Background: We set out to compare resident perspective regarding self-rated ability to perform abortion procedures, abortion attitudes and satisfaction with training at programs with routine and optional abortion training. Methods: We distributed surveys and conducted 1-h focus groups for 62 residents at six New York City OB/GYN programs; three offer routine abortion training. We compared resident survey responses at programs with routine versus optional training regarding self-rated ability to perform abortion procedures, abortion attitudes and satisfaction with training. We reviewed focus group transcripts to understand differences related to satisfaction with abortion training. Results: Residents at routine programs reported higher proportions of self-rated ability to perform abortion procedures (all surveyed procedures p ≤ 0.05) and were more likely to fully participate in abortion services than residents at optional programs (42/45 vs. 12/17, p = 0.03). Residents at routine programs were more likely to be “very satisfied” with training (44/45 vs. 12/17, p < 0.001) based on three aspects of training: patient care management, self-rated ability to perform abortion procedures and rotation characteristics. Conclusion: Residents who received routine abortion training have higher rates of self-reported procedural competency and are more likely to be satisfied with training than residents who were offered optional training.