, who finished her residency in Chicago in June. "I felt I had to reinvent the wheel. I was going to other institutions, in some cases out of state; there were issues about malpractice coverage and getting institutional approval. Luckily, I had a network of attendings in other cities willing to train me, but they had to jump through hoops as well."

The Planned Parenthood clinic where she ended up didn't have a formal program, and it took some convincing to get the physician there to take her in, she said.

While Dr. Stulberg was persistent, she saw other residents put aside their interest in the procedure when confronted with creating their own training program. It makes her wonder how many residents aren't getting the abortion training they want because they don't have time to set up the learning experience.