By Steven Foley MD, FACOG
Why do the ACGME and ACOG continue to mandate opt-out abortion training instead of allowing medical professionals to opt in? Their unwavering ideological commitment to promoting abortion in all settings appears to be the driving force. Since the implementation of opt-out training in 2018, there has been no compelling evidence that the number of abortion providers has increased. The ANSIRH/ACOG survey from 2008–2009 found that 14% of physicians provided abortion services—well before the policy change. In the 2023–2024 KFF National Survey, that number remained essentially unchanged at 12–14%. Clearly, the policy has failed to achieve its stated goal.
So why persist with an opt-out model? The answer seems to lie in a broader agenda: the marginalization of pro-life pregnancy care. ACOG’s assertion that “abortion is healthcare” is deeply flawed—especially when considering the unborn. Abortion has become a central focus, eclipsing the broader mission of comprehensive women’s health.
The ACGME’s opt-out mandate also raises serious ethical and legal concerns. It disregards the Coats-Snowe Amendment, which was enacted to protect individuals from coercion by institutional authorities—faculty and administrators who may pressure or penalize pro-life students and residents. This dynamic exposes a troubling hypocrisy in the application of Critical Theory, where those who oppose abortion are now the ones being oppressed.
Moreover, these policies infringe upon First Amendment protections, including religious freedom and the right to conscientious objection. ACGME and ACOG are not only promoting abortion training in OB/GYN and Family Medicine but are also extending it to mid-level providers such as Certified Nurse Midwives (CNMs), Nurse Practitioners (NPs), and Physician Assistants. While these professionals are vital to healthcare delivery, they are not adequately trained to manage complications that may arise from abortion procedures. The goal here is not comprehensive care—it is access. This is further evidenced by their unregulated support for mifepristone.
Abortion is the taking of human life. We must stand firm against policies that normalize and expand this practice under the guise of healthcare. The opt-out model has failed to increase provider numbers, violated individual rights, and undermined the integrity of medical education. It’s time to reexamine this approach and restore respect for conscience in medicine.
