Abortion Provision by Family Physicians After Integrated Opt-Out Training in Residency

Reproductive Health Education In Family Medicine(RHEDI) supports family medicine residency programs to establish a required rotation in sexual and reproductive health (SRH), including abortion. We evaluated long-term training effects by examining the practice patterns of family physicians 2 to 6 years after residency graduation, to determine whether and how the practices and abortion provision of those with enhanced SRH training differ from those who did not receive this training.

We invited 1,949 family physicians who completed residency training between 2010 and 2018 to complete an anonymous online survey about residency training and current provision of SRH services.

We received 714 completed surveys, a 36.6% response rate. Of those who received routine abortion training during residency (n=445), 24% had provided abortion after graduation, significantly more than the 13% providing abortion who had not received routine training during residency, and much higher than the 3% provision rate found in a recent representative study. Abortion-trained respondents were also more likely than the comparison group to have provided other SRH care. For both medication and procedural abortion, respondents who trained in the family medicine setting were significantly more likely to have provided abortion after residency than those who trained only in dedicated abortion clinics (31% vs 18%, and 33% vs 13%, respectively).

Abortion training during family medicine residency is strongly linked to postresidency abortion provision, and is crucial in preparing family physicians to meet the full range of their patients' reproductive health care needs.