June Contest Theme: The Impact of Decisions
Our June Essay Contest invited AMSA members to reflect on how they, as future physicians, can support their patients’ decisions in the exam room—free from political influence—while considering how landmark rulings like Dobbs have reshaped their approach to decision-making, not only in reproductive care but also in other aspects of life.
We thank all those who submitted essays and congratulate our top 5 winners!
MEDICAL STUDENT CATEGORY
1st Prize
When Decisions Redefine Us
Written by Temiloluwa Owolabi
2nd Prize
Building the World We Want to Practice In
Written by Emma Weisner
Honorable Mention
Abortion Is a Decision You Make Out of Love
Written by Erin Silliman
Under the Shadow of Dobbs: Are We Complicit or Complacent?
Written by Amanda Moser
PREMEDICAL STUDENT CATEGORY
1st Prize
Decisions Beyond the Exam Room: Practicing Autonomy in a Post-Dobbs America
Written by Pranitha Kaza
EXPLORE BELOW & SHARE!
1st Prize Med Student Essay – When Decisions Redefine Us
When Decisions Redefine Us
Written by Temiloluwa Owolabi
I often wonder where I can practice medicine without compromising the values that are dear to me, if pursuing certain specialties also means preparing for legal battles or if I can be the doctor my patients need without putting my license or future at risk. These questions stay with me, not just because they challenge my career plans but because they shake the core of why I chose medicine in the first place. Yet here I am, a future physician preparing to enter the U.S. healthcare system in the aftermath of Dobbs v. Jackson Women’s Health Organization, and these uncertainties shape every decision I make.
Born and raised in Nigeria, where conversations about reproductive health were rare and abortion was both illegal and morally condemned. The idea was unthinkable. If I had become pregnant outside of marriage, the decision would have already been made for me. There would be no choice. Choosing medicine was my way of breaking that silence. I believed and still believe that my body belongs to me, and the decisions concerning it should too.
I thought of the United States as a symbol of patient-centered care and medical autonomy but the Dobbs decision in 2022 changed that perception. It did not just overturn decades of legal protection for abortion; it challenged the foundation of ethical practice in medicine. The boundary between healthcare and government interference became dangerously unclear. Twelve states have banned abortion entirely, and many others have implemented harsh restrictions. Even where abortion remains legal, the impact of Dobbs lingers.
Medical schools hesitate to teach essential procedures. Students are uncertain about what they can safely ask.
Providers second-guess what they can say or do. Fear replaces trust, and silence replaces dialogue.
Planning to practice medicine in the U.S., I have always had a clear picture of the kind of physician I wanted to be. I imagined sitting across patients in their most vulnerable moments, offering clarity instead of confusion and standing by their choices with empathy and strength. I was taught that medicine was about trust and honoring autonomy. I never imagined that in a country I once viewed as a global model of medical freedom, those values would be under threat.
The Dobbs decision did not just change a law; it reminded me that even in places with strong institutions,
basic human rights are never guaranteed and that borders certainly do not protect rights.
I went from planning to apply broadly to residency programs across the U.S. based on mentorship and academic fit to weighing in legal landscapes and abortion policies. This legal and ethical uncertainty places future physicians in a difficult position. The divide between what we are taught is right and what is legally allowed continues to widen. I want to grow into the best physician I can be but I must also consider where I will be legally protected for practicing evidence-based care.
Scrolling through TikTok one day, I came across a video by creator Becca Bloom, who said,
“Most criticisms fail because they only recognize what is broken, not what will work better within the constraints.”
That got me thinking: what can we, as future physicians, do within the constraints of the Dobbs ruling? As political forces reshape healthcare, we must assert our voices not just in hospitals but also in policy conversations. Physicians must now take more active roles in legal and social movements that advocate for reproductive rights. We are entering an era where healing also means resisting harmful policies that threaten patient autonomy and dignity.
Supporting patients’ decisions go beyond presenting options. It requires creating a space where patients feel safe and heard, regardless of where they come from or what choices they face. Our duty doesn’t just stop at the bedside with individual patients. It means advocating for them, educating ourselves and others, challenging harmful narratives, and integrating reproductive care into everyday medical conversations. Advocacy can simply involve volunteering with abortion support networks, writing to lawmakers about harmful legislation or speaking up when a policy undermines what we know to be good, evidence-based care. As medical students, residents and future physicians, the choices we make shape the future of medicine. I believe medicine, at its core, is a form of resistance against illnesses, injustice and silence.
This is not just a reflection; it is a promise. Because, in the end, it is not only about who makes the decision – it is about who has to live with it.
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2nd Prize Med Student Essay – Building the World We Want to Practice In
Building the World We Want to Practice In
Written by Emma Weisner
In the world I want to practice medicine in, patients can trust not only my medical knowledge, but in the belief that I will prioritize their needs over politics. But today, in the aftermath of the Dobbs decision, that trust is threatened.
In our first year of medical school we receive our white coats and recite the Hippocratic Oath, swearing to respect autonomy, uphold justice, and do no harm to the patients we serve. Even as political and legal changes attempt to erode these principles, we are beholden to the promises we make in those first months of our medical education. These principles may seem like abstract ideals when we discuss them in classrooms and study groups, but they are in fact the foundation of our profession – and this foundation is under threat.
The ethical principles physicians are duty-bound to uphold are in direct conflict with the Dobbs decision.
Autonomy, or the right of patients to make informed decisions about their own bodies and healthcare, is at the center of the ethical debate surrounding abortion care. In no other area of medicine do we deny patients’ access to safe, evidence-based care due solely to personal or political beliefs about “right” and “wrong.” The Dobbs decision makes true autonomy in reproductive healthcare no longer possible.
Beneficence, which requires acting in the best interest of the patient, is also in conflict with Dobbs, as physicians are now legally prohibited from offering the best care in some states. Non-maleficence, the promise we make to “do no harm,” becomes unfeasible when we are forced to delay treatments, like care for a hemorrhaging or septic pregnant patient, to comply with the law. How can we, as trainees and physicians, be faithful to the law and to our oath? How can we practice the care we promise to provide in this new political landscape?
These questions are pressing for all physicians and patients, but especially so for groups that already face huge reproductive inequities. Justice, or the promise to deliver fair and equitable treatment and address healthcare disparities, is also in conflict with these restrictive laws. Marginalized patient groups are already more likely to face barriers to adequate reproductive healthcare and the current medical reality worsens these existing inequalities, a direct affront to justice in medicine.
If we understand that the Dobbs ruling cannot be followed in a world in which we honor and uphold the ethical principles of autonomy, beneficence, non-maleficence, and justice, how are we to proceed? The first step is to acknowledge that medicine is inherently political. When we step in to the exam room, the operating room, or begin our morning rounds, we must understand and reckon with our role in the political system. Regardless of our actions, we shoulder the emotional weight of knowing we may not be able to both follow the law and uphold our ethical duties as physicians.
Though these challenges are too large to take on alone, there are ways that we, even as trainees, can defend the autonomy of patients and the ethical duty of physicians. Full and honest counseling, even when abortion isn’t legally available, is a vital first step. We can be aware of the options a patient may have outside of the institutions that we train in and offer this information to them. There is much to be done outside of the hospital too: we can lend our voices to hearings and briefs to advocate for legislative change. Especially at the state level, medical student voices really do matter – states want to retain future physicians, and we can make clear to lawmakers the reforms that we demand if we are to return as attendings. Even in institutions where clinical skills training is unavailable, we can advocate for medical education reform. If we ensure we are highly trained in ethical reasoning, we will be able to make more informed decisions about providing equitable care to our patients.
In a post-Dobbs world, upholding the time-honored ethics of medicine demands vigilance, courage, and a renewed commitment to placing patients, not politics or our own beliefs, at the center of every decision we make.
As trainees, we are uniquely positioned to envision a future where patient care is guided by ethics and compassion and where physicians act as guardians of autonomy, beneficence, and justice.
Let’s start building the world we want to practice in.
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Honorable Mention Med Student Essay – Abortion Is a Decision You Make Out of Love
Abortion Is a Decision You Make Out of Love
Written by Erin Silliman
She already had two children. She and her partner had never expected to become pregnant again, and they couldn’t afford another baby. When I met her during my women’s health elective rotation for her D&E consultation, she was already tearful. Not because she doubted her decision, but because she was drowning in guilt. Her community had raised her to believe this choice meant shame. That it made her selfish, immoral. But what I witnessed in that exam room couldn’t have been further from that narrative.
She asked the provider, “Are we making the right decision?”
The doctor didn’t flinch. Instead, she said something that has stayed with me ever since:
“Abortion is a decision you make out of love.”
She told the patient that this procedure wasn’t a failure of motherhood, it was an act of it.
Choosing not to carry this pregnancy was a decision rooted in care for her existing children, for her family’s stability, and for her own well-being.
The patient exhaled. A truth had been spoken aloud.
In that moment, I understood something that all the modules, workshops, and policy memos hadn’t been able to teach me:
how powerful it is when a physician affirms someone’s humanity in the face of systemic judgment.
This was all unfolding post-Dobbs. The decision to overturn Roe v. Wade has disrupted not only our access to care but also the very trust between patients and their providers. Though abortion was still legal in Washington state, I could feel the anxiety present in each room of the free-standing abortion clinic. Patients were crossing state and international borders to get to this clinic. My own classmates weighed whether it was safe, or even possible, to train in certain states.
Dobbs changed where I’ll apply for residency. It’s changed the questions I will ask programs during interviews. And it’s made one thing very clear: I’m not just choosing a specialty, I’m choosing whether I’ll be free to care for patients without fear, surveillance, or political interference.
As a future OB/GYN, I want to practice medicine in a way that resists stigma and centers the patient. I believe in informed, autonomous decision-making, not just in abortion care, but in all aspects of healthcare. Dobbs tried to redefine whose decisions matter. But in every clinic room, we have the power to help patients reclaim that right. One conversation, one act of love, at a time.
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Honorable Mention Med Student Essay – Under the Shadow of Dobbs: Are We Complicit or Complacent?
Under the Shadow of Dobbs: Are We Complicit or Complacent?
Written by Amanda Moser
I sat in Law auditorium on the first day of Penn Preview, almost a year ago to the day, fidgeting in the swivel chair, surrounded by unfamiliar faces, anxious to hear the PSOM administration speak. Looking back, I now see that day as the beginning of my journey toward understanding the ethical foundations that would guide my path in medicine- and that those once unfamiliar faces would soon become the peers who push me to question, to imagine more, and to lead with justice and integrity.
Dr. Cindy Christian stood at the podium, easing the room with humor before introducing what she affectionately called the “Christian Computation,” her own take on Einstein’s famous E=mc2: H = GZC2. In her words, health is a function of genetics multiplied by one’s zip code (ZC), squared.
Now, as I sit in that same auditorium seven months later, having completed courses in genetics, biochemistry, hematology, neurology, and psychiatry, I reflect on her equation with new insight. The power of that ZC2 speaks to how deeply social determinants impact health. As I’ve progressed through medical school, I’ve sought to understand, and more importantly, address, that impact—incorporating my passion for health equity and advocacy into the foundation of my training.
If I could expand Dr. Christian’s framework today, I would propose another variable, a second “C2,” not from the patient’s perspective, but from the providers. CC: Complicity and Complacency. Medicine is complex. Even with unlimited time, no number of lectures or research papers could fully encapsulate the intricacies of human illness. It is not for lack of trying. But if we accept that we cannot know or do everything, the real question becomes: what matters most?
Through courses like “Doctoring” and “Intro to Clinical Medicine”, patient panels, and standardized patient encounters, we are encouraged to hone the so-called “soft skills” of medicine. The core message underlying these experiences is beautifully simple: be human. Be present. Listen to your patients. Hear their stories. Let their narratives inform your clinical judgement and reshape your understanding of compassionate care.
But amidst the daily grind of academic excellence—the publishing, the boards, the resume-building—I’ve noticed how often these humanistic elements are sidelined. Patient panels become background noise to be tolerated while Anki decks and lecture notes take center stage. The quiet, profound work of connection is deprioritized in favor of measurable achievement. Today, we learn medicine not just in lecture halls, but under the shadow of Dobbs v. Jackson, a ruling that restricts clinical judgment. Since the Court’s decision, we face two choices: comply with politically driven injustice or remain silent—both at the expense of our patients’ wellbeing.
In our Doctoring course, we’re taught to “listen to the patient.” To recognize the patient’s autonomy as sacred.
But that ideal has been challenged. Patients are asked to navigate health systems bound by legislative mandates—and we, their providers, are too. For many of us, it’s a profound ethical reckoning:
How do we support patient decisions that laws may not permit?
These changes do not exist in abstraction. I have seen firsthand how Dobbs reverberates through our curriculum, our community, and our conscience. In class, we discuss legal geography and its consequences: how crossing a state line can mean the difference between access and denial. In clinic, I’ve seen the fear in patients’ eyes when disclosing pregnancies. In conversations with peers, I’ve noticed a deepening urgency: to resist, to advocate, and to learn how to safeguard care even within constraining systems.
And so, I return to the question: Are we complicit or complacent? Are we passive in the face of a system that limits reproductive autonomy, that prioritizes legal mandates over medical judgment? A system that pushes us to follow rules, not question them—even when our silence costs our patients their dignity, safety, and choice.
When political rulings begin to dictate medical decisions, neutrality is no longer ethical. As trainees, we must be vigilant not only in our knowledge of pharmacology and physiology, but also in our civic awareness, legal literacy, and moral courage.
This is not a condemnation, but a call—a call to see the patient in front of us not only as a case, but as a citizen with rights that we are charged to uphold, especially when systems fail them. In building my future in medicine, I hope to be both a student of science and a steward of humanity—someone who knows that while H = GZC2 might explain health, healing begins when we lean into that final, often-forgotten CÇ and dare to challenge our role as providers and choose to continually reflect and do better.
We must be more than clinicians¬—we must be translators, protectors, and advocates. We must know how to write appeals, to cite precedent, to educate lawmakers as well as patients. It is our duty to create safety where policy has removed it, and to reassert humanity where it has been stripped away.
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1st Prize Premed Essay – Decisions Beyond the Exam Room: Practicing Autonomy in a Post-Dobbs America
Decisions Beyond the Exam Room: Practicing Autonomy in a Post-Dobbs America
Written by Pranitha Kaza
The summer of 2022 marked more than a Supreme Court ruling; it was a turning point for how I, and many aspiring physicians, think about care, ethics, and community. When the Dobbs v. Jackson Women’s Health Organization decision overturned decades of legal precedent protecting abortion access, I felt grief, but I also felt clarity. In a moment when the boundaries between medicine and politics collapsed so visibly, even though I was only at the start of my undergraduate career at the time, I knew that my commitment to becoming a physician would require not just clinical training, but a lifelong engagement with advocacy.
Like many pre-medical students, I was once introduced to medical education as being a linear path: do well in school, gain experience, apply, train, and serve. But since Dobbs, the questions I ask myself about that path have shifted. Will I be trained to provide full-spectrum reproductive care? Can I safely advocate for patients in states where abortion is banned or criminalized? How do I reconcile the oath to do no harm with legal mandates that force harm: delaying care for miscarriages, forcing continuation of nonviable pregnancies, or discouraging patients from seeking help?
These aren’t just hypothetical concerns. In states with abortion bans, medical students and residents are being trained in limited environments, unable to learn essential skills or discuss options openly. And patients, especially those who are low-income, BIPOC, or undocumented, are shouldering the weight of that silence and fear.
I’ve worked with community organizations focused on bodily autonomy, patient education, and reproductive health access to bring it to my own campus. Through a campus student organization, Support, Health, and Education (S.H.E.) for Women, I’ve helped organize and advocate for menstrual equity and distribute accurate, accessible health information about contraception in spaces where stigma and disinformation run deep. This work has shown me the power of local advocacy and the harm of national decisions that ignore it. The Dobbs ruling didn’t just impact clinics; it disrupted the trust between communities and their providers, raising questions about who medicine serves and who it excludes.
That loss of trust is especially dangerous in a field like medicine, where consent and confidentiality are cornerstones of ethical care.
As a future physician, I want to be in a position to affirm, not control; to protect, not punish.
I want every patient, regardless of their zip code or income, to know that their body belongs to them and that my job is to support their decisions, not impose my own or those of the government. But that commitment requires preparation. It means working with mentors who believe in autonomy, even when it’s politically inconvenient. And it means staying grounded in community, not just learning from textbooks, but from doulas, abortion storytellers, midwives, and patients themselves. The hidden curriculum in medicine is shaped just as much by politics as it is by professors. And the Dobbs decision calls me to be vigilant beyond reproductive health.
If the state can insert itself into one kind of care, it can do so elsewhere: gender-affirming care, contraception access, maternal health, even end-of-life decisions. Each of these domains rests on the same foundation: that people deserve to make informed choices about their bodies, free from coercion. As someone entering this profession, I see it as my responsibility to reinforce that foundation: not only in my practice, but in policy, research, and education.
There is grief in this moment. But there is also resolve. The surge of organizing in the wake of Dobbs, from youth activists to physicians risking their licenses to care for patients, is a testament to what’s possible when we refuse to normalize injustice. Thirteen states have moved to enshrine abortion rights in their constitutions since the ruling, and more are mobilizing. These decisions matter, too. They remind us that patient-centered care doesn’t end in the exam room. It lives in our institutions, our ballots, our classrooms, and our daily conversations.
The impact of Dobbs has been seismic, but it has also clarified my purpose. I am not becoming a physician in spite of this moment—I am becoming one because of it. My path is not just about learning to heal; it’s about helping build a system where everyone has the right and resources to make decisions about their own body. That is the kind of medicine I believe in. That is the kind of future I’m fighting for.
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