Dilation and evacuation training in maternal-fetal medicine fellowships

• Published in: American journal of obstetrics and gynecology Vol. 210; no. 6; pp. 569.e1 - 569.e5
• Main Authors: Rosenstein, Melissa G., MD, MAS, Turk, Jema K., MPA, MA, PhD, Caughey, Aaron B., MD, PhD, Steinauer, Jody E., MD, MAS, Kerns, Jennifer L., MD, MPH
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.06.2014
• Subjects: Abortion, Therapeutic - education; Adult; Attitude of Health Personnel; Data Collection; dilation and evacuation; Education, Medical, Graduate - statistics & numerical data; Fellowships and Scholarships; Female; Humans; Male; maternal-fetal medicine training; Obstetrics - education; Obstetrics and Gynecology; Pregnancy; Pregnancy Complications - surgery; Pregnancy Trimester, Second; second-trimester abortion; Specialization; United States; United States; second-trimester abortion; maternal-fetal medicine training; dilation and evacuation
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2014.01.038

Objective Many maternal-fetal medicine (MFM) specialists provide dilation and evacuation (D&E) procedures for their patients with fetal or obstetric complications. Our study describes the D&E training opportunities that are available to MFM trainees during their fellowship. Study Design National surveys of MFM fellows and fellowship program directors assessed the availability of D&E training in fellowship. Univariate and multivariate comparisons of correlates of D&E training and provision were performed. Results Of the 270 MFM fellows and 79 fellowship directors who were contacted, 92 (34%) and 44 (56%) responded, respectively. More than one-half of fellows (60/92) and almost one-half of fellowship programs (20/44) report organized training opportunities for D&E. Three-quarters of fellows who were surveyed believe that D&E training should be part of MFM fellowship, and one-third of fellows who have not yet been trained would like training opportunities. Being at a fellowship that offers D&E training is associated with 7.5 times higher odds of intending to provide D&E after graduation ( P  = .005; 95% confidence interval, 1.8–30). Conclusion MFM physicians are in a unique position to provide termination services for their patients with pregnancy complications. Many MFM subspecialists provide D&E services during fellowship and plan to continue after graduation. MFM fellows express a strong interest in D&E training; therefore, D&E training opportunities should be offered as a part of MFM fellowship.