EDITORS’ NOTE: The following post first appeared in MedPage Today.
The recent U.S. Supreme Court decision to overturn Roe v. Wade will undoubtedly restrict the reproductive healthcare that many physicians can provide. Critically, it will also threaten the clinical knowledge and skills of the next generation of physicians.
As medical students, we firmly believe that any comprehensive reproductive health education includes abortion. More than 800,000 surgical and medication abortions are performed in the U.S. each year, making it one of the most common surgical procedures performed on women in the U.S. and a growing part of medication management within a range of specialties, from family medicine to psychiatry. Thus, foundational knowledge of the physical and psychosocial effects of abortion is imperative for all physicians-in-training, regardless of their intended specialty.
This training is especially crucial now, as the future of abortion provision faces an existential threat: researchers expect the proportion of ob/gyn residents with access to abortion training to drop from 92% to at most 56% post-Roe. Most of these physicians will go on to practice in the same state where they completed residency training, meaning that over time, provider losses will be concentrated in states that ban or severely restrict abortion. This will further exacerbate access disparities, which already disproportionately harm marginalized populations.
While there is a heightened need for comprehensive reproductive health education in the wake of Roe being overturned, abortion curricula, even as they stand now, are inconsistent and limited across U.S. medical schools. In 2020, researchers found that half of medical schools included no formal training or only one lecture on the topic. Ob/gyn residency programs have attempted to rectify this disparity by standardizing abortion education in graduate medical education; however, this solution reaches only a fraction of all residents whose patients need abortion care. Medical student advocacy organizations like the Medical Students for Choice have been instrumental in expanding abortion curricula within undergraduate medical education thus far; however, systemic action remains necessary.
The solution lies within national organizations overseeing medical education, such as the National Board of Medical Examiners (NBME), the Liaison Committee on Medical Education, the Association of American Medical Colleges, and the American Association of Colleges of Osteopathic Medicine. These organizations can ensure that future generations continue to understand abortion as a foundational clinical skill and an essential tenet of patient autonomy by (1) standardizing curricular requirements for medical school accreditation; and (2) testing abortion knowledge and skills on all NBME subject and licensing examinations.
Implementing a universal curricular standard across U.S. medical schools would rectify current educational disparities, ensuring that all medical students have the opportunity to learn about abortion in clinical practice, from indications to management.
Moreover, testing abortion as a core concept on all NBME subject and licensing examinations would promote clinical competency for individual learners, encouraging students to retain the abortion education they receive while safeguarding against inadequate training at medical schools that fail to comply with national curricular standards.
Taken together, these improvements in medical education can codify abortion as a core reproductive health competency for all physicians-in-training, which is especially crucial now as future generations face worsening abortion access disparities. As medical students, we understand that academic medicine has both the power and the responsibility to equip our generation with the skills to perform abortions and the understanding of it as a safe, life-saving medical procedure. The time to act is now.