Abortion Care Teaching 'Inconsistent in UK Medical Schools'

Peter Russell

April 05, 2022

The provision of abortion education for medical undergraduates varies widely across UK medical schools, according to new research.

A study published online in BMJ Sexual & Reproductive Health  found that time dedicated to the subject varied between medical schools and that many educators said they faced barriers to teaching the subject.

With 1 in 3 women in the UK likely to have an abortion before the age of 45, researchers said it was essential that medical schools addressed those barriers to ensure that tomorrow's doctors understood the clinical complications of abortion in order to treat patients effectively in an emergency, whatever their personal cultural or religious beliefs.

Also, because abortion had a complex legal history across all four UK nations, an understanding of the law and of ethics was essential, they suggested.

Several medical organisations, including the Royal College of Obstetricians and Gynaecologists (RCOG), the Institute for Medical Ethics, and the National Institute for Health and Care Excellence have emphasised the importance of abortion education. However, the research team, led by Homerton University Hospital NHS Foundation Trust in London, said there was little published research on how this translated to undergraduate medical education in practice.

Survey on Clinical, Legal, and Ethical Aspects of Abortion Teaching

To investigate further, they analysed survey responses from clinical curriculum leads in obstetrics and gynaecology, sexual health, and women's health at 25 of the 33 GMC-accredited medical schools across the UK. One survey covered ethical and legal aspects of abortion teaching, the other clinical aspects.

The responses revealed that:

  • The number of hours spent teaching ethical and legal factors ranged from under 1 hour to over 8 hours, with most clinical teaching lasting under 2 hours

  • Barriers to teaching were reported by 68% of respondents

  • 74% of respondents said they would welcome additional guidance on teaching abortion to medical undergraduates

Sensitive Topic

Difficulty accessing clinical placements and a lack of curriculum time were cited as common barriers. And almost half of respondents (45%) felt that abortion was a sensitive topic, with 18% saying they had ethical concerns about teaching the subject.

At one medical school, abortion education was said to be optional, and one respondent from Northern Ireland stated that they did not provide any clinical education on abortion as the procedure was illegal there at the time of the survey in early 2019.

Some medical schools assessed the ethical and legal aspects of abortion in objective, structured clinical examinations, but only 31% of clinical leads surveyed said that abortion was included in clinical assessments.

Topics covered in clinical teaching varied among the medical schools, which the researchers warned "is likely to produce significantly different abortion-related knowledge among graduates from different institutions".

Around 3 in 4 respondents to each survey wanted further guidance on best teaching practice.

The study highlighted open-access educational resources that were available, including an eResource from the RCOG, that the authors said "may help address some of the barriers cited by educators". Using such material "could improve the quality of abortion teaching in UK medical schools, equipping future doctors with the knowledge, attitudes and skills to treat people seeking abortions with confidence and respect", they concluded.

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