3 in 4 Future Doctors Say State Abortion Laws Will Likely Influence Residency Location

Three in four future doctors in the United States say that a state’s position on abortion access will likely influence their decision to choose the location for medical training, a new survey finds. 

This comes at the heels of the U.S. Supreme Court overturning Roe v. Wade in 2022 through its Dobbs v. Jackson Women’s Health Organization decision. 

Dubbed Dobbs, the new ruling dismantled the constitutional right to privacy and autonomy over personal reproductive choices that had been in place since 1973 and relegated states to make laws regarding abortion access. So far, 14 states now ban abortion from conception, and 11 ban it between six and 22 weeks after the last menstrual period.

Researchers from Emory University, who published their findings today in the Journal of Medical Ethics, analyzed data from nearly 500 responses from medical students across 125 U.S. medical schools. 

The researchers found that more than 75% of the medical residency applicants factored in Dobbs’ potential downstream effects on their medical specialty choice, family and personal and patient health as they prepared for the crucial next step in their careers. 

Respondents also noted that the changes in abortion access also influenced other future decisions, such as reproductive healthcare and contraception access tied to the residency training location. 

Around 72% said Dobbs influenced where to start a family and nearly 58% considered access to contraceptive access for themselves or their family in residency locations. Additionally, about 54% of respondents said the Dobbs decision would likely influence their medical specialty choice. In fact, nearly 60% of respondents indicated they were unlikely or very unlikely to apply to a state with abortion restrictions. 

“When medical students become residents, they assume the responsibility to fulfill the ethical duties of medical practice. As a result of Dobbs, physicians across the U.S. are now being prevented from upholding these duties — physicians must advocate for their patients when policies directly cause harm by contradicting best practices as determined by evidence-based guidelines,” the researchers said in a statement. 

According to the American Medical Association (AMA), the impact of the Dobbs ruling was especially felt by obstetrics and gynecology (OB-GYN) training programs. This medical specialty focuses on women’s health and reproductive care. 

Following the ruling in 2023, interest in OB-GYN fell by nearly 5% in terms of applicants across the country. In states that outright banned abortion, there was an 8% dip in the volume of OB-GYN applications, AMA said. In states with limited abortion access, the number of applications decreased by nearly 6%. 

The decrease in OB-GYN interest is largely due to concerns about how the changing laws will potentially affect medical training to perform life-saving procedures, such as an abortion, the report from AMA said. 

“In the current political climate, not all residencies are able to offer training in all areas,” Deborah Spitz, M.D., residency program director at the Department of Psychiatry and Behavioral Neuroscience at the University of Chicago Medicine, told the AMA in July. 

“People applying in OB-GYN need to be mindful of the fact that in large groups of states, they're not going to be able to get comprehensive training, and there are programs in those states that are going to be sending them to other states to get training in providing abortion, for example,” Dr. Spitz added. 

To add to this, the researchers from Emory University say that there is “no question” that medical training and practice are inevitably related to the evolving political climate and that this may influence the future healthcare landscape. 

“The next generation of physicians must grapple with this insult to the core of what it means to be a doctor, and this is reflected in their choices of where to complete residency,” the researchers said.