Abortion education in UK medical schools: a survey of medical educators

Abstract

AimThe 2019 National Institute for Health and Care Excellence (NICE) guidance on abortion care emphasised the importance of teaching the topic at undergraduate and postgraduate level. This study aimed to investigate the current provision of undergraduate abortion education in UK medical schools.MethodsRelevant medical ethics and clinical leads from the 33 established UK medical schools were invited to complete surveys on the ethico-legal or clinical aspects, respectively, of their institution’s abortion teaching. The surveys explored how abortion is currently taught, assessed the respondent’s opinion on current barriers to comprehensive teaching, and their desire for further guidance on undergraduate abortion teaching.ResultsSome 76% (25/33) of medical schools responded to one or both surveys. The number of hours spent on ethico-legal teaching ranged from under 1 hour to over 8 hours, with most clinical teaching lasting under 2 hours. Barriers to teaching were reported by 68% (21/31) of respondents, the most common being difficulty accessing clinical placements, lack of curriculum time, and the perception of abortion as a sensitive topic. Some 74% (23/31) of respondents would welcome additional guidance on teaching abortion to medical undergraduates.ConclusionsEducation on abortion, particularly clinical education, varies widely among UK medical schools. Most educators experience barriers to providing comprehensive abortion teaching and would welcome up-to-date guidance on teaching both the clinical and ethico-legal aspects of abortion to medical students. It is essential that medical schools address the barriers to teaching, to ensure all medical students have the knowledge, skills and attitudes to provide competent and respectful abortion-related care once qualified.

Abortion teaching must empower medical students and doctors to advocate for reproductive justice

“…Alarmingly, a survey of clinical curriculum leads at UK medical schools found that some had ethical concerns about providing teaching on abortion. 4 While we understand and respect that students and educators may have differing views rooted in their personal values and beliefs, it's hard to see what ethical imperative could negate the need for doctors to understand a procedure that may be required to save a life. All we are advocating for is knowledge.…”

“…We have free open access medical education resources, such as those by Doctors for Choice UK,9 as well as a curriculum from the Royal College of Obstetricians and Gynaecologists 10. A “lack of teaching time” is often the immediate response to calls for anything to be taught more comprehensively at medical school,4 but this cannot be justified for medical provision that one third of women will need. It is hard not to see sexist undertones or political influences in this omission of termination of pregnancy from medical education.…”

“…2 A recent survey of 25 UK medical schools found that most students receive fewer than two hours of clinical teaching on termination of pregnancy, but up to eight hours of teaching focuses on the ethicolegal aspects of abortion. 4 Is it really more important that we understand the circumstances in which we must deny a pregnant patient bodily autonomy, than it is for us to know how to support and care for them? Given that the entirety of clinical abortion teaching takes place on average in under 120 minutes, how much of that time do you suppose gets dedicated to hearing the voices of the one in three women who have had an abortion?…”

“…A recent survey of 25 UK medical schools found that most students receive fewer than two hours of clinical teaching on termination of pregnancy, but up to eight hours of teaching focuses on the ethicolegal aspects of abortion 4. Is it really more important that we understand the circumstances in which we must deny a pregnant patient bodily autonomy, than it is for us to know how to support and care for them?…”

Seven days in medicine: 30 March to 5 April 2022

“…Students at UK medical schools are missing out on comprehensive education on abortion care amid highly variable curriculums, research in BMJ Sexual & Reproductive Health found 1. All 18 of 33 medical schools that completed an ethico-legal survey said that they provided compulsory education on ethical and legal aspects of abortion care.…”