A version of this piece can be found in the May 2016 Issue of Medical Forum WA.
There are many things that medical students have to know and a limited amount of time in which to learn them (especially now that most universities offer condensed four-year postgraduate degrees). The upshot of this is that there are always going to be topics that aren’t covered as well as they could be, and I’m okay with this so long as there is a sensible reason why. It makes sense, for example, that we learn the details of surgeries and cosmetic medicine after we have mastered the basics. But I don’t believe that medical and surgical abortion, a topic I learned almost nothing about in medical school, falls into this category.
A medical course that ignores abortion seems a tad irresponsible to me considering that one in three Australian women will have one in their lifetime. I can guarantee that abortion will have touched more lives than Fanconi Syndrome, a rare disease I spent a week learning about in Problem Based Learning. Doctors should at least have a basic understanding of how abortions are performed, where they can be done, their pros and cons and how to counsel people appropriately. Without this, a large chunk of the population may receive suboptimal care at a sensitive time of their life.
This is not a phenomenon limited to Western Australia, or even to Catholic universities. An article in the Student BMJ refers to abortion as ‘the forgotten rotation’. In her piece for the Sydney Morning Herald entitled ‘How Medical Schools are Failing to Educate Doctors in Abortion Care’, Jenna Price describes how many students get no instruction about abortions, and that this could contribute to doctors lacking the necessary understanding to provide this common procedure.
Like abortion, contraception is another common presenting complaint that medical students should be taught more about. I’m often surprised and disappointed by the number of people who are not aware of the wide variety of contraceptives available, or have little understanding of how they work. This is especially evident when it comes to Long Acting Reversible Contraceptives (LARCs); despite being highly effective and affordable, less than 7% of women in Australia use LARCs and discussions about them occur in only 15.4% of GP contraception consultations. This latter statistic is particularly concerning: with variable quality school-based sexual education, many people in our community will learn about contraceptive methods from medical professionals. Unless we as doctors have a comprehensive understanding about contraception (i.e. more than a one hour lecture at medical school), we are at risk of perpetuating misinformation and not providing out patient’s with the best care possible.
I can appreciate that creating medical courses is a difficult business, and that there are places where interested types can learn more (thank goodness for Sexual and Reproductive Health WA). However, because the majority of the community is having sex, shouldn’t we make sure that all future doctors are learning enough about it?