a.       General Overview: Clinical training is provided in first and second trimester medical and surgical abortion, contraception in medically complex patients as well as permanent female sterilization procedures. Our Early Pregnancy Assessment Center complements training in management of early pregnancy of unknown location/ectopic pregnancies, ultrasound training and use of manual vacuum aspiration.  There is ample exposure to pediatric gynaecology and complicated contraceptive clinics as well as recurrent pregnancy loss clinics.  Rotations with a medical genetics clinic are available as well. Fellows also have the opportunity to solidify their generalist competency and skills, by participating in general Obstetrics and Gynaecology work.
b.      Abortion Training: First and second trimester surgical training will be provided across several hospitals and free-standing clinics in Vancouver.   Additional rotations across the province are available, and across sites 7000 surgical abortions are performed annually.  Training will include manual as well as electric vacuum aspiration, dilatation and evacuation, dating ultrasounds, and digoxin injections. The majority of abortion procedures are provided with IV sedation; advanced gestational age (up to 25weeks) procedures tend to be provided under general anesthesia. First trimester medical abortion training will be through the university based CARE program.  Medical second trimester training occurs in collaboration with Maternal Fetal Medicine service at the BC Women’s hospital.
c.       Call Schedule: Fellows have the opportunity to participate in the general Obstetrics and Gynaecology call schedule. The extent of this can be adjusted to the fellow’s wishes. BC women’s hospital is a busy academic center with over 7000 deliveries per year. The fellow will work with a team of residents and medical students, providing in-house 12-14 hours shifts of consultative coverage for the family medicine as well as the midwifery service. Gynaecology call is separate, provided as 24 hour shifts at Vancouver General Hospital (VGH); again working with a team of residents and medical students.
d.      Generalist Duties: Fellows will be able to maintain and develop their skills as generalist obstetricians and gynecologists. Trainees will have the opportunity to participate in outpatient clinics, inpatient and outpatient surgeries, as well as on call activities within the specialty.  The majority of Obstetrics care is provided at BC Women’s; while Gynecologic care is predominantly at VGH and St. Paul’s Hospital.
e.      Teaching Opportunities: The fellow will be involved in teaching medical students as well as residents during their Family Planning / Ryan rotation. Additionally, teaching is part of the generalist duties.  Aside from clinical teaching there will be opportunities, to teach during lectures, journal clubs, as well as collaborate on research projects. Fellows will further participate in outreach and training across the province, including a telephone consultation service.
f.      Contraceptive Training: Contraceptive counseling and initiating contraception, including emergency contraception and LARC methods will be integrated as part of the abortion care. Additionally, there will be clinics for adolescents as well as women with complex medical problems. Access to surgical sterilization training via laparoscopy is offered through the CARE program at BC Women’s.
g.       Clinical Training Sites: Clinical training sites are mostly in Vancouver:

  • BC Women’s hospital is a tertiary care center and is the home of the CARE Program, which provides approximately 2500 abortions annually. Here, the majority of training including the advanced gestational age abortion training will be provided. Second trimester medical abortion training will also be provided here.
  • The Early Pregnancy Assessment Clinic (EPAC) is also housed at BC Women’s.
  • Freestanding clinics (including Bagshaw Clinic): provision of first and second trimester surgical abortion.
  • Additionally three are hospital and freestanding clinic services in Kelowna and Victoria, which offer abortion care, and contraceptive care.