Restrictive abortion laws cause concerns about training for OB-GYN residents

There has been a flood of state laws restricting abortion since the Supreme Court said access to the procedure was no longer a constitutional right. Those laws are affecting how medical residents in obstetrics and gynecology are trained in performing abortions and in counseling patients about their reproductive choices. Ali Rogin speaks with Dr. Sarah Osmundson to learn more.

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John Yang : There has been a flood of state laws restricting abortion since the Supreme Court said access to the procedure was no longer a constitutional right. Currently, abortion is totally banned in 14 states and 27 states prohibit abortions past a certain point in the pregnancy.

As Ali Rogin reports, those laws are affecting how medical residents and obstetrics of gynecology are trained in performing abortions and in counseling patients on their reproductive choices.

Ali Rogin : A recent survey published in the Journal of Graduate Medical Education showed residents said they feel like they’re participating in the enactment of injustice. Another resident said there’s a big conflict of interest between the patient’s well-being and what we feel is right for the patient, and then trying to cover ourselves from a legal standpoint.

Dr. Sarah Osmundson is an OB-GYN and a board member of the Society for Maternal Fetal Medicine. Dr. Osmundson, thank you so much for being here.

In addition to practicing as an OB-GYN, you’re also a professor teaching the next generation of OBGYN. What are you hearing from the students that come through your programs about the future that they have and whether they’re getting enough training?

Dr. Sarah Osmundson, OB-GYN : Yeah, thank you so much for having me and for talking about this topic. You know, I think I’m hearing a lot of echoes of that statement that the sort of incoming generation of clinicians, medical students and residents, are very concerned about the type of training that they can receive, both in OBGYN and just in reproductive health in general, and they’re very concerned about practicing in states that restrict reproductive Health.

Ali Rogin : So it’s not really just about whether they have access to the training during their residency, but their abilities to continue to practice once they’re done with their with their training.

Sarah Osmundson : Yeah, absolutely. And I think it’s also important to understand that there are, you know, there are technical procedures that that our residents learn during training. And you know, these are procedures that we use for all types of health care dilation and curitage is used for miscarriages. It’s also used for abortion care, for the full spectrum of reproductive health care.

But I think the bigger picture is being able to have open and frank discussions with patients and being able to really offer them all the care within our states and within our institutions.

Ali Rogin : You’re in a state with a total abortion ban. What are the conversations like with those students that are worried about the type of training they’re going to receive.

Sarah Osmundson : Yeah, a lot of — I’ve had several discussions with medical students who are kind of at a point where they can determine where they’re going to practice, and many, I would say, most of those medical students have chosen not to apply to residency programs in restrictive states because of the concern that there are just overall limitations on the type of reproductive health care training that they receive.

Ali Rogin : And what is that going to mean for the future of OB-GYN care in general in these states?

Sarah Osmundson : Yeah. I mean, I am very concerned. I mean, I think we still attract wonderful and talented residents. But you have to consider that if your pool of students who are willing to go to restrictive states is smaller, we are just going to get, you know all of our programs in these states are going to get less and less talented students, or students that are less interested in providing this full spectrum of care.

So I’m very concerned that this is going to affect the quality of the residents that we are able to attract. And many residents stay in their states, and they practice in the states where they train, they practice in the institutions that they train. So the trickle down effect is less and less OB-GYN in these restrictive states.

Ali Rogin : What are you seeing from hospitals? Are they trying to pursue any workarounds to make sure that students have the training that they need, that their residents have the training they need?

Sarah Osmundson : Yeah, and I think a lot of training programs are trying to find those workarounds. And there certainly are options to send trainees out of state to receive specific like concentrated time periods where they learn skills.

But I think you know, if I reflect back on my residency training, you know, reproductive health care, including abortion, was a part of every element of training that I had, and it wasn’t just something that I did in a span of, like a month rotation. It was part of every single rotation. And

And so I’m concerned that even if we are able to provide sort of the technical expertise, we lose out on certainly the full volume of care, but also on the counseling and decision making that comes around being able to offer that care within our institutions.

Ali Rogin : And how do you feel about students like the ones that we read about in the intro, who are feeling like they have to choose between what’s right for their patients and shielding themselves from legal liability?

Sarah Osmundson : I completely understand this. I think this is exactly what physicians like myself are feeling. They are just reflecting kind of what we experience every day, where there is definitely a tension between what we know is the right medical decision for patients, and then what type of decisions could impact our freedom and our profession in general.

Ali Rogin : Dr. Sarah Osmundson, O-BGYN and a board member of the Society for Maternal Fetal Medicine. Thank you so much for joining us.

Sarah Osmundson : Thank you.