After Supreme Court upends Roe v. Wade, medical colleges weigh impact on training doctors

The high court’s ruling leaves abortion access in the hands of the states. Almost half the nation’s obstetrics and gynecology residency programs are in states that are expected to ban abortion.

The Supreme Court has determined that abortion is now a matter for the states, and some medical colleges now must wrestle with tough decisions in training the next generation of doctors.

After nearly 50 years since the landmark Roe v. Wade decision, the high court ruled Friday that there’s no constitutional right to an abortion. The court’s conservative majority said the issue is now up to individual states.

Thirteen states have issued laws that prohibit abortion immediately or within a month, while seven more states are expected to prohibit abortion in the coming weeks or months, The Washington Post reports.

David J. Skorton, president and CEO of the Association of American Medical Colleges, issued a statement denouncing the decision, saying the ruling will harm patients. Part of the training of doctors includes reproductive healthcare.

The ruling also complicates the training of future physicians, Skorton said Friday.

“It is crucial that physicians have comprehensive training in the full spectrum of reproductive health care, since similar medical procedures address many health conditions,” Skorton said in the statement. “All medical schools currently require students to complete a clerkship in obstetrics and gynecology, and OB-GYN residencies are required to provide training or access to training on the provision of abortions, though residents with objections may opt out of performing induced abortions.

“The AAMC will evaluate the court’s decision and its implications for medical education and health care,” Skorton said.

Analysts project as many as 26 states could impose restrictions on abortion. Nearly half (45%) of the nation’s obstetrics and gynecological residency programs are in states that are certain or likely to prohibit abortion, according to an April analysis in Obstetrics & Gynecology. So students in those programs are likely to have no access to in-state abortion training, the study found.

‘Deeply concerned’ about teaching

Mary Sue Coleman, president of the University of Michigan, said she is worried about the court ruling’s impact on training doctors.

“Our campus is more than half women; we care about our own communities as well as those we serve through clinical care and education,” Coleman said in a statement. “I am deeply concerned about how prohibiting abortion would affect U-M’s medical teaching, our research, and our service to communities in need.”

Abortion remains legal in Michigan and Michigan Medicine said it would continue to offer abortion services.

“Many of the patients we see are diagnosed with fetal anomalies or experience other complications that make ongoing pregnancy and giving birth dangerous, or they have serious underlying illnesses or other needs that make abortion care in an outpatient facility not possible,” Michigan Medicine leaders said in a statement. “At Michigan Medicine’s hospitals, we primarily provide abortions for patients who need hospital-level care. Our commitment is to be there for those who need the specialized care we can offer.”

UW Medicine in Washington state said its students and residents will continue to learn about all aspects of reproductive healthcare, including abortion. Washington state law protects access to abortion services.

“As an integrated clinical, research and learning health system, UW Medicine is committed to training the next generation of healthcare professionals, and we believe that our medical students, residents and fellow trainees must learn about all aspects of reproductive healthcare, including family planning, contraception and abortion, to care for patients effectively and responsibly,” UW Medicine said in a statement.

UW Medicine said the school of medicine’s curriculum won’t change. Medical students aren’t required to participate in abortion care, but those who want clinical training in Washington will continue to be able to get it, the system said.

However, UW’s School of Medicine also serves neighboring states, including Idaho and Wyoming, which have trigger laws that are slated to bar abortion access following the high court’s ruling.

“Some OB-GYN and Family Medicine clerkship sites in states where abortion care was available will no longer offer abortion care to patients, and those educational opportunities may no longer exist,” the system said.

‘Champion the right of women’

Robert N. Golden, dean of the University of Wisconsin School of Medicine and Public Health, said the institution is “assessing how it may impact clinical training.”

“We remain completely dedicated to our patients, and will provide the best care possible and trustworthy, accurate medical information,” Golden said in a statement. “We will continue to provide outstanding, comprehensive obstetrics and gynecology residency training.”

Allison Brashear, vice president for health sciences and dean of the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, said in a statement that the school supports an individual’s right to make their own health choices.

"A woman’s right to the best health care includes the right to the best reproductive health care. Access to a safe abortion is a necessary facet of women’s health care,” she said.

“As our faculty deliver care to the Western New York community, and as we educate the next generation of health care providers, we will champion the right of women to make all of their health care decisions within the context of the patient-provider relationship,” Brashear added. “UB will continue to advocate for the rights of our physicians to provide all patients with safe, effective and accessible health care when they need it.”

‘Dangerous time’ for doctors

Iffath A. Hoskins, president of the American College of Obstetricians and Gynecologists, called the ruling “a direct blow to bodily autonomy, reproductive health, patient safety and health equity in the United States.”

“The impact of this irresponsible decision will fall disproportionately on people who already face barriers accessing health care, including people of color, those living in rural areas, and those without ample financial resources,” Hoskins said in a statement.  “This decision, which has been foreshadowed for many months, confirms that this is a dark and dangerous time for the women and doctors of America.”

Skorton, the AAMC’s leader, condemned the Supreme Court’s ruling and said it would limit access to care and interfere with the physician-patient relationship. It also will exacerbate healthcare disparities, particularly among historically disadvantaged groups, he said.

“We strongly oppose this decision and will continue working with our medical schools and teaching hospitals to ensure that physicians are able to provide all patients with safe, effective, and accessible health care when they need it,” Skorton said.