Abortion ruling set to influence med school applications

Following the recent United States Supreme Court ruling that reversed Roe v Wade and handed to individual states the power to decide on women’s abortion rights, nearly half of aspiring medical students say states’ decisions will influence where they apply to study, a new survey shows.

“I refuse to apply to any medical schools in states where women don’t have rights to their bodies. I want a quality education that is going to let me grow and develop,” wrote one pre-medical student on the survey conducted by Kaplan, a global educational services company that, in addition to offering Medical College Admission Test prep courses, provides admissions consulting to guide pre-medical students throughout the application process.

“I don’t want to be given a subpar education because the law refuses to give women rights.”

The representative survey of 300 university students from across the United States who are applying to medical school this fall is the first of its kind taken since last June when the Supreme Court reversed Roe v Wade, decided in 1973, that established a woman’s right to abortion nationwide.

The survey showed that nearly half of aspiring medical students say that the decision either definitely or probably will affect their decision on where to apply for medical school. Almost a third say it may or may not affect their decisions and 9% said it would not affect their decisions.

“I’m not surprised,” says Jon Boeckenstedt, vice provost for enrolment management at Oregon State University. “Anyone who works in enrolment management or admissions knows that there are a wide variety of factors that influence student choice, and we’d expect that trend to be true for medical schools as well as for undergraduate institutions.”

Kaplan’s survey of medical school applicants was part of its round of routine surveys. “At Kaplan,” says Jennifer Moore, executive director of pre-med programs, “we think it’s important to amplify student voices on a variety of topics, especially issues relating to education and public policy.”

Increased interest in activism

While pre-law students are well known for having strong opinions about politics and public policy, the decision to survey pre-med students was driven by the fact that recently the nation’s future doctors have also been showing an increased interest in activism.

“We wanted to poll them on the recent Supreme Court decision because this issue resonates particularly with the student group. It’s a unique area where science and the law, and education and people’s personal beliefs intersect.

“And, also, abortion is a medical procedure that some of these students may very well perform one day, depending on the specialty they choose to go into. It is certainly something that has been part of the standard medical education for some time now.

“It is a procedure that would come up anywhere obstetrics and gynaecology is practised. This is something that when medical students are making their rounds in third and fourth years of medical school, when they’re on the OBGYN [obstetrics and gynaecology] rounds, they would expect to see and become educated on,” she told University World News.

Trigger laws went into effect

Immediately after the Supreme Court overturned Roe, trigger laws in a number of states went into effect that make either performing an abortion or having one a criminal offence. In Wisconsin, the overturning of Roe meant the reinstatement of a law dating back to 1849 that banned abortion.

In several states, it meant the operation of ‘heart beat’ laws that outlaw either performing or having an abortion after six weeks.

Dr Jennifer Kerns, who teaches obstetrics and gynaecology at the University of California in San Francisco, told National Public Radio on 3 May 2022 that the term “fetal heartbeat” at this point in gestation is misleading. “What we’re really detecting is a grouping of cells that are initiating some electrical activity,” she explains. “In no way is this detecting a functional cardiovascular system or a functional heart.”

Nevertheless, Texas, Idaho, South Carolina, Iowa and a number of other states now have such laws that will all but remove abortion – despite the only treatment in some life-or-death situations for the mother, such as an ectopic pregnancy, being the removal of the foetus.

Just as the Supreme Court ruling allows states to ban or severely restrict abortion, it allows states to maintain easy access to abortion, which states like New York, New Jersey, Michigan, Oregon, Washington State and California have done.

Accordingly, wrote one pre-med student: “Coming from a Democratic state like California that aligns with the values I believe in, I probably won’t be applying to med schools in Alabama [where abortion, even to save the life of the mother, is illegal] or other Republican states that overturned Roe v Wade.”

The student’s reference to “other Republican states” includes Mississippi – the case that overturned Roe, Dobbs v Jackson Women’s Health Organization, was brought by Thomas E Dobbs, state health officer with the Mississippi State Department of Health – and other Republican-led states that filed amicus curiae (friend of the court) briefs in support of Mississippi’s suit.

Libertarian vs moral views

One of the students who said that the Dobbs decision would not impact where they applied for medical school phrased their decision in reasoning in libertarian terms. “A med school’s beliefs do not define my own.” Another used the language of admissions counsellors: “I would like to go to a school that is the best fit for me. No matter what their stance on reproductive health care.”

By contrast, the students who said that the Dobbs decision had affected their decisions tended to frame their answers in moral and civic terms.

“I value accessible healthcare. I want to be able to pursue higher education that will allow me to practise ethical healthcare that is helpful to those who need reproductive health services,” said one.

Another stated: “With reproductive health on the line, other problematic issues may also come on [to] the chopping block, and if I were to become a future doctor, I would not want my morals/ethics to be tested by some government ruling.”

Potential legal jeopardy

At least one of the quotes that Russell Schaffer, Kaplan’s director of communications, provided to me indicates not only that these pre-med students are aware of how, in certain states, not being allowed to employ the full gamut of obstetrics and gynaecology techniques risked the life of their patients but, also, how fulfilling their Hippocratic Oath could put them in extreme legal jeopardy.

“I will likely practise where I go to school. If I want to be an OBGYN [obstetrician-gynaecologist], I don’t want to have to choose between letting a patient die and spending life in jail.”

According to the Association of American Medical Colleges, more than 60% of medical students matriculate at a medical school in their home state, a figure that is about ten percentage points less than the average of undergraduates as reported by the top 20 universities Boeckenstedt analysed in his blog.

The percentage of students who came from states with liberal abortion laws who studied out of state was significantly greater than that of students who came from states with restrictive abortion laws. However, at the University of Alabama, the percentage of students from states with liberal abortion laws vs those from states with restrictive laws was surprisingly close: 35.5% to 25.5%, respectively. The same was true of Florida State University.

Boeckenstedt told me that once all the data is in, it will likely be that just as there is movement by those concerned with abortion rights away from anti-abortion states, there might be movement toward those states from aspiring medical students who live in more liberal states but want to study in states where the laws are more aligned with their personal views.

This already occurs when students who do not live in Utah go to the (Mormon) Brigham Young University or enrol in the University of Notre Dame, institutions with more conservative religious affiliations, he wrote in his blog.

Moore told University World News that going forward Kaplan will continue to survey students to see if concerns about abortion laws actually do impact where pre-medical students apply and, ultimately, decide to go.

Like Boeckenstedt, she believes that the Dobbs decision is “causing waves among pre-medical students, since this issue intersects both science and, for many, deeply held moral views – both for those who are pro-choice and those who are pro-life”.

The abortion issue has shown that in addition to being very career focused, pre-meds evince “an increasingly strong strain of social activism ... on a variety of issues”.