Dustin Costescu


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    Introduction: In 2015, mifepristone was approved in Canada, making it the 61st country to do so.  Prior to mifepristone, there were only 60 physicians providing medical abortion in Canada. In anticipation of the commercial availability of mifepristone in 2017, clinicians prepared clinical practice guidelines and an online medical abortion training course.  Health Canada mandated training  prior to prescribing or dispensing mifepristone, however, in late 2017, the regulation was relaxed from “mandatory” to “recommended”.
    Methods: We present participant data on the first 16 months of medical abortion training to provide an estimate of clinicians who are currently eligible and/or likely to provide mifepristone medical abortion across Canada.
    Results: Overall, 167 Obstetrician/Gynaecologists, and 408 Family Physicians (which make up the majority of abortion providers in Canada) have completed the Medical Abortion Training Course.  1346 pharmacists have completed the course and are eligible to dispense the medication. 173 nurses (of which 112 are nurse practitioners with prescribing privileges), 6 midwives, and 151 medical students and residents also have been trained in medical abortion.  There is a physician trained in every province and territory, however there is no pharmacist trained in Nunavut, a northern territory.
    Conclusion: There is widespread interest and uptake of mifepristone medical abortion in Canada.  Within the first year of availability of mifepristone, over 2000 medical professionals have completed the medical abortion training course.  In contrast to pre-mifepristone, where very few physicians provided methotrexate-based medical abortion, there are at least 575 physicians currently eligible to prescribe, and 1346 pharmacists eligible to dispense mifepristone.