Abortion training during IM residency?

[primarycare4me]

A controversial question yes, but I am curious if anyone knows of any IM docs who provide abortion services. I have met many thru ob and family med but no IM docs yet...just curious if anyone knows of this or knows of elective opportunities during resideny for this training as an IM doc?
Thanks-

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[t33sg1rl]

Generally IM physicians do not provide any type of OB care. Family docs practice adult medicine, pediatrics, and ob/gyn, but IM docs practice only adult medicine-no ob/gyn or pediatrics. Abortion or any other similar obstetric surgeries are not something an IM physician would ever perform.

 

[NYMd2008]

Abortion or any other similar obstetric surgeries are not something an IM physician would ever perform.

Agree.

Talk about a fully loaded question!

 

[Slitherin]

From what I understand most abortions are in fact medical and not surgical, and many are provided by FP and other primary care, so an IM doc could do this, with that said I think it would be pretty unusual.

 

[Toohotinvegas33]

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[jdh71]

From what I understand most abortions are in fact medical and not surgical, and many are provided by FP and other primary care, so an IM doc could do this, with that said I think it would be pretty unusual.

It seems reasonable to me that a person who is not trained nor able to perform a D and C should not be trying to provide "medical" abortion services, because if your "medical" abortion fails you are going to have to send the mess to your local OB/GYN colleagues who are not going to be happy fixing the mess you created. Certain FP programs are heavy in OB/GYN and these FP who provide this service are probably properly trained to handle the complications.

EDIT: You might be able to find a primary care track of IM that would give one enough elective time in OB/GYN that an IM doc would be able to do abortions - it would have to be the right program at the right place

 

[BlackNDecker]

What about the Women's Health track offered by some IM programs? Not really sure what this involves, but it seems reasonable that there'd be enough additional electives offered that would enable one to become an abortifacianado...if one so desired.

 

[skypilot]

I'm sure you can get the training if you want it. Just set up some electives with your local Family Medicine or Ob department. It is like any procedure, do enough of them to get competent and certified and you can add them to your practice if you want to.

 

[DrNick2006]

It seems reasonable to me that a person who is not trained nor able to perform a D and C should not be trying to provide "medical" abortion services, because if your "medical" abortion fails you are going to have to send the mess to your local OB/GYN colleagues who are not going to be happy fixing the mess you created.

Actually, I don't see the problem. There is no difference between attempting a medical abortion that subsequently requires a D&C to any other medically managed disease that progresses to require surgical care or even specialist medical care.

And its not as if a medical abortion is all that complicated.

 

[jdh71]

Actually, I don't see the problem. There is no difference between attempting a medical abortion that subsequently requires a D&C to any other medically managed disease that progresses to require surgical care or even specialist medical care.

And its not as if a medical abortion is all that complicated.

Well . . . first off, a pregnancy is NOT a disease. An abortion represents an elective intervention, and if your "medical" abortion doesn't take, and the woman needs a D and C to complete the process, it will have been a mess you created, that needn't not have been created by you, and now your mess will have to be handled by another. "Medical" abortion sounds pretty straight forward - Mifepristone plus Cytotec - but if the abortion is incomplete, and a signifcant a number of medical abortions do end in incomplete abortion, D and C is almost always required. While in the meantime with a open cervical os you run the risk of endometritis, pelvic abcess, even sepsis.

Your OB/GYN colleagues will handle your mess, but as a matter of professionalism, I think it is only responsible than any physician that offer these services be able to see them through from the start, unless of course you have already made arrangement for such a situation with your local OB/GYNs and they are fine with the arrangement.

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