Stopping harassment and mandating training are not two mutually exclusive remedies. As lawyers, we work to make more laws to help stop harassment. We also depend on doctors to push for more mandatory training. It’s not like it’s an either/or proposition.

Plus, you seriously are scaring me about the under-training of doctors.

Am I the only one who was scared by that statement? There is NO mandatory procedure training in med school?! Then what the hell are they learning??

I’m gonna start asking my docs a hellova lot more questions before they touch my body. The first being, “Have you ever done this before???”

I’m not really arguing with you! Just bitter. :)

Its not that significant when you actually get down in the trenches of the real world instead of theorizing in a forum. Here’s the scenario:

1) OB/GYN docs in a given geographical area have never done an abortion before, they get requests for both emergency and elective abortions.

2) OB/GYN docs went thru “mandatory” training in med school/residency. However, they still wont offer elective services, and they arent competent enough to provide emergency services, therefore they refer all the emergencies out to a tertiary academic medical center like mine, where I do them.

3) OB/GYN docs went thru mandatory training, and they decide to offer elective/emergency abortions as part of their career, THAT THEY OTHERWISE WOULD NOT HAVE DONE WITHOUT THE MANDATORY TRAINING. They dont have to refer patients out, and women have better access to reproductive services in general.

I submit to you that scenario #3 is so rare as to be a pipe dream, and that comes from 30+ years experience in both rural OB/GYN clinics and major academic medical centers. Either people desire to offer abortion services, or they dont. Mandatory training wont change anything.

There are 2 main reasons why docs dont offer abortions:

1) Moral opposition
2) Too much associated baggage with the field (i.e. intimidation)

You’re never going to get group #1 to offer abortions, regardless of whether you make the training mandatory or not. They wont be required to do emergency abortions either, because they dont do them on a regular basis and arent required by EMTALA laws to offer services for which they are not experienced/competent enough to provide.

Instead of using a blunt instrument like mandatory training that WONT SOLVE THE PROBLEM AND WILL DECREASE THE NUMBER OF PEOPLE GOING INTO THE OB/GYN FIELD, we should work on the real problem which is intimidation. Unlike mandatory training, eliminating harassment/intimindation WILL BRING A LOT OF OB/GYN AND OTHER DOCS OUT OF THE WOODWORK to provide abortions.

I already stated that I do in fact perform emergency abortions. I just dont offer electives.

Mandating training does not equal competence and it wont improve access to abortions either. Under your model, you will have a bunch of resentful OB/GYNs who were forced to observe/perform a few abortions during training. What will inevitably happen is that they wont perform those services once they are in the workforce. EMTALA laws dont require the provision of services in the context of incompetent providers, so when a 25 weeker with PPROM and chorio presents to the ER and the OB/GYN docs on staff havent done an abortion for the last 20 years, guess what happens. They ship the patient to an outside hospital like mine where I do the abortion.

Its the same deal for all procedures. An ER doc who has not done a thoracotomy in 10 years is not required by EMTALA to provide such a service, even if the life of the patient is in jeapordy. It requires the HOSPITAL to provide such services, but it gives exceptions for docs who are insufficiently trained/experienced to do it themselves.

Mandating abortion training will reduce the whole pool of OB/GYNs, meaning less surgeons in gyn-onc to remove a cancerous ovary or uterus for example. Like I said, OB/GYN is an umbrella term for a bunch of different subspecialties in which you can be a competent practitioner without ever actually doing an abortion.

I’d much rather the emergency abortion patients be sent my way rather than be subjected to a rural OB/GYN whose last abortion was 20 years ago as part of their “mandatory” abortion training. The care for women is BETTER when they have experienced people doing the work. Mandating the training wont alter that.

No, its not. Like I said before, there is no mandatory procedure training in med school. Thats true for abortions, its true for intubations, its true for vasectomies, etc

That said, it should be offered alongside all of the other standard ob/gyn curriculum, and students should have the chance to opt out of actual abortion procedures (they should still be taught how to perform emergency D&C and D&X procedures for the reasons Sheelzebub states).

The point isn’t to “persuade” people to become abortion providers. The point is that medical school is supposed to train doctors to do their jobs. Not every doctor needs to be trained in every single procedure, but they should probably be trained in the procedures that are common and important in their field. It’s ridiculous that doctors have to go to outside, special settings in order to receive training for one of the most common surgical procedures.