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30 years after Morgentaler ruling, future doctors say medical schools neglect abortion training

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Three years into her medical training at McGill University, Charlotte Rosen says she has had just one lecture, so far, on abortions.

« Overall, » Rosen says, « in all Canadian medical schools, there is a lack of education on it. » 

« Medical students, in almost any field, will see patients who have had, or will have, an abortion — and it’s important to know that. » 

In 2011, researchers at the University of British Columbia found that between 1974 and 2005, nearly one in three women in Canada had an abortion in their reproductive years. 

Despite that evidence that it is a common procedure, a recent study confirms just how little training the family doctors — the people who perform most abortions — receive in school.

That study published in June in the online journal BioMed Central concluded family medicine residents need more training on abortions, with existing programs providing little education and exposure to the procedure. 

« After a combined 12 years of undergraduate and post-graduate medical education, we have been exposed to a grand total of one hour of official curricular education on abortion, » said two of the study’s authors, Daniel Myran and Jillian Bardsley, in a commentary in the August issue of Canadian Family Physician.

Family medicine residents when they carried out the study, both are now family doctors.

Dr. Henry Morgentaler celebrates at a news conference in Toronto, after abortion was decriminalised by the Supreme Court of Canada in 1988. (Blaise Edwards/The Canadian Press)

« How can this be when January 28, 2018 marked the 30th anniversary of the 1988 Morgentaler decision decriminalizing abortion in Canada? » they asked, referring to the landmark Supreme Court ruling which struck down Canada’s abortion law as unconstitutional, opening access to the procedure across the country.

Myran and Bardsley, along with Tania El Hindi and Kristine Whitehead, surveyed 1,518 family medicine residents across the country in 2016 to see how abortion care is taught in Canadian medical schools. 

They found that 57 per cent of residents surveyed had received no formal education on abortion.

When respondents had any received training, they reported it was often brief: only 20 per cent reported having more than one hour of instruction on abortion throughout the course of their medical education.

This is despite the fact that family doctors perform the majority of abortions in Canada: 75 per cent of all therapeutic abortions were performed by family doctors in 2014-2015, according to Canadian Institute for Health Information data cited by Myran and Bardsley.

Still a stigmatized subject

Rosen has taken it upon herself to integrate more information about abortion care into her own medical training. She is the co-president of the McGill chapter of Medical Students for Choice (MSFC), a U.S.-based organization which advocates for medical students and post-graduate training in abortion and family planning.

Charlotte Rosen, a third-year medical student at McGill University, wants to see more discussion on abortion counselling in the medical curriculum.

« It’s obviously a stigmatized subject. It’s obviously a controversial subject, » Rosen says. « All trainees and all physicians need to be equipped to cope with that. »

MSFC gives medical students a chance to hear more about the abortion care outside of their formal education, hosting lectures and workshops covering different aspects of care and organizing a tour of Montreal’s Morgentaler clinic.

« It is also important to learn about counselling women on abortion, » Rosen said. 

« Growing up in a post-Morgentaler world, we think that abortion is accessible and no problem. But there are still barriers to accessing abortion. »

Adequate abortion-care training is one of many contemporary issues being discussed at McGill University at a conference now underway, called Abortion Beyond Bounds.

The conference reflects on the Morgentaler decision and takes a close look at some of the issues surrounding abortion today, such as access.

The conference’s co-organizer, Rebekah Lewis, whose doctoral studies focus on residency training in family medicine and obstetrics and gynecology, says access to abortion depends on well-trained physicians.

Abortion pill’s arrival creates training opportunity

The emergence of the abortion pill in Canada, Lewis says, may trigger medical licensing bodies and medical schools to take a second look at how abortion is covered in medical education and training.

Mifepristone, a drug which induces a medical abortion, began rolling out in Canada almost two years ago and is now available in most provinces, including Quebec.

Lewis says with more doctors prescribing the drug as a method to terminate a pregnancy, there is an opportunity for certifying bodies to take a second look at the need to standardize abortion training across Canada.

But the drug’s availability is not enough, Lewis says.

« Availability of abortion is still dependent on physicians trained and willing to provide that service, » she says. « If you don’t have physicians willing and able to provide, you don’t have services. »

In a statement to CBC News, the College of Family Physicians of Canada (CFPC), which establishes the professional standards for the training and certification of family physicians, says it is « currently reviewing how education is included in family medicine residency training at each of the Canadian medical schools. »

For Rosen, who has seen increasing interest in the subject matter from her peers, it’s welcome news.

« It’s good to hear that they are reviewing so that perhaps there can be official, formal competencies developed for this subject matter, » she said.

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Nostalgia and much more with Starburst XXXtreme

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Get a taste of adventure with Starburst XXXtreme based on the legendary NetEnt Game. The nostalgic themes are sure to capture fans of the classic version as they get treated to higher intensity, better visuals, and features. The most significant element of the game is its volatility. Patience will not be an essential virtue considering the insane gameplay, and there is a lot of win potential involved. It retains the original makeup of the previous game while adding a healthy dose of adrenaline. 

Starburst Visuals and Symbols

The game is definitely more conspicuous than before. The setting happens over a 5-reel, 3-row game grid with nine fixed win lines, which function if a succession from the left to the right reel is present. Only those players that that attain the highest win per bet line are paid. From a visual standpoint, the Starburst XXXtreme slots illustrates lightning effects behind the reels, which is not surprising as it is inherited from the original version. Available themes include Classic, Jewels, and Space. The game is also available in both desktop and mobile versions, which is advantageous for players considering the global pandemic. According to Techguide, American gamers are increasingly having more engaging gaming experiences to socialize to fill the gap of in-person interaction. Starburst XXXtreme allows them to fill the social void at a time when there is so much time to be had indoors. 

Starburst XXXTreme Features

Players get to alternate on three features which are Starburst Wilds, XXXtreme Spins, and Random Wilds. The first appears on reels 2,3, or 4. When these land, they expand to cover all positions while also calculating the wins. They are also locked for a respin. If a new one hits, it also becomes locked while awarding another respin. Starburst XXXtreme offers a choice between two scenarios for a higher stake. In one scenario with a ten times stake, the Starburst Wild is set on random on reels 2,3, or 4, and a multiplier starts the respin. The second scenario, which has a 95 times stake, starts with two guaranteed starburst wilds on reels 2,3, or 4. it also plays out using respin game sequence and features. The game also increases the potential with the Random Wilds feature to add Starburst Wilds to a vacant reel at the end of a spin. Every Starburst Wild gives a random multiplier with potential wins of x2, x3, x5, x10, x25, x50, x100, or even x150.

The new feature is sure to be a big hit with the gaming market as online gambling has shown significant growth during the lockdown. AdAge indicates the current casino customer base is an estimated one in five Americans, so Starburst XXXtreme’s additional features will achieve considerable popularity. 

What We Think About The Game

The gambling market has continued to diversify post-pandemic, so it is one of the most opportune times to release an online casino-based game. Thankfully Starburst XXXtreme features eye-catching visuals, including the jewels and space themes. These attract audience participation and make the gameplay inviting. The game also has a nostalgic edge. The previous NetEnt iteration featured similar visuals and gameplay, so the audience has some familiarity with it. The producers have revamped this version by tweaking the features to improve the volatility and engagement. 

That is characterized by the potential win cap of 200,000 times the bet. Starburst XXXtreme does not just give betting alternatives for players that want to go big. The increase of multipliers also provides a great experience. If the respins in the previous version were great, knowing that multipliers can go hundreds of times overtakes the game to a new level. 

Players should get excited about this offering. All of the features can be triggered within a single spin. Whether one plays the standard game or takes the XXXtreme spin route, it is possible to activate all of the features. Of course, the potential 200,000 times potential is a huge carrot. However, the bet size is probably going to be restricted and vary depending on the casino. It is also worth pointing out that a malfunction during the gameplay will void all of the payouts and progress. Overall, the game itself has been designed to provide a capped win of 200,000 times the original bet. 

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Anglais

‘We’re back’: Montreal festival promoters happy to return but looking to next year

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In downtown Montreal, it’s festival season.

In the city’s entertainment district, a musical act was conducting a sound check on stage Friday evening — the second day of the French-language version of the renowned Just For Laughs comedy festival. Tickets for many of the festival’s free outdoor shows — limited by COVID-19 regulations — were sold out.

Two blocks away, more than 100 people were watching an acoustic performance by the Isaac Neto Trio — part of the last weekend of the Festival International Nuits d’Afrique, a celebration of music from the African continent and the African diaspora.

With COVID-19 restrictions continuing to limit capacity, festival organizers say they’re glad to be back but looking forward to next year when they hope border restrictions and capacity limits won’t affect their plans.

Charles Décarie, Just For Laughs’ CEO and president, said this is a “transition year.”

“Even though we have major constraints from the public health group in Montreal, we’ve managed to design a festival that can navigate through those constraints,” Décarie said.

The French-language Juste pour rire festival began on July 15 and is followed by the English-language festival until July 31.

When planning began in February and March, Décarie said, organizers came up with a variety of scenarios for different crowd sizes, ranging from no spectators to 50 per cent of usual capacity.

“You’ve got to build scenarios,” he said. “You do have to plan a little bit more than usual because you have to have alternatives.”

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Anglais

MELS new major movie studio to be built in Montreal

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MONTREAL — MELS Studios will build a new film studio in Montreal, filling some of the gap in supply to meet the demand of Hollywood productions.

MELS president Martin Carrier said on Friday that MELS 4 studio construction will begin « as soon as possible », either in the fall or winter of next year. The studio could host productions as early as spring 2023.

The total investment for the project is $76 million, with the Quebec government contributing a $25 million loan. The project will create 110 jobs, according to the company.

The TVA Group subsidiary’s project will enable it to stand out « even more » internationally, according to Quebecor president and CEO Pierre Karl Péladeau. In the past, MELS Studios has hosted several major productions, including chapters of the X-Men franchise. The next Transformers movie is shooting this summer in Montreal.

Péladeau insisted that local cultural productions would also benefit from the new facility, adding that the studio ensures foreign revenues and to showcase talent and maintain an industry of Quebec producers.

STUDIO SHORTAGE

The film industry is cramped in Montreal.

According to a report published last May by the Bureau du cinéma et de la télévision du Québec (BCTQ), there is a shortage of nearly 400,000 square feet of studio space.

With the addition of MELS 4, which will be 160,000 square feet, the company is filling part of the gap.

Carrier admitted that he has had to turn down contracts because of the lack of space, representing missed opportunities of « tens of millions of dollars, not only for MELS, but also for the Quebec economy. »

« Montreal’s expertise is in high demand, » said Montreal Mayor Valérie Plante, who was present at the announcement.

She said she received great testimonials from « Netflix, Disney, HBO and company » during an economic mission to Los Angeles in 2019.

« What stands out is that they love Montreal because of its expertise, knowledge and beauty. We need more space, like MELS 4, » she said.

There is still not enough capacity in Quebec, acknowledged Minister of Finance, the Economy and Innovation Eric Girard.

« It is certain that the government is concerned about fairness and balance, so if other requests come in, we will study them with the same seriousness as we have studied this one, » he said.

Grandé Studios is the second-largest player in the industry. Last May, the company said it had expansion plans that should begin in 2022. Investissement Québec and Bell are minority shareholders in the company.

For its part, MELS will have 400,000 square feet of production space once MELS 4 is completed. The company employs 450 people in Quebec and offers a range of services including studio and equipment rentals, image and sound postproduction, visual effects and a virtual production platform.

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