The Potential Overturning of Roe v. Wade: What Does This Mean for UWSOM Students

The following was emailed to students on June 14, 2022:

Dear University of Washington School of Medicine students,

As we await the published opinion of the Supreme Court on Dobbs v. Jackson Women’s Health Organization which would overturn Roe v. Wade, and Planned Parenthood v. Casey we want you to know we as an organization are unequivocally committed to healthcare equity and the principle that everyone should have full access to the healthcare services they need and desire, including reproductive medicine.

As both a medical school and healthcare organization, we believe that access to reproductive autonomy is a human right.

Quoting from Dr. Ramsey’s recent message in The Huddle, “We believe that all medical decisions, including the decision to have an abortion, should be a decision made between a pregnant individual and their clinician. And as a learning organization committed to training the next generation of clinicians, we believe that our resident and fellow trainees should have experience in all aspects of reproductive health, including family planning, contraception, and abortion.”

Given the likelihood that Roe v. Wade will be overturned, you may have concerns about the implications this decision will have on your medical education.

Curriculum

Regardless of where you are in the WWAMI system, the curriculum will continue to cover the full spectrum of reproductive healthcare including contraception and all forms of pregnancy loss as well as complications from pregnancy loss. This includes elective abortions. Physicians need this knowledge to provide essential care to their patients. Additionally, abortion care will continue to be tested on USMLE exams, and we are required to teach abortion care as part of a comprehensive medical education. In the Foundations phase of medical school, we will continue to cover abortion and contraception in the Lifecycle block. New in the 2022-2023 academic year will be an optional session with experts in reproductive health for those who want to go more in depth around access, advocacy, and history. Dr. Stephenson-Famy welcomes student input and plans to partner with relevant student groups to put this session together for interested students. This will not in any way replace content, only enhance it for those with interest.

Specifically, we will continue to cover abortion care during coverage of early pregnancy and emphasize the implications for maternal mortality of unsafe abortion and reduced access to abortion in both the U.S. and global settings.

The block level objectives will continue to include methods of managing reproductive function including:

·       family planning

·       treatments for infertility

·       management of conditions of the reproductive organs

·       gender-affirming care

Session level objectives will continue to highlight abortion and contraception as essential reproductive care:

·       By listening to a patient’s story, practice prioritizing the most effective and safest methods for providing interventional therapy for family planning and contraception.

·       Describe the pharmacologic methods to regulate fertility and reproductive function of males and females. Apply your knowledge of the pharmacologic and barrier methods of contraception, to appropriately select a contraceptive method for a patient based on the medical and gynecologic history.

·       Identify non-contraceptive uses of hormonal birth control methods for treating common medical and gynecologic disorders.

·       Describe and counsel regarding the action of emergency contraception including ethical issues for patients and providers.

·       Describe medication and surgical abortion regimens and protocols and review non-judgmental counseling and ethical issues for patients and providers.

Clerkships

With respect to OB/GYN and Family Medicine clerkships, there are already variations in what is available regarding abortion care depending on the clerkship site. For example, Catholic institutions do not teach abortion care.

What does this mean for clerkships that previously included abortion care? Depending on the final decision, some OB/GYN and Family Medicine clerkship sites in some WWAMI states where abortion care was available will no longer be able to offer that to their patients or as an educational opportunity.

We will work with the OB/GYN and Family Medicine clerkships to determine the best way to share information with students regarding which clerkship sites will include opportunities to participate in abortion care and continue to work on the development of elective clerkship options which will include abortion care opportunities.

Unknowns

There are many variables and unknowns regarding the legalities of crossing state lines for training and for receiving abortion care. Please be patient as we navigate the many unknowns; as information becomes available; we will provide additional updates.

Support

We know these are very troubling times and some students will need extra support. We are working with UWSOM Student Wellness and Counseling Services and others across the region to determine how best we can meet your mental health and personal reproductive health care needs. We will share more information about support services soon.

Caucuses

Currently, we are planning to hold two caucuses shortly after the Supreme Court decision becomes available. The purpose of these caucuses will be for like-minded students to have a safe, supportive space to come together in solidarity to share their feelings, thoughts, worries and questions with each other. One caucus will be only for students who believe that access to reproductive choice including elective abortion is a human right. The other caucus will be only for students who believe that elective abortion should be illegal in many/most/all circumstances. We hope this provides students a safe space to share their feelings about the Supreme Court decision and its impact on their medical education and future practice. The caucuses will be conducted via Zoom to accommodate the various schedules for all students across the region. Specific information about when the caucuses will be held will be sent after the Supreme Court decision.

Each session will be facilitated by professionals from City University. We also hope each session include an OB/GYN or family medicine physician with beliefs that align with the caucus who will serve as a clinical expert and answer specific questions about the implications of the Supreme Court ruling.

Additional mental health support resources and services will be provided prior to and following the caucuses.

Respect

We are a unique medical school in that we serve five states. There are many benefits to learning in different environments: from training in a level one trauma center in an urban environment, to getting to know a small community in a rural state, you have opportunities to learn about and from people who share your values and from those whose values differ from yours. You were all chosen to be UWSOM students for who you are as individuals. This is invaluable to your education because once you are doctors, you will not be choosing only like-minded patients.

In this spirit, it is important to remember that your classmates across the region may not agree with your politics or your values. Please be respectful of each other’s views and opinions.

Suzanne Allen, MD, MPH

Vice Dean for Academic, Rural and Regional Affairs

University of Washington School of Medicine