Oke-Matilda-Jane-Dr-Apr16Medical Schools should not neglect teaching contraception and abortion.

There are lots of things that medical students need to know and a limited time in which to learn them. And even more so in a condensed four-year postgraduate degree! Inevitably, there will always be topics that aren’t particularly well covered.

I’m OK with that as long as there are good and sensible reasons underpinning what’s in and what’s out. It makes a lot of sense to learn more complex details relating to surgery and cosmetic medicine. But I don’t believe it’s a good thing that medical and surgical abortion, a topic I learned almost nothing about in medical school, falls into the ‘what’s out’ category.

A medical course that ignores abortion seems a tad irresponsible to me, particularly when you consider that one-in-three Australian women will have one. I guarantee that abortion will touch more lives than Fanconi Syndrome, a rare disease I spent one week focusing on in Problem Based Learning.

Pregnancy-test-womanDoctors should have, at the very least, a basic understanding of how abortions are performed, where they are done, their pros and cons and how to counsel people in an appropriate manner. Without such knowledge, a large chunk of the population may well receive suboptimal care at a time when they’re highly vulnerable.

This is neither a phenomenon limited to Western Australia, nor even to Catholic universities. An article in Student BMJ refers to abortion as the ‘forgotten rotation’. An article in the Sydney Morning Herald entitled, ‘How Medical Schools are Failing to Educate Doctors in Abortion Care’, Jenna Price describes how many students receive no instruction regarding abortions and the potential ramifications of a basic lack of understanding relating to what is a relatively common procedure.

Contraception is another common presenting issue, and medical students should be taught a lot more about it. I’m surprised and disappointed in equal measure by the number of people who are unaware of the wide variety of contraceptives. Little wonder they have little understanding of how they actually 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. The latter statistic is particularly concerning. With variable quality, school-based sexual education a lot of young people will learn about contraception and its intricacies in a GP surgery.

Unless we, as doctors, have a comprehensive understanding about contraception and abortion – and definitely more than a one-hour lecture at university – we risk perpetuating a chain of misinformation that falls well short of best patient care.

I appreciate that creating a medical course is a difficult business and it’s a very good thing that places exist where those interested can learn more. Thank goodness for Sexual and Reproductive Health WA!

Meanwhile, the majority of the community is having sex. Shouldn’t we ensure that all future doctors learn more about it?

ED: Matilda graduated in 2015 with the School of Medicine Medal at the University of Notre Dame. She blogs at  www.matildawhitworth.com

References available on request.

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