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Dec. 5, 2003
Facts About Abortion Training in U.S. Medical Schools 
The October 1, 2003 issue of JAMA, (Journal of the American Medical Association) presents some fascinating information regarding the decline in the number of abortionists in the United States and efforts by the abortion industry to increase their numbers and stop the nationwide closing of abortion clinics due to various factors, not the least of which is the aging of abortion providers.

In an article entitled "Educational and Legislative Initiatives Affecting Residency Training in Abortion," three physicians, Angel M. Foster of Harvard Medical School, Jane van Dis of the University of Hawaii, and Jody Steinauer of the University of California point out the following:

"In 2000, approximately 1.31 million abortions were performed in the United States, but access to abortion services has decreased during the last 14 years. In 2000, 87% of U.S. counties were found to have no abortion services and 99% of all facilities that perform more than 400 terminations per year were located in metropolitan areas.

"In 2000, there were a total of 1,819 sites where abortion procedures were performed, representing an 11% decrease since 1996 and a 37% decrease since 1982.

"The decline in abortion services has also coincided with a decline in routine abortion training in residency programs. The percentage of obstetrics and gynecology residency (OB/GYN) programs that routinely included first trimester abortion training decreased from 23% in 1985 to 12% in 1991. Second trimester abortion training was routinely provided in 21% of programs in 1985 but only 7% of programs in 1991.

"In 1993, in response to the shortage of abortion services and growing anti-choice [obviously the authors are not pro-life] activity, medical students mobilized to form Medical Students for Choice (MSFC), a grassroots organization with more than 7,000 members in the United States and Canada. MSFC's first organizing effort was to petition the Accreditation Council for Graduate Medical Education (ACGME) to make abortion training a required component of OB/GYN residency programs.

"In 1995, responding to both the decline in residency training opportunities and the increasing shortage of abortion services, the ACGME made more explicit the requirement that all OB/GYN residency programs seeking accreditation provide routine abortion training. The ACGME requirements differentiate between spontaneous abortion [miscarriage] and induced abortion, mandating that all residents obtain training in the management of spontaneous abortion. With respect to induced abortion, residency programs are required to provide ‘access to experience’ and residency programs and/or individual residents with religious or moral objections are allowed to opt out of induced abortion training. This ‘access’ can be provided as either an elective or a required rotation and, unlike other OB/GYN procedures, the mandate does not require that residents perform induced abortion procedures."

The Coats Amendment  
"Enforcement of the ACGME requirement was made more difficult when the U.S. Congress adopted what has been termed the Coats Amendment [named for its author, former Senator Dan Coats of Indiana]. The Coats Amendment to the Omnibus Consolidated Rescissions and Appropriations Act of 1996 (Pub L 104-134) states that residency programs will be deemed accredited by the federal government, or any state or local government that receives federal funds, even if programs fail to comply with abortion training accreditation requirements. Thus, a residency program that chooses not to provide abortion training to its students either in its own facilities or through an arrangement with another facility is protected from loss of federal funding. Similarly, state and local governments that receive federal funding must also treat these programs as accredited and cannot refuse them 'legal status . . . financial funding or other benefits.'

"In 1998, in response to the nationwide shortage of abortion services, the New York chapter of the National Abortion and Reproductive Rights Action League (NARAL/NY) developed the Residency Training Initiative (RTI) which called for New York City’s public hospitals to move from elective to required routine abortion training for the city’s OB/GYN residents (allowing objecting residents to opt-out of the training). The initiative, which requires that all OB/GYN residents in the City’s 11 public hospitals be trained in both medical and surgical abortion was instituted in 2002. [This occurred right after the election of New York City’s pro-abortion RINO Mayor, Michael Bloomberg, who put it into effect.]

"In August 2002, California enacted a state law (AB-2194) that reiterates the language of the ACGME mandate, requiring that abortion training be available at each of California’s 6 public medical schools (those with moral or religious objections are permitted to opt out). However, the California legislation also states that institutions that decide not to teach abortion procedures must ensure that OB/GYN residents can receive abortion training at other institutions.

"In 2000, less than 7% of abortions were performed in hospitals, thus many hospital-based residency programs must establish formal programs with community-based facilities [such as Planned Parenthood]. In 1999, the privately funded Ryan Residency Training Program (RRIP) was created to provide technical and financial support for residency programs to comply with the ACGME, develop curricula and competency criteria for abortion training, and facilitate collaborative relationships between academic and non-academic institutions. The RRTP has worked with the New York City public hospital system to fully implement the New York City training initiative as well as with lawmakers in drafting the California legislation. Based at the University of California, San Francisco, the RRTP has supported 15 OB/GYN departments in 6 states to establish formal rotations in abortion and expects the establishment of 7 others in 5 additional states in 2003.

"To date, educational and legislative initiatives affecting training in abortion have focused almost exclusively on OB/GYN residency programs. A 1995 study found that the vast majority (71%-88%) of family practice residency programs did not include abortion training. Increasing the number of family physicians who perform abortions has the potential to greatly improve access to this service and address some the current geographic and rural-urban disparities.

"A study published in 1999 found that 57% of obstetricians and gynecologists who performed abortions were 50 years or older. Replacement of abortion providers who are approaching retirement age depends on training a new generation of clinicians."

We hope that the information in this article will inspire those of you who are politically active, particularly at the state level, to investigate what is going on in your publicly funded medical schools with respect to abortion training. State legislation modeled after the Coats Amendment, for instance, might be helpful in holding back the efforts of the pro-abortion crowd to develop abortionists among young residents.

Rock for Life Remembers Holly Patterson 
American Life League's Rock for Life, the nation’s premier pro-life youth organization, is launching the "Remember Holly Patterson Campaign to rally San Francisco-area youth to expose the falsehoods spread by the country’s largest abortion provider, Planned Parenthood Federation of America. Holly Patterson died after taking RU-486 as prescribed by Planned Parenthood.

Republican National
Coalition for Life

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