“We’re called upon to be nonjudgmental”: A qualitative exploration of United States medical students’ discussions of abortion as a reflection of their professionalism.

Medical educators may assess learners’ professionalism through clinical scenarios eliciting value conflicts – situations in which an individual’s values differ from others’ perceived values. We examined the extent to which United States (US) medical students’ discussion of abortion highlights their professionalism according to the six American Association of Medical Colleges (AAMC) professionalism competencies.
We conducted anonymous, semi-structured qualitative interviews with 74 US medical students applying to OB/GYN residency. Interviews explored attitudes toward abortion and abortion case vignettes. We analyzed interview transcripts using directed content analysis for alignment with the AAMC professionalism competencies: humanism, patient needs superseding self-interest, patient autonomy, physician accountability, sensitivity to diverse populations, and commitment to ethical principles.
Students’ genders, races, religions, and geographic regions were diverse. Attitudes toward abortion varied, but all students commented on themes related to at least one AAMC professionalism competency when discussing abortion care. Statements demonstrating students’ humanism, prioritization of patient autonomy, and sense of physician accountability were common. Most comments reflected positive professionalism practices, regardless of personal views on abortion or provision intentions; very few students made statements that were not aligned with the AAMC professionalism competencies.
All students in this study exhibited professionalism when discussing abortion, regardless of personal views on abortion or intention to provide this care. Case-based discussions involving abortion could be used to explore professionalism competencies among medical learners.
Discussing abortion has the potential to elicit values conflict, which enables learners to exhibit professionalism. Case-based abortion education should be included in medical school curricula to measure medical professionalism in future physicians, and to serve as a tool for teaching professionalism in medical school.