Unintended consequences: abortion training in the years after Roe v Wade.

The US Supreme Court's 1973 Roe v Wade decision had clear implications for American women's reproductive rights and physician ability to carry out patient choices. Its effect on physician abortion training was less apparent. In an effort to increase patient access to abortions after Roe, provision shifted from hospitals to nonhospital clinics. However, these procedures and patients were taken out of the medical education realm, and physicians became vulnerable to intimidation. The consequent provider shortage created an unexpected barrier to abortion access. Medical Students for Choice was founded in 1993 to increase abortion-training opportunities for medical students and residents. Its mission ensures that motivated medical students will learn and a growing number of physicians will commit to comprehensive abortion provision.

First impressions: what are preclinical medical students in the US and Canada learning about sexual and reproductive health?

BACKGROUND: This study evaluates the inclusion of sexual and reproductive health (SRH) topics in preclinical US and Canadian medical education. STUDY DESIGN: Between 2002 and 2005, we sent surveys to the student coordinators of active Medical Students for Choice chapters at 122 US and Canadian medical schools. Students reported on the preclinical curricular inclusion of 50 specific SRH topics in the broad categories of pregnancy, contraception, infertility, elective abortion, ethical and social issues, and other topics. RESULTS: We received 77 completed surveys, for an overall response rate of 63%. Coverage of pregnancy physiology and STIs/HIV was uniformly high. In contrast, inclusion of contraceptive methods and elective abortion procedures greatly varied by subtopic and geographic region. Thirty-three percent of respondents reported no coverage of elective abortion-related topics. CONCLUSIONS: Inclusion of contraception and elective abortion in preclinical medical school courses varies widely. As critical components of women's lives and health, we recommend that medical schools work to integrate comprehensive family planning content into their standard curricula.

Medical Students for Choice's Reproductive Health Externships: impact on medical students' knowledge, attitudes and intention to provide abortions.

BACKGROUND: The number of abortion providers in the United States has declined dramatically in the past 15 years, threatening women's already limited access to abortion services. Improving medical students' training in abortion could help abate this public health crisis. STUDY DESIGN: From 2004 to 2006, we surveyed students before and after their participation in Medical Students for Choice's Reproductive Health Externship (RHE) program to assess their knowledge about abortion and unintended pregnancy, attitudes about performing abortions, intentions to provide abortions in the future and (in 2006) counseling patients. RESULTS: Following participation in an RHE, 15% more students answered at least 75% of questions about unintended pregnancy and abortion correctly (p=.006) than prior to participation. RHE participants were more supportive of abortion provision (p<.001) and more inclined to provide abortions in the future (p=.008). In 2006, the RHE participants were twice as likely to feel comfortable counseling patients about abortion (p<.001). CONCLUSIONS: Early clinical experiences with abortion and family planning can impact medical students' knowledge, attitudes, intentions to provide abortions and ability to counsel patients, potentially improving women's access to comprehensive reproductive health care in the future.