Creating a New Paradigm for Abortion-related Medical Education

May 11, 2024


Creating a New Paradigm for Abortion-related Medical Education

Written by Jeff Koetje, MD, AMSA Reproductive Health Programming Strategist

What do you do when the standard mold for something is no longer adequate, no longer relevant, or no longer right (or never was)? You create something that is, and leave the old thing behind. This is, at the core, what abolitionist movements are all about – rather than attempting to reform something around the edges, effort and energy is put toward creating something new that is so compelling, so irresistible, so much better than the old thing that people will be drawn to it, and away from the thing that needs to just be abandoned. This is what Toni Cade Bambara meant when she stated, in reflection on her own activities as an artist-activist, “As a culture worker who belongs to an oppressed people my job is to make revolution irresistible.”

The AMSA Reproductive Health Project is deeply inspired and moved by Toni Cade Bambara’s words, and we delight in knowing that each and every one of us has the power and capacity to create, even if we do not consider ourselves as “artists” in a formal sense. In fact, we are of the belief that revolutionaries are much more about creating the transformed conditions for new possibilities and new paradigms than about destroying, or burning down, the old. (Not that we won’t also throw the lit match!)

Standard medical education is one of those “things” that is no longer adequate, no longer relevant, and was never right (when analyzed through a lens of anti-racist, intersectional feminism). This is especially true of medical education standards when it comes to teaching and training abortion care, family planning, and reproductive healthcare in general. This is hardly a new insight. In fact, our beloved allied organization, Medical Students for Choice (MSFC) got their start in 1993 due to student demand for increased abortion training. And study after study have confirmed what we have long known: standard medical education is woefully and inexcusably lacking in education and training in abortion provision.

We certainly should ask ourselves, why that is. Why – knowing what we know about the inadequacy of abortion care training (and reproductive health medical education in general) – has so little changed in 10, 15, 20, 25, 50 years? For the sake of brevity, let’s summarize all the various reasons why this way: masculinist sexism and misogyny. The culture – and thus the norms and standards – of medical education and practice continues to be rooted in the ideology of white supremacist heteropatriarchy.

The truth of this is not insignificant for medical education, training, and practice. Because, in so many ways, it determines everything, including what is not taught, what is taught, and how what is taught is taught.

White supremacist heteropatriarchy cannot ever be reformed, and it can’t be fixed, because it’s working exactly as designed. So rather than putting lots of energy into something that can’t and doesn’t want to be reformed, we remember the wisdom of Toni Cade Bambara: we create something new that is entirely different and so compelling that it makes “revolution irresistible.” So, if the root of the problem of the inadequacy of reproductive health medical education is white supremacist heteropatriarchy, then the “new thing” we need to create is reproductive health medical education grounded in anti-racist, intersectional feminism, and see how people (medical students) respond.

So, that’s what we did. In partnership with the RJ Med Ed Project at the University of Michigan Medical School, we’ve designed an accredited two-week Elective in Abortion Care, Family Planning, and Reproductive Justice. We’ve offered the elective three times, most recently in January 2024. And each time we’ve run it, we’ve made it explicitly clear to the student participants that our philosophical commitment is to anti-racist, intersectional feminism; our political commitment is to the Reproductive Justice Movement; and our academic commitment is to liberatory and Love-based pedagogies. And we extend a generous invitation to participants to consider and deeply reflect on the following themes and topics:

  • Reproductive Justice: Framework, definitions, and herstory
  • Historical Injustices and Today’s Crises: The continuous thread of scientific and medical racism and sexism in Reproductive Health and abortion care
  • Family Planning and Abortion Care: Options counseling, values clarification, medication and procedural abortion, messaging and framing
  • Her Stories of Resistance: Honoring those who fight back, speak up, and labor to get free
  • Power and Control in Reproductive Health & Abortion Care: Religion, morality, masculinity and medicine – who gets to claim the right to shape reality
  • Reproductive Health, Rights, and Justice: Access, disparities, and structural competency
  • Reproductive Health Law and Policies: At the intersection of medicine and law, patient and community, care and advocacy
  • Affirmative Patient Care: Sexual and reproductive healthcare for LGB+, trans, queer, and non-binary people
  • Human-centered Care: Professional humility, trauma-informed sensitivity, cultural safety, and non-violent communication

And how have students responded to this new thing? Well – here’s one student’s reflection on her experience in the January 2024 elective:

“The Reproductive Justice elective with AMSA [and the University of Michigan Medical School] was exactly the open, honest curriculum that I was looking for when I started down my journey to self-awareness. Nothing was censored. Nothing was considered “hush-hush.” Every topic we discussed openly without fear of offending the establishment or an administrator at an institution – this was one of the most revolutionary aspects of this course. The topics truly aimed to center the voices of individuals that are working to effect change and are intimately tied to the history of medicine’s intersection with marginalized communities…I had no idea what essential information I was missing until I elected to take this course.”  [MS3 elective participant]

Does this appeal to you? Do you feel your spirit pulled toward it? Might it even feel…irresistible? If so, we want you to join us in this elective! We’ll be offering it twice during the 2024-25 academic year: September 23 – October 4, 2024 and January 20-31, 2025. M4s can take the elective for credit (through VSLO), and all medical students (all years) can audit the elective (non-credit bearing). Click here to take your next step deeper into the irresistible revolution of transformed and transformative medical education and training in justice-centered reproductive healthcare!