背景美国最高法院2022年在多布斯诉杰克逊妇女卫生组织的裁决推翻了罗伊诉韦德案,允许各个州确定堕胎限制,对研究生医学教育(GME)产生重大影响。虽然重点是各州制定限制,在堕胎权利得到保障的州,影响同样重要。急诊医学(EM)是医疗保健系统内的安全网,使其成为理解这些法律变化对GME的更广泛影响的理想选择。目的探讨加利福尼亚州EM居民改变堕胎立法的经验和观点。保护堕胎的状态.方法采用先验现象学进行定性研究。来自加利福尼亚州一个大型大学计划的13个研究生4年级EM居民在2023年参加了半结构化访谈。采用专题分析法对数据进行分析。结果确定了四个主题:(1)改变堕胎立法对实践的影响;(2)受立法影响的个人和专业决定;(3)在实践中应对法律不确定性;(4)超越临床实践的倡导和参与。居民报告说,人们对堕胎法律对EM实践的影响的认识和关注程度各不相同,这些法律对他们职业决定的影响,需要法律指导,和对宣传的承诺。这些主题突出了法律变更之间复杂的相互作用,个人价值观,和专业责任。结论这项研究强调了多布斯决定对加利福尼亚州EM居民的重大影响,揭示居民面临着独特的道德,legal,以及可能影响其职业身份形成的宣传挑战。
Background The US Supreme Court\'s 2022 ruling in Dobbs v Jackson Women\'s Health Organization overturned Roe v Wade, allowing individual states to determine abortion restrictions, significantly impacting graduate medical education (GME). While focus has been on states enacting restrictions, the impacts in states where abortion rights are safeguarded are equally important. Emergency medicine (EM) serves as a safety net within the health care system, making it ideal for understanding the broader implications of these legal changes on GME. Objective To explore the experiences and perspectives of EM residents regarding changing abortion legislation in California, an abortion-protective state. Methods We conducted a qualitative study using transcendental phenomenology. Thirteen postgraduate year 4 EM residents from a single large university-based program in California participated in semistructured interviews in 2023. Data were analyzed using thematic analysis. Results Four themes were identified: (1) impact of changing abortion legislation on practice; (2) personal and professional decisions influenced by legislation; (3) navigating legal uncertainties in practice; and (4) advocacy and engagement beyond clinical practice. Residents reported varying levels of awareness and concern about the implications of abortion laws on EM practice, the influence of these laws on their career decisions, the need for legal guidance, and a commitment to advocacy. These themes highlight a complex interplay between legal changes, personal values, and professional responsibilities. Conclusions This study highlights the significant impact of the Dobbs decision on EM residents in California, revealing that residents face unique ethical, legal, and advocacy challenges that may affect their professional identity formation.