Abortion bans limit training options for some future US doctors


A view of the medical bed and procedure room where abortions once took place, inside the Tulsa Women’s Clinic, in Tulsa, Oklahoma, U.S. June 20, 2022. REUTERS/Liliana Salgado

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Aug 15 (Reuters) – Ian Peake, a medical student at the University of Oklahoma, spent four years shadowing doctors at a Tulsa abortion clinic because his school did not offer courses in abortion. abortion or training.

But the Tulsa Women’s Clinic halted abortion services in May when Oklahoma enacted a near-total ban, and the provider closed permanently after the U.S. Supreme Court struck down constitutional protections against abortion. in June. Peake, 33, ran out of local options for learning about abortion.

“It’s basically impossible to get abortion education in the state,” said Peake, who is now applying to residency programs outside of Oklahoma. “We’re going to have swaths of the country where medical students won’t really know how these procedures work.”

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In interviews, a dozen doctors, activists and medical students said they fear the next generation of doctors trained in states with severe abortion restrictions will lack crucial skills to treat women.

Even before the Supreme Court overturned Roe v. Wade of 1973 that legalized abortion nationwide, some conservative states banned institutions from teaching how to perform abortions. The June ruling, which allowed states to decide the legality of abortion, left more medical schools and residency programs unable to offer comprehensive training in obstetrics and gynecology.

Ninety-two percent of obstetrics and gynecology residents reported having access to some level of abortion education in 2020, according to a study published in April by the Journal of the American College of Obstetricians and Gynecologists. The researchers predicted that number would drop to 56% at best after Roe’s knockdown.

Already, seven states, including Texas and Alabama, no longer have clinics providing abortion services, according to the Guttmacher Institute, an abortion rights research group.

The procedure used to perform elective abortions, known as dilation and curettage, is necessary in an emergency, such as if a pregnant woman has a heart attack, stroke, or begins hemorrhaging. It is also necessary to remove tissue from the uterus after an incomplete miscarriage to prevent infection and sepsis.

“It goes beyond what people call abortion,” said Maya Hammoud, professor of obstetrics and gynecology at the University of Michigan Medical School. “That’s how it’s going to affect everything else in women’s health.”

‘VERY CONCERNED’

Medical schools are not required to provide education on abortion. But the Accreditation Council for Higher Medical Education (ACGME), which evaluates and certifies residency programs, requires all residents to learn how to perform abortion procedures before graduating.

The council proposed revisions to its guidelines in obstetrics and gynecology after Roe’s overthrow, saying programs in states that restrict access to abortion must help aspiring doctors travel to another state to receive training. If a resident is unable to travel, programs should still train the resident using classroom lessons and simulations.

Several doctors and an activist have expressed concern about whether the simulation – which is often performed on a dragon fruit or papaya – could adequately prepare residents for real-world treatment.

“I am very concerned that at some point, highly respected medical schools are taking in graduate students who have not received modern medical training,” said Pamela Merritt, executive director of Medical Students for Choice, an abortion rights group. “Even if they get the green light to intervene to save a pregnant person’s life, they won’t be able to do so.”

Anti-abortion advocates say medical schools and residency programs will continue to teach emergency procedures to save a woman’s life, even if they don’t teach how to perform voluntary abortions .

“We’ve seen abortion activists employ misinformation and scare tactics aimed at women who don’t deserve this stress,” said Kristi Hamrick, spokeswoman for Students for Life of America, an anti-abortion group.

Louito Edje, associate dean for graduate medical education at the University of Cincinnati School of Medicine and an ACGME member, said she expects most institutions to help their residents travel to receive real-world training.

But training could still suffer, she said, if more students are crammed into fewer facilities and there isn’t enough patient flow to provide hands-on practice for everyone.

The University of Michigan has set up a task force to prepare for an influx of residents coming to Ann Arbor for training, said Lisa Harris, a professor of obstetrics and gynecology who is co-chair of the task force.

However, given the ever-changing legal landscape around abortions in the state, Harris said the task force is also considering ways to help residents travel for training outside the state if Michigan is implementing a ban.

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Reporting by Rose Horowitch; Editing by Colleen Jenkins and Aurora Ellis

Our standards: The Thomson Reuters Trust Principles.

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