Journal Notes: The Dobbs Decision, One Year Later: A Special Article Collection in JGME
Since the US Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, 25 states have enacted laws to ban or restrict abortion access. For residents, fellows, and educators in graduate medical education (GME), these laws have many scrambling to adapt and to find jurisdictions where they can teach, learn, and perform the procedure. Additionally, more than 400 bills targeting the rights of lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other sexual and gender diverse identities (LGBTQIA+) are active or have passed in the 2023 US legislative session, with some still in limbo as lawsuits play out in the courts.
One year later, we are already seeing how these laws have begun to affect residents, fellows, and the communities they have begun to serve. The June 2023 issue of the Journal of Graduate Medical Education includes six articles addressing the effects of the Dobbs decision and other legislation restricting the practice of evidence-based care, as well as one article on how the level of care in different areas of the country can influence where a resident chooses to practice.
Editorial
Graduate Medical Education’s Role in the Battle for Evidence-Based Care
Authored by Editor-in-Chief Gail Sullivan, MD, MPH and Deputy Editors Deborah Simpson, PhD; Anthony R. Artino Jr.; PhD, and Lalena M. Yarris, MD, MCR, this editorial clearly lays out the effects of laws restricting the rights of patients and physicians to consider and choose evidence-based, high-quality care and looks at what actions can be taken.
Special Articles
Reworking Emergency Medicine Resident Education Post-Dobbs v. Jackson Women's Health Organization
This article focuses on the challenges faced by residents and fellows in emergency medicine in states with abortion bans, such as potential criminal liability and deciding where to learn and practice. The authors propose several updates to emergency medicine education and training and ACGME requirements.
The Influence of Anti-LGBTQIA+ Legislation on Graduate Medical Education
Across the United States, 70 percent of state legislatures are considering at least one policy targeting the rights of LGBTQIA+ individuals. This article explores both institutional strategies and national reform measures to protect these rights nationwide.
Turning Rage Into Action: Abortion Care and Residency Training in the United States
Using examples of obstetrics and gynecology residency programs in two abortion-restrictive states, the authors make a strong case for advocacy based on medical ethics principles of patient autonomy, beneficence/non-maleficence, the patient-clinician relationship, and inviolability of human life.
Perspective
Focusing on one resident’s experience on a rotation in Mound Bayou, Mississippi, where the nearest academic health care system is two hours away, this article explores the ways the system fails to support physicians in low-resource areas, including access to birth control.
Original Research
In this study involving focus groups with learners and leaders in national obstetrics and gynecology professional and academic organizations, participants identified their main concerns about the post-Dobbs landscape, including decreased availability of abortion training, the climate of fear and uncertainty in the field, and the impact of the ruling on their patients' access to care.
ACGME News and Views
Roe v. Wade, Dobbs, and the Future of Graduate Medical Education
Articles in the News and Views section are published by and include updates and perspectives from the ACGME. This article summarizes a session held at the 2023 ACGME Annual Educational Conference to discuss the issues around the Dobbs court decision and its impact.
As the political situation continues to evolve, with the effects on GME continuing to ripple out in the months and years to come, JGME will remain committed to publishing quality research perspectives from those affected most. An upcoming episode on the JGME podcast, Hot Topics in MedEd, will delve into these issues with authors featured in this latest issue.
Guest blogger Kevin Gladish is a staff editor for the Journal of Graduate Medical Education. He’s been at the ACGME since 2016, and is also a performer, writer, and storyteller.