- Several states enacted abortion bans after the Supreme Court overturned Roe v. Wade.
- The decision has alarmed many medical students interested in becoming OB-GYNs.
- The students said abortion bans could limit their education and exposure to life-saving care.
Before the Supreme Court overturned Roe v. Wade, Lyle Sue considered becoming an OB-GYN.
But now she’s not so sure.
“It pushed me more because of my own mental health,” Suh, who is in her third year of medical school, told Insider. “I really can’t go into an area that is governed so tightly. Like medicine, which already has so much that’s out of our hands — this kind of just adds another hurdle to what we can do.”
Suh’s experience echoes that of other medical students who are considering majoring in reproductive care but also recognize that they will be entering a field where they will have to navigate confusing bureaucratic catacombs and a political minefield.
“They’re going to have to go through all these hurdles”
Natalie Sorias, a third-year medical student at the University of Massachusetts, told Insider that she is passionate about women’s reproductive health care and, despite the challenges ahead, will likely continue to try to work in the field.
“I went into medical school trying to keep an open mind as much as possible,” Sorias told Insider, “but the population I’m really interested in is women.”
Sorias, who also researches female genital mutilation in Cairo, said she noticed that “the people who are kind of neglected are the women” and this “inevitably affects the children”.
As a first-generation Egyptian-American, Sorias said she was disappointed, heartbroken and angry by the decision to overturn Roe v. Wade.
“Being an immigrant — people come to America bragging about its progress and amazing health care and all that stuff,” she said. “I was really hoping that being in this country would mean being part of the world’s example of reproductive justice. It’s just kind of embarrassing that we’re not, and it’s really disappointing for people that it’s going to be affected.”
Now she’s concerned about matching a residency program in a state that doesn’t offer the full range of reproductive health education, including abortion at different stages, and how competing programs might fare in states where abortion is legal.
After medical school, students go on to train in a residency program where they become local doctors. Nearly 44 percent of obstetrics and gynecology trainees — or 2,638 of 6,007 — are trained in programs located in states that “certainly or probably do not have access to in-state abortion training” because of state bans on the procedure, according to an April study , published in the journal “Obstetrics and Gynecology”.
“It’s not only difficult,” Sorias said. “It also greatly increases the competition for anyone trying to get in.” [Obstetrics]which is care for the door of a career that needs more providers to begin with.”
Eshani Dixit, a medical student at Rutgers Robert Wood Johnson Medical School, echoed Sorias’ concern.
“It definitely seems more and more difficult in terms of making sure that I have access to education that is not only related to my desire to become an abortion provider, but also just related to the practice of obstetrics and gynecology as a field and to making sure that we provide quality care to our patients,” Dixit told Insider.
She said she feared being in a position where only a medical emergency would allow her to have a legal abortion.
“But I’m nervous about being in these situations and not being able to adequately care for the patients I serve,” she said.
Morgan Levy is a third-year medical student at the University of Miami in Florida, where abortions are prohibited after 15 weeks with a few exceptions, such as to save the life of a pregnant patient.
Levy said she will have to consider an out-of-state residency rotation because she worries there is a “significant amount of training in the field” that she “wouldn’t be able to get, simply because the procedure wouldn’t be legal for a patient to get. ”
“I think that’s a reality that a lot of students are going to face,” Levy said. “They’re going to have to go through all these hurdles to go and find somewhere where they can actually get the training they’re looking for.”
“We do the best for the patient”
The Obstetrics and Gynecology study recommended that programs establish “travel diversion for residents to receive abortion education in states with protected access to abortion.” However, the study notes that travel rotations may not be feasible for the large number of residents who train in states with limited access to abortion.
The Accreditation Council for Graduate Medical Education, which accredits residency programs, has introduced proposals that would require programs in states with abortion restrictions to provide residents with alternative training in states that do not.
“The proposed revisions help ensure that obstetrics and gynecology residency programs provide residents with the knowledge, skills, and abilities necessary to practice comprehensive reproductive health care in the United States without violating the law of any is a resident, physician educator, or residency program,” an ACGME spokesperson said in a statement.
The proposed revisions are still open for public comment before being presented to the ACGME board for approval.
Su said she fears providers will become too apathetic to patients’ needs, as they are now placed in precarious circumstances when seeking an abortion.
“We do what’s best for the patient. We go through the best treatment, then the next,” she said. But she said if she ends up in a state abortion facility that is limited, then the scope of her training and the care she can provide is compromised.
She added that she thinks doctors should do everything in their power to do no harm and “when there are fully established laws that prevent you from providing the best possible care to a patient, it’s just very mentally taxing.”
Suh said that even if it ends up in a state where abortion is not strongly prohibited, it still has a ripple effect.
“Even though we’re in a state where it’s still legal to have an abortion, we’re seeing a noticeable increase in the number of people coming in to see what options there are for permanent infertility,” Su said.
Both Sorias and Suh said they are concerned about the adequate training that all OB/GYN residents will receive as a result of states having different policies.
“Every OB-GYN should be well trained and experienced in performing abortions because it is life-saving care,” Sorias said. “So it makes no sense to me that over 50% of OB/GYN providers in the country are in a place where they don’t know how to do this. I will be very disappointed and scared.’
Maureen Phipps, chief executive of the American College of Obstetricians and Gynecologists, said that after Roe is overturned, “the impact on physician training will be dire and the consequences will be long-lasting.”
“Medical education must be comprehensive and our trainees must be prepared to meet all patient needs with confidence. When 44% of OB/GYN residents are trained in states that now have the authority to ban abortion, patients will have to question whether their gynecologist has had access to the quality of training we’ve all come to expect,” Phipps said in a statement.