Proposal for ACGME Funding Pregnancy Termination Related Travel and Medical Expenses

Proposal for ACGME Funding Pregnancy Termination Related Travel and Medical Expenses

July 11, 2022
Petition to
Accreditation Council for Medical Education Authorities at Accreditation Council for Medical Education
Signatures: 648Next Goal: 1,000
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Why this petition matters

Started by Melissa Saab Vance

Below is the text of a letter calling for the Accreditation Council for Graduate Medical Education to pledge their financial support for trainee travel and pregnancy termination related medical expenses. Please kindly review, and consider "co-signing" by signing this petition with your name and credentials. I sincerely appreciate your time and consideration of this request. 

With Gratitude, 

Melissa Saab Vance, MD (PGY-4), Board Certified Family Physician



July 15, 2022

Accreditation Council for Graduate Medical Education

401 North Michigan Avenue, Suite 2000

Chicago, IL 60611

Dear Accreditation Council for Graduate Medical Education Authorities:

My name is Melissa Saab Vance, and I am a geriatric medicine fellow training in Ohio. I am writing to ask you, the ACGME, to pledge financial support for physician trainees requiring travel for pregnancy termination care. 

During my third year of residency, I became pregnant with my daughter. The pregnancy was complicated by gestational diabetes. Post-partum, I bled for twelve weeks, struggled with breastfeeding, and extended my training by fifteen weeks (8 of which were unpaid) to recover before returning to work. Upon returning to work, I struggled with postpartum anxiety for which I continue to receive treatment a year later. 

I planned my pregnancy and the extension of my training. The choice to structure my career around motherhood was mine. I could not imagine the trauma, pain, and unbearable sadness one would feel being forced to do what I did against their will. 

Graduate medical education is both physically and mentally taxing. The busy 24-hour shifts, 80-hour work weeks, grant proposals, and research projects have proven so physically challenging that pregnant physicians remain at increased risk of both late and early term pregnancy complications1. Surgeons for example, have a pregnancy loss rate of 42%, which is double that of the general population2. As my personal story illustrates, a complicated pregnancy and postpartum course impose significant influence on a physician trainee’s career trajectory. An ambitious trainee should never be forced to extend their training or put projects on hold to carry an unwanted pregnancy to term. Furthermore, given the degree to which parenthood can restructure one’s career, no trainee should be forced into this lifetime commitment against their will. 

In the wake of our Supreme Court’s reversal of Roe vs. Wade, should a trainee become pregnant in my state, they would need to travel two hours out of state to terminate the pregnancy legally. For those living in Mississippi, West Virginia, Texas, and many other states the distance is farther and often requires air fare. Because physicians in training remain at the mercy of the MATCH for job placement, trainees who match in states without laws protecting their bodily autonomy remain at disproportionate risk to incur financial, professional, and psychological hardship should they desire termination. 

In recent weeks private companies like Meta, Citigroup, Amazon, and others have publicly pledged to fund travel for their employees seeking safe, legal pregnancy termination care. To maintain equity across the graduate medical education landscape, my colleagues and I are calling upon you to do the same. As our salaries are subsidized by the federal government, often in concert with state universities or religiously affiliated private hospitals, demanding this of our individual employers remains impossible. The burden then falls upon you, the ACGME, as our accrediting body to protect us. Please protect the bodily autonomy of your cis-gender women, transgender men, and all gender non-binary trainees with a uterus by pledging your financial support for pregnancy termination related travel and medical care. 

1.       Katz VL, Miller NH, Bowes WA Jr. Pregnancy complications of physicians. West J Med. 1988 Dec;149(6):704-7. PMID: 3074567; PMCID: PMC1026619.

2.      Rangel EL, Castillo-Angeles M, Easter SR, et al. Incidence of Infertility and Pregnancy Complications in US Female Surgeons. JAMA Surg. 2021;156(10):905–915. doi:10.1001/jamasurg.2021.3301


With Gratitude,

Melissa Saab Vance, MD

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Signatures: 648Next Goal: 1,000
Support now