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A Medical Student's Guide to Improving Reproductive Health Curricula

Introduction

The Association of Reproductive Health Professionals (ARHP) and Medical Students for Choice® (MSFC) have updated A Medical Student's Guide to Improving Reproductive Health Curricula, initially developed by and for medical students to help evaluate and improve reproductive health curricula in medical schools. Since it was first published in 1999, the Guide has been distributed to thousands of medical students and has helped to improve curricula and training in many medical schools.

Why the need? In the United States alone, it is estimated that:

  • 54 percent of women who have abortions report using a contraceptive method during the month they became pregnant1
  • 49 percent of all pregnancies in each year are unintended2; 24 percent of all pregnancies (excluding miscarriages) and half of all unintended pregnancies end in abortion each year3
  • 87 percent of all counties lacked an abortion provider in 2000; in non-urban and rural areas, the provider shortage increased to 97 percent4
  • 19 million new sexually transmitted infections (STIs) occur each year5 yet only 30 percent of physicians routinely screen patients for STIs6
  • 15 percent of infertile women can attribute the cause of infertility to pelvic inflammatory disease (PID) resulting from an untreated STI7
  • Questions about sexual activity and intimate relationships are included in only 26–50 percent of routine medical histories8

Although medical schools in the United States provide sufficient training in medical issues related to pregnancy, they often fail to adequately cover routine services such as family planning, primary care for infertility, and STI treatment and prevention. Most provide little, if any, training in abortion. Instruction is also lacking on provider-patient communication around sensitive issues such as HIV/AIDS, substance abuse, domestic abuse, and unintended pregnancy.

Medical knowledge alone does not guarantee high-quality patient care. Effective reproductive health care also requires skilled history-taking and sensitive patient counseling and education.

  1. Jones RK, Darroch JE, Henshaw SK. Contraceptive use among U.S. women having abortions in 2000-2001. Perspectives on Sexual and Reproductive Health 2002;34(6):294-303.
  2. Henshaw SK. Unintended pregnancy in the United States. Family Planning Perspectives 1998;30(1):24-29, 46.
  3. Finer LB, Henshaw SK. Abortion incidence and services in the United States in 2000. Perspectives on Sexual and Reproductive Health 2003;35(1):6-15.
  4. Ibid.
  5. Centers for Disease Control and Prevention. Trends in Reportable Sexually Transmitted Diseases in the United States, 2004. Available from www.cdc.gov/std/stats/trends2004.htm#ref1.
  6. St. Lawrence JS, Montaño DE, Kasprzyk D, Phillips WR, Armstrong K, Leichliter JS. STD screening, testing, case reporting, and clinical and partner notification practices: A national survey of US physicians.American Journal of Public Health 2002; 92: 1784 – 1788.
  7. Ness RB, Randall H, Richter HE, Peipert JF, Montagno A, Soper DE, et al. Condom use and the risk of recurrent pelvic inflammatory disease, chronic pelvic pain, or infertility following an episode of pelvic inflammatory disease. American Journal of Public Health 2004; 94: 1327 – 1329.
  8. Coulehan JL, Block MR. The Medical Interview: Mastering Skills for Clinical Practice, 4th ed. Philadelphia, PA: F.A. Davis Company; 2001:186.