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Future Abortion Providers

Discussion in 'Topics in Healthcare' started by kelaskov, Mar 3, 2007.

  1. kelaskov

    kelaskov Junior Member

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    I'm interested in comments from those receiving or planning on pursuing abortion training. What inspires you to seek training and will your residency choice depend on elective abortion training provided by the residency? If your residency hasn't provided formal training, what are you doing to get trained? Any comments/feedback from students who have done MSFC internships or 4th year abortion/family planning electives appreciated. Thanks!!
     
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  3. nibrocli

    nibrocli Senior Member

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    I'm also very interested in this topic. I'd like to know more about being trained while doing a residency that is NOT is family medicine or ob/gyn (I know these are the two standard routes).

    A thread I started in the pediatrics forum was closed due to some nasty attacks. This thread is not meant to start an abortion debate.

    Please stay on-topic.
    Thanks.
     
  4. Med_Leviathan

    Med_Leviathan Member

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    Lose the smiley, troll.
     
  5. mules05

    mules05 Member

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    I would imagine that residency programs that don't focus on reproductive health and gyn surgery wouldn't offer training in performing abortions. I'd actually venture that perhaps doctors that aren't trained and board-certified in gyn surgery shouldn't be performing these potentially dangerous procedures at all. I don't let my cardiologist check for skin cancer or my dermatologist interpret an echo, so why would I trust any other specialist to perform procedures outside the scope of his or her training?
     
  6. evade

    evade Our Lady of DNA

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    I've done the Reproductive Health Externship through MSFC, and it was a very rewarding experience. Feel free to PM me with any questions; I expect this thread to sink under the weight of trolls (or debate, which isn't the point) pretty quickly.
     
  7. nibrocli

    nibrocli Senior Member

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    This is simply untrue. Abortion is relevant to several specialties besides gyn & FP. Other specialties can and do incorporate training into their residency programs. Many of us want more info on this, that's all. Also, it is hardly a dangerous procedure.

    Again, please keep this thread on-topic. If you have relevant info, we'd like to hear it. We're not too interested in what you'd imagine or venture that perhaps is true. I'm not trying to be harsh, but it has become frustrating that we cannot get info from people who are actually knowledgable on this public forum.
    Thanks.


     
  8. kelaskov

    kelaskov Junior Member

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    Hi there Premed student. As a sophmore in college, I doubt you have much to add to this forum. Please come back-if you're ever accepted to medical school and would like more information on becoming an abortion provider.
    :)
     
  9. mules05

    mules05 Member

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    How, exactly, is it relevant to specialties not dealing with reproductive health? Perhaps I'm just not as bright as you, but when I see baby, I think OB. Perhaps peds, but since said baby is no more at the end of it, you'd have a hard time convincing me that a pediatrics should have anything to do with a surgical procedure. Also, I said POTENTIALLY dangerous, which is indeed the case for any surgical procedure, no matter how minor, which is why we have surgical residencies to train physicians to perform them.

    You can ask for a thread to be kept on topic, but you were the one who brought up the idea of physicians in random specialties performing abortions, not me.
     
  10. kelaskov

    kelaskov Junior Member

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    Actually, some pediatricians who focus on adolecent medicine provide abortion services, IUD placement and other gyn procedures. Teens constitute a large percentage of the unintended pregnancies and many have elective abortions. I also met a general surgery resident who was pursuing elective abortion training. The data is clear that both surgical and medical abortion procedures are safe and easy to learn.

    If you provide abortion procedures, and are are in peds/IM/Gen Surg., or another area that does not generally provide elective abortion care, please describe how (and why) you got your training. Many thanks!
     
  11. nibrocli

    nibrocli Senior Member

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    please, let's not start things like this.

    i'd rather not try to convince you, but if you are really interested in relevance, you can check out MSFC or NAF.

    routine surgical abortion is not really surgery. there's no incision or general anesthesia. it's dilation and evacuation, which is not beyond the scope of pediatricians, emergency medicine physicians, IM, etc. family medicine typically trains in the procedure, and this specialty is very much like peds in that it's a medical specialty, rather than a surgical one.

    as kelaskov said, feel free to input if you have experience or knowledge in abortion training!
    cheers.
     
  12. DropkickMurphy

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    :laugh:
     
  13. DropkickMurphy

    Banned

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    Let me guess.....you'd also like the address, phone number, and details on the security measures of the locations that providing too right? :rolleyes:
     
  14. DropkickMurphy

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    I don't think you will find any EP who does abortions in the ED...... :rolleyes: You're making a mountain out of an anthill (it isn't even a molehill). I'm going to take a stab in the dark and guess that you disagree with abortion?
     
  15. tacrum43

    tacrum43 Behold the mighty echidna

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    Does no one else find it disturbing that there is a smiley face in this thread? Even if you do support abortion, I would think you would at least agree that it is not a happy topic.

    I do have a question, however. Do we have to get training in how to do an abortion? I do not plan to ever do the procedure, and have a moral objection to it. Is it required that a doctor (who is not an OB) has knowledge and training in this area in order to obtain a medical license? I hope not.

    I also hope I don't get flamed, though I don't really care.
     
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  17. nibrocli

    nibrocli Senior Member

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    i really don't think so. kelaskov's private message & post history don't sound like it. maybe i'm not enough of a cynic :)
     
  18. DropkickMurphy

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    You really should try it some time......it makes life a lot easier :laugh:
     
  19. nibrocli

    nibrocli Senior Member

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    many of us are very passionate about all aspects of women's healthcare, and we are enthusiastic to learn more about it and talk to others who share our views.
    no worries, if you don't care to learn the procedure, you'll never have to.
     
  20. DropkickMurphy

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    One of the anti-abortion people on here has a thing in their signature about this. I don't believe so, based on that and also on Panda Bear's comments. He encountered a similar issue I do believe, so you might PM him and ask.
     
  21. psipsina

    psipsina Senior Member

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    My understanding is that at most (if not all) schools its optional, there if you are interested, ok if you're not. I know that doctors aren't legally required to provide abortions, only to refer patients to someone who will if that is the patient's desire. I think it would be weird to force you to do something outside your own moral comfort zone.
     
  22. tacrum43

    tacrum43 Behold the mighty echidna

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    Okay then. Just seems kinda creepy for the OP to put a smiley face in the thread. I just don't see how it could ever be a happy topic. Guess we'll have to agree to disagree.

    Well that's a relief. I was worried it was going to be a big deal, and that I would be forced ot either do something I didn't want to or else not be able to practice medicine.
     
  23. kelaskov

    kelaskov Junior Member

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    My intentions in starting this thread are to find out more about abortion training outside of Obgyn/FP residencies. Program names, specifics including what's involved with the training ie. length/min # of procedures, etc. would be greatly appreciated.

    I was at a wonderful conference where the keynote speaker was a pediatrition who provided elective abortion. I've also met a general surgeon pursuing abortion training. I'm interested in knowing more about non-traditional abortion providers. Do they practice in provider-shortage areas? Do they seek training due to personal ideals of feminism? etc.

    As a medical student who plans to get elective abortion training but is undecided as to what specialty to persue-I'm interested in the above.
     
  24. Tired

    Tired Fading away

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    You started this thread in Pediatrics?! And you're suprised that people flamed you out of there?

    Good God, you are such a smug and self-righteous troll.
     
  25. nibrocli

    nibrocli Senior Member

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    i am interested in pursuing abortion training during a pediatrics residency. the medical director of Planned Parenthood is a pediatrician. The keynote speaker at last year's Medical Students For Choice conference is also a pediatrician.

    let's keep personal attacks out of this and only post if you have helpful information relevant to the original post.
    cheers!
     
  26. OncoCaP

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    Why don't you shadow an abortion provider (a Planned Parenthood center might the logical place to start finding such a person)? That physician or mid-level provider can probably tell you about the training options. As far as the training required, it seems that if you feel this is your calling, you may be forced to go OB/GYN. It seems like there is a shortage of such providers. That being said, there may be physicians with non-accredited training providing abortions; it wouldn't surprise me.

    Take a look at this Planned Parenthood article:
    http://www.plannedparenthood.org/news-articles-press/politics-policy-issues/abortion-access/abortion-training-6130.htm
    "Abortion training is now seldom considered an integral part of a residency in obstetrics and gynecology, and the number of programs routinely teaching these skills has sharply dropped during the last 20 years. Further, many family practice physicians — primary caregivers who are often called upon to address a range of reproductive health needs — do not receive training in the prevention or management of unintended pregnancy.

    They make it sound like it's somewhat difficult to get this training, and they seem to suggest that OB/GYN residencies are the way to get it. If anyone would know how to get the right training, I'm sure they would be the ones. Another point of contact might be the Department of Health in the state where you wish to practice. For example, the Texas Department of Health evidently licenses abortion providers and requires reporting of certain information.

    States that get strict about who can perform an abortion seem to run into legal issues, but I'm not familiar with the laws beyond Roe v. Wade and various rules concerning notification, providing information, time delays, etc. (I don't know the medical training requirements that are specified by law.).

    In case anyone is wondering, while I agree that some abortions are medically necessary to save the mother's life, I'm strongly opposed to elective abortions; I view them as legalized killing of children.
     
  27. georgia_md

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    Something really disturbing about seeing "cheers" and smiling brocoli together in a thread about abortion.

    I apologize for straying away from the original subject. my bad
     
  28. Tired

    Tired Fading away

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    1) The medical director for Planned Parenthood (or, to be more appropriate, the Vice President for Medical Affairs) is Dr. Vanessa Cullins, who was a practicing Ob/Gyn prior to going into health administration.

    2) Good luck findng a program that does surgical training for Pediatrics residents, when only about 1/3 of Ob/Gyn programs still offer training in elective termination. I find it unlikely that any surgeon would allow a Pediatrician to work in their OR, even in a training situation.

    3) Thank you for continuing to instruct us on when, and when not, to post. I'm sure I will not be the only person who will not be listening to you.

    4) Your patronizing tone will undoubtedly attract a lot of flaming very soon. Know that I will find it very amusing when it occurs.

    Cheers!
     
  29. nibrocli

    nibrocli Senior Member

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    abortions are not performed in the OR. family practice (a medical specialty, not a surgical one) physicians perform them. the term "surgical" abortion is a bit of a misnomer.

    i know that Jacobi in the Bronx teaches the procedure as part of their residency in pediatrics. if anyone knows of others let us know.
    thanks!

    yes, yes, Dr. Cullins is wonderful. I should have said ONE of PP's many medical directors, as we have one per affiliate. i do know of Dr. Clayton McCkracken, who is a pediatrician, and medical director of Inter Mountain PP, the affiliate in the Dakotas & Montana.
     
  30. ForbiddenComma

    ForbiddenComma Tanned for Bowling

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    Is that right? That doesn't sound right. The D&C seems like it would be standard for any OB/GYN to learn. Remember that it is performed for nonelective reasons too -- hydatiform moles, concurrant ca. in the mother, fetal death, etc. Of course residents should be able to opt out of learning, but that seems strange that 2/3 of all OB/GYN residencies don't even offer it at all.

    Do you have a link for that?


    BTW I give this thread 4-5 hours before it is locked due to flames :smuggrin:
     
  31. indo

    indo Feed me a stray cat

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    Weber's law
     
  32. astrife

    astrife Senior Member

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    Does anyone know if abortions are covered by private insurance plans, medicare, or medicaid?
     
  33. ForbiddenComma

    ForbiddenComma Tanned for Bowling

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    In some cases it is... I've seen it up on the board at my hospital's surgery wing a few times. Latex allergy is one reason.
     
  34. OncoCaP

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    http://www.medicine.mcgill.ca/MJM/issues/v08n02/crossroads/82157.pdf

    ACCESS TO ABORTION SERVICES IN CANADA
    AND THE U.S.
    In spite of the legality of abortion in the U.S. and
    Canada, many women continue to lack access to
    abortion services. Two factors in particular- the
    declining number of abortion providers and a change in
    the distribution of abortion facilities- have significant
    adverse consequences for women's health, particularly
    for poor and rural women (17, 18). In Canada, only
    17.8% of hospitals provide the service, and some
    provinces have no provider (17). Similarly, in the
    United States, in 2000, 87% of counties had no provider
    (18).
    A variety of factors have contributed to the decline in
    the number of providers. They range from physicians'
    personal moral objections to fears of becoming targets
    of violence or harassment (19-26). In addition, certain
    laws in the U.S. targeting abortion providers create
    barriers, while physician-only laws restrict other
    medical personnel such as nurse practitioners from
    providing abortions (27, 28). Abortion education in
    medical schools and residency programs is limited,
    which has been shown in several studies to decrease the
    likelihood of physicians choosing to provide abortions
    (25, 26, 29, 30).


    30. Westhoff C. Abortion training in residency programs. Journal of
    American Medical Women's Association 49(5): 150-154; 1994.

    ABORTION IN MEDICAL SCHOOL
    CURRICULA: THE REALITY
    As 48% of women aged 30-34 in the U.S. have
    experienced an unintended pregnancy, and 4 out of 10
    women seek abortion services sometime during their
    reproductive life, the lack of abortion education in
    medical curricula significantly affects medical students'
    ability to address women's reproductive needs (1).
    Espey et al. (2005) (3) surveyed Obstetrics and
    Gynecology clerkship directors to determine the extent
    of abortion education in U.S. medical schools. They
    found that 17% of schools had no abortion education at
    all and that in many other schools, coverage was
    minimal (3).
    One organization, Medical Students for
    Choice (MSFC), is currently surveying medical schools
    in the U.S. and Canada about their individual curricula.
    The preliminary results of MSFC's study of the
    reproductive health content of preclinical medical
    education found that nearly 40% of the more than 50
    schools surveyed do not teach any aspect of abortion in
    the preclinical years (4). Indeed, the study found that,
    on average, more class time is dedicated to Viagra than
    to abortion procedures, pregnancy options counseling,
    or abortion law and policy (4). This glimpse into U.S.
    and Canadian medical curricula reveals that abortion is
    not a standard component of preclinical education.
     
  35. Droopy Snoopy

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    No kidding, it's like a bat signal for all the SDN crazies with nothing else to do on a Saturday night. No OP I don't have any substance to contribute to the topic (being an M2 looking at residency training like a wild and distant land), but last I checked I'm a member here and can post wherever I please.
    +pad+
     
  36. Tired

    Tired Fading away

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    I love it when premeds tell me about surgical procedures.

    In case you ever get in, you might want to know this: Although you have probably seen "abortion clinics" on television where women have elective termination done on an outpatient basis, procedures in the operating room continue to be very prevalent.

    Although you present the procedure as a relatively benign and noninvasive process, I suspect you will change you tune when or if you ever have the chance to witness one. Even first trimester terminations, involving only dilation and curretage, is extrememly uncomfortable and, for many women, very painful. When done in the ED, morphine/versed is the common pain cocktail given at my institution. Many providers at my school's Ob department offer women the option of going to the OR for their procedures, where they have access to an anesthesiologist who can maintain a deeper level of sedation.

    The case of second trimester D&Es is even more dramatic. I have yet to see a provider offer these in the office, as it requires a greater degree of dilation, suctioning, etc. I can imagine that there are probably some providers who do this in the office, but I have never met one.

    Thank you for your input. Feel free to offer further opinions on subjects you clearly have no training in.
     
  37. Tired

    Tired Fading away

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    I'll find a citation, but understand what I'm saying. I didn't say that only 1/3 of programs offer training in D&C, I said only 1/3 offer training in elective termination. The actual mechanics may be similar, but the process and counceling are different. At my home program, residents who refuse to perform elective termination are still required to learn and practice the legal, ethical, and conceling aspects of providing abortion services.


    Any time a premed tries to tell the med students what they can and cannot post, you can pretty much count on it. :D
     
  38. nibrocli

    nibrocli Senior Member

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    depends on the plan. some insurance plans are really great, and will cover everything. on the other hand, i've had to tell many women that their insurance will not cover the procedure. it's terrible for them.
     
  39. astrife

    astrife Senior Member

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    double post
     
  40. nibrocli

    nibrocli Senior Member

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    i'm a med student and a former planned parenthood medical assistant and abortion coordinator, nice to meet you:)

    i've seen about 100 procedures, and it's been an amazing, life-changing experience. they were all less than 18 weeks gestation. after that, they were in fact referred to a hospital. i agree that a post-18 week procedure wouldn't be done in an office setting.

    anyone else have any info on residency training?
     
  41. Tired

    Tired Fading away

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    Here it is, and it was lower than I thought:

    The percentage of U.S. Obstetric / Gynecologist (OB-GYN) residency programs that trained residents in surgical abortion declined from the late 1970s to the mid 1990s. A study by the Alan Guttmacher Institute in 1992 revealed that:

    - Only 12% required surgical first-trimester abortion training as an integral part of their course. This was a decrease from 23% in 1985.
    - Only 58% included such training as an elective.
    - Only 7% offered routine training in second-trimester abortions. This was a decrease from 21% in 1985.
    - "More than 80% of programs in private, non-Catholic hospitals and public hospitals provided some form of abortion training in 1991-1992, but only 6% of programs in Catholic hospitals and no military programs did so." 2,3



    Rita Rubin, "More med schools offer abortion training," USA Today, 2000-NOV-21, at: http://www.usatoday.com/life/health/women/lhwom143.htm

    H.T. MacKay & A.P. MacKay, "Abortin training in Obstetrics and gynecology residency programs in the United States, 1991-1992," Family Planning Perspectives, Vol. 27, #3, 1995-MAY/JUN, Pages 112 to 115. Summary available at: http://www.agi-usa.org/pubs/journals/2711295.html
     
  42. OncoCaP

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    Oh really? How was it life-changing? Did it make you want to go into the medical field?

    Also, given that you have worked in the industry, I'm surprised you can't just e-mail or call up some of your former co-workers and get this information? Is the list of abortion-included residencies such a well-kept secret? It just seems like there aren't that many non OB/GYN training options for abortions.

    Also, do you have any information on the training requirements. Are there even any training requirements legally required in most states?
     
  43. Tired

    Tired Fading away

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    Ah yes, a first year D.O. student, as I see from your previous posts.

    Guess that kicks your credibility way up . . . :laugh:
     
  44. TexasRose

    TexasRose Gotta run
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    to the OP:

    It's possible that you might find better information in the General Residency forum. Residents would have better answers for you about their training than your fellow med students.

    I think that you will still run into the same degree of discomfort with your questions, though. It's a very sensitive subject and will draw attention whereever you post.
     
  45. georgia_md

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    I love it when medical students tell premeds about surgical procedures :laugh:
     
  46. nibrocli

    nibrocli Senior Member

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    i'm attending a u.s. allopathic medical school.
     
  47. nibrocli

    nibrocli Senior Member

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    tried. got pretty ugly there too. thanks for the thought though.
     
  48. OncoCaP

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    So you are basically admitting to being a troll? I get the impression that you already know the answer to your question and are just trying to cause trouble by taking a sensitive subject and treating it with no care whatsoever.
     
  49. Tired

    Tired Fading away

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    Oh come now. I have almost 6y experience as an ED tech, including 4 years in the ED of a Women's and Children's hospital. I went through all my third year rotations and all my MSIV sub-i's. At this point I have as much abortion experience as every resident and attending outside of Ob/Gyn and FP.

    Then all of a sudden I'm getting told by someone that abortions aren't done in the operating room, that they're not surgical procedures, and that they're simple and benign. In addition the same poster "instructs" everyone on what they can and cannot post, but doesn't even know who the medical director is of an organization he/she supposedly worked for?

    You would suggest what, that I not call bullsh!t when I read it?
     
  50. nibrocli

    nibrocli Senior Member

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    well, given your comment on legalized child killing, i'd rather not go into that now.
    yeah, the standard is definitely the ob/gyn or fp route. the only docs i know personally got trained that way. but since i'm not leaning ob/gyn or fp right now, i thought this huge public forum might be such a great info resource.

    hmmm...i don't know about specific training requirements. but i know you can't do it unless you have proper training. i think the specific rules vary by state.
     
  51. nibrocli

    nibrocli Senior Member

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    no, not at all! i certainly don't know the answers about training. i only know about obgyn or fp training.
    and i didn't start this thread. but i think the OP saw the thread i did start, shared an interest, and tried again here.
     
  52. OncoCaP

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    Ok, I can respect that.

    I didn't realize that the FP practice route was "standard" for getting abortion training.

    With respect to your thinking you either lack judgment, basic sensitivity, or are a troll who likes negative attention (perhaps without realizing it).


    How do you know you can't do it unless you have "proper training"? What does "proper training" mean anyway? Is this just your impression or can you quote a law?

    Also, why don't you talk to your former employer? Did you make them mad and they won't talk to you anymore? It seems like you should already have the resource at your fingertips (outside of SDN, where you will get flamed). You story doesn't hang together.

    By the way, do you like VeggieTales? Your Avatar reminded me of them:

    [​IMG]
    [​IMG]
     

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