Abstract
Dear Editor:
In June of 2022, The Supreme Court of the United States overturned the landmark 1973 Roe v. Wade ruling, which provided the constitutional right to an abortion. There is no denying that the restrictive abortion regulations after overturning Roe will impact newly vulnerable individuals to legal surveillance, civil detentions, forced interventions, and criminal prosecutions depending on their states of residence. 1 However, focusing narrowly on abortion as the sole issue at stake obscures the comprehensive rights that people are owed; it has far greater implications, including privacy, freedom of choice, ethical dilemmas among physicians, and medical education. We—a group of current medical students, fellow, and faculty—wish to comment on the implications of this reversal for patients, trainees, and providers.
Approximately 44.8% of Accreditation Council for Graduate Medical Education (ACGME)–approved obstetrics/gynecology residency programs are in 26 states that will—or are likely to—outlaw abortions following the Supreme Court decision. 2 Residents in these states will not only be unable to receive training on how to perform abortions but it will affect their ability to become proficient in other areas of miscarriage management that require similar uterine curettage procedures. This will ultimately lead to future providers not being appropriately equipped to perform lifesaving procedures, which will inadvertently result in a net harm to society. Irrespective of the detriment in competency, every accredited program is still required to provide an option for their residents to receive abortion training. 3 However, there will be limited availability given that only approximately half of eligible programs will be in states where abortion is likely to remain legal. 2
Not only will these states be likely to see an increase in visiting residents seeking abortion training, but also increased patient volume of patients who cannot receive abortion care in their home states. This increased burden will limit the ability of teachers on-site to provide meaningful education if they are also constantly trying to balance not falling behind in their clinical responsibilities.
Even if residents were to go to states where abortion is legal for training in these specific procedures, many of these residents could face legal consequences of practicing these skills in their home states due to the massive “gray area” created in terms of what will be considered a legitimate lifesaving reason for an abortion. 4
This decision will also curtail reproductive-health education for medical students. Many medical-education governing bodies are already concerned about the legal ramification of schools providing education on abortion care in states where abortion is now illegal. Moreover, this void in training would also influence interested students to apply for residency only in those states where abortions are still legal, while the states that criminalize abortion will have difficulty in recruiting obstetrics/gynecology house staff, creating a dilemma of its own for the administrators. 5
To conclude, we believe that, beyond the incredibly negative impact on patients, trainees and medical students will also potentially lose valuable education.