Intern year generally is quite busy with inpatient and other programmatic requirements, and many residencies do not have built-in elective time. This year is a great time to explore abortion training opportunities. Ask faculty, senior residents, and even reach out to alumni from your program. Find out how easy or hard it is to access abortion training, and that will give you a good baseline for where to start.

Your PGY1 abortion training goals:

1. Ask faculty and senior residents about access to abortion training, identify allies and faculty mentors.
2. Meet with your program director about your intentions regarding abortion training. Ask specifically about your program’s capacity to facilitate “away” rotations at a non-residency affiliated site, and what the process is to establish that affiliation. Those affiliations are legal agreements and can sometimes take months to establish; therefore it’s best to know what your options are from the start. Also ask if your residency insurance covers procedures at an external site that does abortions and contraception. If not, please review the Residency-Specific Logistics tab below.
3. If you can, request your PGY2 elective month in the second half of the year; that will give you more time to apply to different organizations for hands-on training.
4. Complete self-learning modules on abortion care so you’re establishing a solid foundation for when you do your elective. Consider completing TEACH’s Early Abortion Training Curriculum or their Abortion Pill CME, as well as RHEDI’s Medication Abortion Interactive Case. You can also access a variety of modules and presentations at Innovating Education in Reproductive Health.
5. Log everything. IUD insertions and removals, vaginal deliveries, postpartum hemorrhage management, EMBs, colposcopies, implant insertions and removals, cervical ripening balloon placements, miscarriage management, D&Cs, etc. The more you can objectively show that you have the skills necessary to learn to provide abortions, the smoother the process will be for you. Your residency should already be offering a system (such as New Innovations), to help you log procedures, so utilize that.
6. Become an advocate: Join your local Reproductive Health Access Network Cluster, connect with other likeminded individuals, write op-eds supporting abortion access and training for family medicine residents, and join the Reproductive Health Member Interest Group through the AAFP.

Depending on how your residency is structured, you may have the opportunity to do at least one if not multiple “away” electives. If your program or town does not already offer a high-volume abortion training experience, reach out to one of the following organizations to explore availability and apply for an away elective.

• Medical Students for Choice Resident Opportunities
• Midwest Access Project
• Abortion Training Centers

Note that these organizations have tight application deadlines and availability—so reach out as soon as you become a PGY2 or PGY3 since opportunities are usually limited.

Your PGY2 & PGY3 abortion training goals:

1. 1. As soon as you decide you would like to do an abortion training elective, reach out to the organizations above to set up a meeting to discuss your application and goals. They can help you decide which program is the right fit for you.
   2. Apply to the program(s) of your choice, as soon as you can. 
   3. Once you’ve been accepted and have a training clinic location, this is where the difficult logistical matters come into play. You may need to provide a number of documents to the clinic, which vary by location and type of clinic. These documents may include:
      • legal agreements between your residency program and the clinic;
      • proof of malpractice insurance coverage (either covered by your residency or proof of purchase separately; and
      • licensure

Let the clinics/programs guide you in this process, as they are the experts here.

1. 1. Continue to log all applicable procedures as mentioned above.
   2. Continue to be an advocate: Join your local Reproductive Health Access Network Cluster, connect with other like-minded individuals, write op-eds supporting abortion access and training for family medicine residents, and join the Reproductive Health Member Interest Group through the AAFP website.
2.  

Legal agreement: The training clinic you will be rotating at may require a legal agreement between the clinic and your residency program. This is one of the earliest barriers you may face, as it could take 6-12 months for this legal agreement to be approved. Once you know which clinic you’ll be rotating at, then you can get the process started to work with your program director and their legal team to create this affiliation. Since the Dobbs decision in June of 2022, there may be additional time and complexities involved in  planning away rotations. Starting as early as possible, and being flexible about timing and location (if you can) may be key to achieving your goals. 

Licensure: If you’ll be doing an abortion training elective away in a different state, you may require a temporary license to practice medicine. This process can also be time consuming and difficult, so it is best to start early. Communicate with the clinic you will be rotating with and they can make recommendations on how to meet their licensure requirements. 

Malpractice: You’ll be required to provide proof of malpractice insurance coverage, either through your residency program or as an individual purchase. If your residency program is unwilling to include abortion training on your malpractice insurance, then you may be able to purchase it separately (approximately $150/week). Contact MSFC for specific information about which insurance companies to contact. 

Funding: If abortion training isn’t offered in your location, it may be expensive to do an elective in a different city or state, so consider these funding options:

• If you apply through the Medical Students for Choice Training to Competence Externship, then you may be able to get some of your travel, housing, host facility, insurance, and transportation costs reimbursed at the end of your externship.
• The Barnett A. Slepian Memorial Fund may be able to cover part of your training fees, housing, travel, other related expenses.
• Contact the organization you are doing your elective through and they may provide you with information about scholarships you can apply for to have the costs covered. Consider asking your residency if your CME allotment can cover any part of your away elective experience.

Legal and Regulatory Assistance: As part of your training process, you will want to consider the logistical, legal, and regulatory steps necessary for you to be able to integrate abortion care into your practice. Since the Dobbs decision, these considerations are more complex and more important than ever, and vary widely from state-to-state. As you pursue training, we recommend consultation with the following organization for individualized legal, regulatory, and digital security advice:

• Abortion Defense Network
• Resources for Abortion Delivery (RAD)
  Regulatory Assistance for Abortion Providers (RAAP)
• If/When/How Repro Legal Helpline
• Digital Defense Fund Consultation Services
• More resources