British Pregnancy Advisory Service logo

2 July 2014

USA: D&E training in maternal-fetal medicine fellowships

Many maternal-fetal medicine (MFM) specialists provide dilation and evacuation (D&E) procedures for their patients with fetal or obstetric complications. This study describes the D&E training opportunities that are available to MFM trainees during their fellowship. From American Journal of Obstetrics and Gynecology.

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.

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).

The authors concluded that 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.

Dilation and evacuation training in maternal-fetal medicine fellowships. Rosenstein MG, Turk JK, Caughey AB, Steinauer JE, Kerns JL. American Journal of Obstetrics and Gynecology. 2014 Jun;210(6):569.e1-5. doi: 10.1016/j.ajog.2014.01.038. Epub 2014 Feb 1.