Abortion Training: OPT-IN vs OPT-OUT
January 5, 2026
By Tim Millea, M.D. – Chair, CMA Health Care Policy Committee
Until several years ago, OB/GYN residents who sought training in induced abortion were allowed to “opt-in” if they wished that to be part of their training. However, in 2018, the residency curriculum changed significantly when the Accreditation Council for Graduate Medical Education (ACGME) established the requirement that such training be an “opt-out” system. This protocol requires residents who do not want abortion training to notify the supervisory physicians in their program of their decision. These interactions are with individuals who have a direct impact on the residents’ training, evaluations, and future practices. The potential for intimidation, threats, and other potentially career-threatening actions is clear and real.
There is no question that the need for more OB/GYN physicians is great across the country. However, barriers to entering that specialty, such as the current opt-out system, lead to hesitation on the part of medical students considering OB/GYN. When faced with a situation that conflicts with their ethics and moral beliefs, and which invites dismissal of conscience rights and retaliation, their reluctance is understandable.
Fortunately, there is a potential for corrective action that could return the landscape of OB/GYN residency training programs to a more acceptable level. The Coates-Snow Amendment, enacted in 1996, prohibits federal funds to federal, state, and local governments that discriminate against trainees who refuse abortion training or for a program that refuses to provide abortion training. The current opt-out system is an invitation for programs to identify and then single out abortion-opposed residents, which may well violate the Coates-Snow Amendment. The alternative, and preferred, pathway is to return to what has worked well in the past, i.e., the opt-in system. Residents interested in abortion training would have that option available, but the training itself would not be required. While the Coates-Snow Amendment offers protection as a result of funding for the program, the opt-in system provides protection for the residents as they progress through their training.
Further protections are taking shape on Capitol Hill as well. Senator Lankford (R-OK) has introduced S.3238, “Conscience Protections for Medical Residents Act” that would prohibit opt-out abortion training. In addition, Representative Greg Murphy (R-NC) has introduced a similar bill, H.R.6219. Both bills were introduced in late November and have a growing number of co-sponsors. Please visit the links for each bill to familiarize yourself with them and with their sponsors and look for opportunities to support this legislation.
CMA’s Health Care Policy Committee will continue to monitor these and many other efforts to advance, promote, and protect ethical health care and the right to a life of dignity for all who seek our help. Whether unborn, elderly, disabled, poor, or any other reason, CMA members will continue to provide care grounded in the Gospel message: Love of neighbor and respect for the dignity of all life.
Dr. Timothy Millea is the chairman of the Health Care Policy Committee. He is also a CMA board member-at-large, Iowa state director, and president of the St. Thomas Aquinas Guild of the Quad Cities.
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The Greatest Gift
January 6, 2026
At the beginning of the life of Jesus, the Magi gave the Christ Child gold, frankincense and myrrh. Gold was a gift for a king, incense for God and myrrh was given to symbolize the future death of Jesus, for myrrh was used to prepare dead bodies for burial.
At the end of Jesus’ life, he received a similar gift. Two days before the Passover while the chief priests and scribes were plotting to arrest Jesus so they could have Him put to death at the hands of the Romans by crucifixion, Jesus was at the house of Simon the leper. A woman came to him with an alabaster jar of expensive pure nard. Its estimated worth was a year’s wages. She broke the jar and poured it over the head of Jesus. Aware of the criticism around Him, Jesus said, “Let her alone; why do you trouble her? She has done a beautiful thing to me. For you always have the poor with you, and whenever you will, you can do good to them; but you will not always have me. She has done what she could; she has anointed my body beforehand for burying” (Mark 14:6-8).
We too are given gifts at the beginning and end of life. Most of us were baptized as infants with water and at the same time anointed with the oil of catechumenates and sacred chrism. Then at the end of life, we are anointed with the oil of the sick and receive viaticum — our last Holy Communion. Jesus said, “He who eats my flesh and drinks my blood has eternal life, and I will raise him up on the last day” (John 6:54).
God is not just satisfied being with us, He wants to be in us. This is what the sacraments are for, they are infusion centers. Every time we receive a sacrament, we receive a dose of Divine Life or Sanctifying Grace into our souls. And with the Eucharist, we receive the literal flesh and blood of Jesus into our bodies. Cars have gas tanks, we have grace tanks. If we do not regularly take our vehicles to gas stations to fill the tanks with fuel, our cars, trucks and SUVs will die and not run. If we do not regularly go to the grace stations of the sacraments, our souls will likewise die. We need to be regularly filled with grace, the life of God from the sacraments in order to stay alive spiritually. The two sacraments we can frequently receive are confession and the Holy Eucharist.
Jesus was given special gifts at the beginning and end of HIs life, we have been given even more special gifts not only at the beginning and end of our lives but also throughout our lives, with the sacraments. Isn’t it sad and tragic that so many stay away?
If you are looking to do something special this year — call it a resolution — attend Mass daily if you can fit it in your schedule, or adjust your schedule if you can in order to accomplish this. If this is not possible, spend at least one hour weekly in front of a tabernacle or monstrance in a Catholic Church and adore Jesus Christ true God and true man. Along with monthly confession and the daily recitation of the rosary, that great ‘bible on a rope’, you will notice big changes in your life.
Please be assured of my prayers for you and your families as we begin this first period of ordinary time.
