Stephenson-Famy Alyssa, Sonn Tammy, Baecher-Lind Laura, Bhargava Rashmi, Chen Katherine T, Fleming Angela, Kang Morgan Helen, Morosky Christopher M, Schaffir Jonathan A, Madani Sims Shireen, Sutton Jill M, Royce Celeste S
A. Stephenson-Famy is associate professor, Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington.
T. Sonn is professor and vice chair for education, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri.
Acad Med. 2023 Apr 1;98(4):431-435. doi: 10.1097/ACM.0000000000005083. Epub 2022 Nov 8.
The June 2022 U.S. Supreme Court decision on Dobbs v Jackson Women's Health Organization resulted in state-specific differences in abortion care access across the country. The primary concern in the obstetrics and gynecology education community has been the impact on resident and fellowship training programs. However, the impact on undergraduate medical education and the broad implications for future generations of physicians are crucial to address. It is estimated that 48% of matriculants to MD-granting medical schools will receive their medical education in the 26 states with significant abortion restrictions or bans. Undergraduate medical educators need to continue to adequately teach the basic science, clinical care, and population health outcomes of reproductive medicine, including pregnancy and abortion. In addition, students in states with more restrictions on abortion will have less or no clinical exposure, and those in states with few restrictions may be excluded due to overcrowding of learners from restricted states. Students' own health care also needs to be considered, as access to abortion care for themselves or their partners may create applicant pool demographic shifts by state as applicants consider options for where to pursue their medical education. It is important to ensure that teaching of foundational science of pregnancy, abortion, and reproductive health continues throughout the United States. Undergraduate and graduate medical educators will need to closely monitor the downstream impact of decreased clinical exposure of abortion. Further study of the personal health impact of abortion care access for medical students and awareness of the changing applicant pool demographics by state is needed.
2022年6月美国最高法院对多布斯诉杰克逊妇女健康组织案的裁决导致美国各州在堕胎护理可及性方面存在差异。妇产科教育界主要关注的是这一裁决对住院医师培训项目和专科培训项目的影响。然而，解决其对本科医学教育的影响以及对未来几代医生的广泛影响至关重要。据估计，在授予医学博士学位的医学院的入学新生中，48% 将在有重大堕胎限制或禁令的26个州接受医学教育。本科医学教育工作者需要继续充分教授生殖医学的基础科学、临床护理和人群健康结果，包括怀孕和堕胎。此外，在堕胎限制较多的州的学生临床接触机会将减少或没有，而在限制较少的州的学生可能会因来自限制州的学习者过多而被排除在外。学生自身的医疗保健也需要考虑，因为学生及其伴侣能否获得堕胎护理可能会导致申请人群体因州而异，因为申请人会考虑到哪里接受医学教育的选择。确保在美国各地继续教授怀孕、堕胎和生殖健康的基础科学非常重要。本科和研究生医学教育工作者需要密切监测堕胎临床接触减少的下游影响。需要进一步研究堕胎护理可及性对医学生个人健康的影响以及各州申请人群体人口结构的变化情况。
