'We are failing': doctors and students in the US look to Mexico for basic abortion training

On paper, it should not be difficult for Dr Ramos to learn to perform abortions. As a family medicine doctor, Ramos works in a specialty that frequently provides the procedure. He lives in a deep-blue state where it is still allowed. And the administrators running Ramos’s residency program – a kind of apprenticeship that US doctors must undergo to become full-fledged physicians – support Ramos’s desire to learn how to do it. But over the course of his three-year-long residency, Ramos is guaranteed just three days’ worth of training at Planned Parenthood. Residents get to participate in only a handful of abortions. “That’s just not enough if you want to practice abortion care,” said Ramos, who asked to be identified only by his last name to protect his privacy. “I knew that if I wanted to do this, I needed more experience.” That’s why, earlier this month, Ramos traveled to a clinic in Mexico City for two weeks’ worth of training in abortion provision. During his first week at the clinic, which is run by the global organization MSI Reproductive Choices and its Mexican arm Fundación MSI, Ramos performed roughly 60 abortions.

In the years since the US supreme court overturned Roe v Wade, paving the way for more than a dozen states to ban virtually all abortions, a small but growing number of would-be abortion providers have begun to leave the country in search of an education. In 2023, MSI trained nine American doctors to perform abortions at clinics in Mexico. In 2024, it trained 27. So far this year, it is on track to double that number. “On one hand, it’s a tremendous relief to know that medical students and residents aren’t going to have to forego this very important part of their training in their education,” said Pamela Merritt, executive director of Medical Students for Choice. Last year, Merritt’s organization helped eight medical students and residents receive abortion training in Mexico and the UK.

Merritt continued: “It’s also incredibly sad that in the United States, we are failing to train people even to the standard of care indicated by abortion bans.” Every abortion ban in the US permits abortions to save a patient’s life. But without adequate training, doctors may not be skilled enough to perform abortions even in those dire circumstances. Medical schools and residency programs are run by massive hospitals that are heavily dependent on public funding; such institutions tend to be, by nature, leery of anything as controversial as abortion. The Accreditation Council for Graduate Medical Education (ACGME) has required OB-GYN residencies to teach doctors how to perform abortions since the 1990s, but rather than offer training in-house, hospitals have often farmed their residents out to freestanding abortion clinics for training.

Even before Roe fell, this system was faulty: a 2019 study found that, despite the ACGME requirement, just 64% of OB-GYN residency programs offered “routine training with dedicated time” for abortions. Family medicine residents who want to learn to perform abortions face a greater disadvantage, since the ACGME does not require their residency programs to offer any kind of abortion training. Even most OB-GYN residents, program directors reported in the 2019 study, did not achieve what doctors call “competency” when it came to abortion. Without competency – a qualification that’s measured through a melange of doctors’ knowledge, skills and attitudes – doctors may not be able to safely perform abortions on their own.

https://www.theguardian.com/us-news/2025/apr/09/doctors-mexico-abortion-training