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Resident Perceived Competence in Abortion Care by Race

Purpose: Evaluate the association between OB/GYN residents’ race and self-perceived competency providing abortion care.


Background: Implicit bias within medical education contributes to microaggressions towards trainees of color. Internalization of mistreatment can lead to diminished confidence in academic performance.


Methods: Residents completed a voluntary survey before the 2020 CREOG examination assessing access to residency abortion care training, perceived competence, and demographic data.  All demographics were self-reported according to the United States Department of Civil Rights guidelines.


Results: A total of 5,143 residents (94.94%) completed the survey. Compared to white residents, residents of other races reported lower self-perceived competence in medically managing first trimester miscarriage, induced abortion; manual/electric vacuum aspiration (MVA, EVA), second trimester labor induction, managing complications of spontaneous and induced abortion; counseling for spontaneous and induced abortion, and options counseling (all p< .05). There was no difference in perceived competency using mifepristone with misoprostol for induced abortion, dilation and evacuation at >14-16 weeks gestation or providing referrals (all p >.05). There were differences in intent to provide mifepristone to supplement misoprostol, MVA and EVA (all p < .05; but no difference in all other categories (p >.05)).


Discussions: We found small but consistent differences in self-perceived competence in abortion care between white residents and all other race residents. Overall, no difference was found regarding intent to provide most corresponding abortion care services, indicating that self-perceived competence may be incongruent with ability. Internalization of implicit bias experienced during training may be responsible. Residency programs should dismantle biases during training and support learners experiencing microaggressions.

Topics: CREOG & APGO Annual Meeting, 2022, Resident, Faculty, Residency Director, Residency Coordinator, Patient Care, Medical Knowledge, Professionalism, Systems-Based Practice & Improvement, Interpersonal & Communication Skills, GME, Contraception or Family Planning,

General Information

Resident,Faculty,Residency Director,Residency Coordinator,
Patient Care,Medical Knowledge,Professionalism,Systems-Based Practice & Improvement,Interpersonal & Communication Skills,
Clinical Focus
Contraception or Family Planning,

Author Information

Tess E. Chase, MD, Johns Hopkins All Children\'s Hospital; Sarah Horvath, MD; Jema Turk, PhD, MA, MPA; Tony Ogburn, MD; Jody Steinauer, MD, PhD; Katherine Brown, MD

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