Medical students in the United Kingdom are missing out on a thorough education in abortion care
According to a study in BMJ Sexual & Reproductive Health, medical students in the UK aren’t getting the full picture of abortion care because of very different curriculum options and many barriers to effective teaching.
The researchers say that because the procedure is so common, as well as because of its legal, ethical, and emotional problems, it is important for future doctors to get a lot of abortion care training.
And, they say, no matter what a doctor’s own cultural or religious beliefs are, all clinicians must be aware of the clinical difficulties of abortion in order to be able to help patients in an emergency.
Before the age of 45, one in every three women in the United Kingdom will have an abortion. People who work in the medical field have said that abortion education is important.
This includes the Royal College of Obstetricians and Gynecologists; the Institute for Medical Ethics; and the National Institute for Health and Care Excellence.
Because of the complicated legal history of abortion in all four UK countries, as well as the ethical difficulties that it raises, the researchers wanted to know how much abortion is covered in medical school curricula, as well as the scope of the ethico-legal and clinical components of abortion instruction.
They sent two surveys to ethics and clinical curriculum leads in obstetrics and gynecology, sexual health, and women’s health across the 33 publicly funded UK medical schools as of February 2019.
Time spent teaching abortion, teaching methods, topics, assessment, challenges to teaching, and a desire for further advice on teaching abortion care were all covered in the questionnaires.
At least one survey was completed by 25 medical schools. Six people responded to both questions. There were clinical surveys done in 40% of the cases (13/32) and ethico-legal questionnaires filled out in 55% of the cases (18/33)
All respondents to the ethico-legal poll reported their medical school required them to take classes on the ethical and legal elements of abortion care.
This was not the case, however, with clinical survey respondents. They said that instruction on the clinical aspects of abortion care was required (85%).
One medical school offered optional clinical teaching, while another responded that they didn’t offer any because the treatment was banned in their area at the time (Northern Ireland).
The number of hours spent on abortion education ranged from less than an hour to more than eight hours on ethical and legal elements, and from less than an hour to more than six hours on clinical factors.
In each of the surveys, a period of 1–2 hours was the most frequently mentioned: 9 ethico-legal respondents (50%) and 6 clinical respondents (46%).
Lectures were the most common way to teach, and multiple-choice questions were the most common way to test.
In certain medical schools, objective, organized clinical assessments are used to analyze the ethical and legal elements of abortion. However, only about one-third of clinical leads (31 percent; 4/13) indicated that abortion was taken into account in clinical assessments.
Students frequently determine the importance of a topic based on its assessment value: if it is not assessed, it is thought less essential. As medical students’ exposure to a subject influences their career choices in later years, this could have unfavorable consequences for future service provision, the researchers write.
Ethicists and lawyers at all of the schools that responded said that their schools told them about the law in the UK and the right of doctors to refuse to help with abortions because of their moral beliefs.
It was hard to figure out which medical schools were teaching the same things about clinical teaching. No single topic was covered by all of them.
Worryingly, graduates from different universities are likely to have significantly varied abortion-related information, the researchers warn.
More than half (56%) of ethico-legal curriculum leaders said they had difficulty offering abortion education due to a lack of time in the curriculum and a lack of trained or motivated people to teach it.
The majority of clinical respondents (85%) said they had difficulty instructing. Nearly half (45%) thought abortion was a difficult topic and that this was a barrier to teaching it, while nearly one-fifth (18%) had ethical qualms about teaching it.
In each survey, about three out of four people desired more information on how to teach abortion care.
The researchers note that “open-access educational resources on abortion are accessible [e.g., Making Abortion Safe] and, if implemented, may help overcome some of the hurdles highlighted by educators.”
As a result, the quality of abortion education at UK medical schools could increase, providing future doctors with the knowledge, attitudes, and abilities to treat people seeking abortions with confidence and respect, they conclude.
