Using opportunities for early leadership and advocacy during training can allow you to develop these skills with guidance from faculty mentors. Educational and advocacy organizations have created advanced curricula and structured electives to help programs integrate these opportunities into training (see TEACH Advanced Training Curriculum and Organizational Resources Table).
Consider collaborating with faculty or reproductive health organizations to tap into other teaching, research, or advocacy projects during training. For example:
- Work with faculty to help lead didactic, experiential or hands-on sessions for incoming trainees, such as values clarification or papaya workshops.
- Speak at a meeting of Medical or Nursing Students for Choice.
- Work with faculty to expand reproductive health services in your clinics. Successful projects have included protocols for EC access, management of EPL in outpatient settings, and clinic integration of medication abortion.
- Help document successes and obstacles encountered integrating these services.
- Collaborate on a research project, conference presentation, or article publication via the network of educators in reproductive health.
- Consider completing Physicians for Reproductive Health’s Leadership Training Academy.
ADVOCACY AND POLICY
Access to evidence-based reproductive health care has been under increasing threat due to state and federal legislative restrictions, and religious mergers. Laws that increase disparities in abortion access have included public and private insurance prohibitions, required waiting periods, mandated counseling, and targeted regulation of abortion provider (TRAP) laws, to name a few. At the time of this writing, only five states allow advanced practice clinicians to perform aspiration abortions (Vermont, New Hampshire, Montana, Oregon, and most recently California); one state (Mississippi) restricts abortion provision to obstetricians and gynecologists (Guttmacher 2016). These regulations are not applied to provision of comparable medical services, such as uterine aspiration for miscarriage management.
As a clinician, your opinions and expertise are highly respected by both the public and legislators. You have the potential to influence policy and legislation on a local and national level. Clinicians innately have the skills for being effective and powerful advocates, including a wealth of patient stories, technical and scientific knowledge, access to and understanding of research, and experience advocating on behalf of patients (Earnest 2010). An easy introduction to legislative advocacy can be undertaking by joining a lobby day coordinated by a reproductive rights organization, since the scheduling and talking points are usually provided by the organization. To make an impact on institutional policies, consider joining a clinic or hospital committee on practice, training or quality.
Working within your state or national chapter of your professional organization, such as the American Academy of Family Physicians and American Academy of Nursing, is another way to improve education and influence policy and legislation. For example, you can join the curriculum advisory for your specialty or the ACGME Residency Review Committee to ensure adequate inclusion of sexual and reproductive health in the curricula. Or you can advocate within your organization to develop the scope of practice for clinicians to include abortion provision (Weitz 2009) or for transparency in medical education in faith-based restrictions that may interfere with training ( an AMA resolution adopted in 2014). Many organizations have chapters for trainees or early career clinicians, encourage involvement by younger clinicians, and provide funding for meeting attendance.
For organizations that provide materials, support, and training for clinician advocates, see Organizational Resources Table: Advocacy Section. A concise overview of advocacy opportunities can be found through Physicians for Reproductive Health.