Iowa already has the lowest number of OB/GYNs per capita of any state:
States that have enacted abortion bans saw a 10.5 percent drop in applicants for obstetrics and gynecology residencies in 2023 from the previous year, according to new data from the Association of American Medical Colleges.
That decline carries a potential long-term impact on the availability of doctors to care for pregnant people and deliver babies across a large swath of the South and Midwest because medical residents often choose to stay and work where they trained.
“Everybody is saying they knew this would happen, but this is concerning,” said Atul Grover, who leads the association’s Research and Action Institute to examine the most pressing issues affecting American health care. He has a message to policymakers: “You may be discouraging some of the best candidates from coming to your state to train.”
ADVERTISING
The abortion bans implemented across more than a dozen states after the Supreme Court overturned Roe v. Wade last June prompted many medical students to question whether states with new restrictions would offer them the training necessary to care for patients.
A race to teach abortion procedures, before the bans begin
When it came time to submit applications to OB/GYN training programs last fall, Lucy Brown decided against storied medical residencies in Texas and Florida. Nor, to her disappointment, would the Indiana medical student be training close to her family in Kentucky, a region that is losing obstetricians even as its maternal mortality crisis worsens.
In her clinical rotations through Indiana University School of Medicine, the 26-year-old has cared for patients who needed to terminate pregnancies because of cancer and other health reasons. Indiana passed a near-total abortion ban last August that a judge has blocked while the law is being challenged in court.
“When you are in a blue state, you can give her all her options. But in a red state, you are just like, sorry, there’s nothing more that we can do,” said Brown, who decided to do her residency in Maryland, where abortion remains legal. “Everything is up in the air whereas in a blue state, I just follow the guidelines. I can just counsel the way I’m supposed to counsel.”
Grover cautioned that it is too early to tell exactly what’s driving the decline in interest in OB/GYN residencies in states with abortion restrictions. The association also found a 5 percent drop in OB/GYN applicants nationally. Despite the decline, nearly all of the 1,503 residency positions were filled this year because the number of applicants exceeded the number of training slots available, the association said.
Applicants for residencies for emergency medicine — where many obstetric complications are first treated — also dropped dramatically across the country.
Abortion bans influenced Mindy Sharon’s decisions about where to pursue a residency in emergency medicine because ER doctors may need to terminate pregnancies or work with OB/GYN doctors to terminate them. Sharon, who is graduating from the Marshall University Joan C. Edwards School of Medicine in Huntington, W.Va., next week, felt she could not receive a well-rounded medical education in states where abortion is outlawed.
While abortion bans generally create exemptions to protect the life of the mother, hospitals and doctors say ambiguities in laws have resulted in medically necessary abortions being delayed or denied and caused confusion in emergency rooms.
“It really ties peoples’ hands,” said Sharon, 31. “I didn’t want to be in a situation of letting that decision dictate what type of care I could give.”
She decided against applying to residencies in Texas, despite it being home to multiple coveted emergency medicine programs, because of the state’s ban on abortion. And she no longer saw West Virginia, where she also received her bachelor’s degree and master’s in public health, as suitable for the final leg of her education after lawmakers passed a near-total ban on abortion.
“The way health care has been treated here with this ban and the politics of it all just don’t align with my values,” said Sharon, who will head to Stanford Medicine in California this summer. “I would love to come back and take care of West Virginians, but for right now, this is not a place that’s going to advance my training.”
The fall of Roe scrambles abortion training for university hospitals
The Accreditation Council for Graduate Medical Education requires OB/GYN residency programs to offer education and training in comprehensive family planning — including clinical experience in induced abortion — to maintain accreditation, prompting programs in states with bans to send residents to other jurisdictions for training.
“Clinical experience in performing induced abortions is essential to the evidence-based practice of obstetrics and gynecology, and the decision was made to preserve the integrity of the requirement for preparing physicians to practice anywhere in the United States,” the council said in a statement by spokesman Justin Dreyfuss.
States that have enacted abortion bans saw a 10.5 percent drop in applicants for obstetrics and gynecology residencies in 2023 from the previous year, according to new data from the Association of American Medical Colleges.
That decline carries a potential long-term impact on the availability of doctors to care for pregnant people and deliver babies across a large swath of the South and Midwest because medical residents often choose to stay and work where they trained.
“Everybody is saying they knew this would happen, but this is concerning,” said Atul Grover, who leads the association’s Research and Action Institute to examine the most pressing issues affecting American health care. He has a message to policymakers: “You may be discouraging some of the best candidates from coming to your state to train.”
ADVERTISING
The abortion bans implemented across more than a dozen states after the Supreme Court overturned Roe v. Wade last June prompted many medical students to question whether states with new restrictions would offer them the training necessary to care for patients.
A race to teach abortion procedures, before the bans begin
When it came time to submit applications to OB/GYN training programs last fall, Lucy Brown decided against storied medical residencies in Texas and Florida. Nor, to her disappointment, would the Indiana medical student be training close to her family in Kentucky, a region that is losing obstetricians even as its maternal mortality crisis worsens.
In her clinical rotations through Indiana University School of Medicine, the 26-year-old has cared for patients who needed to terminate pregnancies because of cancer and other health reasons. Indiana passed a near-total abortion ban last August that a judge has blocked while the law is being challenged in court.
“When you are in a blue state, you can give her all her options. But in a red state, you are just like, sorry, there’s nothing more that we can do,” said Brown, who decided to do her residency in Maryland, where abortion remains legal. “Everything is up in the air whereas in a blue state, I just follow the guidelines. I can just counsel the way I’m supposed to counsel.”
Grover cautioned that it is too early to tell exactly what’s driving the decline in interest in OB/GYN residencies in states with abortion restrictions. The association also found a 5 percent drop in OB/GYN applicants nationally. Despite the decline, nearly all of the 1,503 residency positions were filled this year because the number of applicants exceeded the number of training slots available, the association said.
Applicants for residencies for emergency medicine — where many obstetric complications are first treated — also dropped dramatically across the country.
Abortion bans influenced Mindy Sharon’s decisions about where to pursue a residency in emergency medicine because ER doctors may need to terminate pregnancies or work with OB/GYN doctors to terminate them. Sharon, who is graduating from the Marshall University Joan C. Edwards School of Medicine in Huntington, W.Va., next week, felt she could not receive a well-rounded medical education in states where abortion is outlawed.
While abortion bans generally create exemptions to protect the life of the mother, hospitals and doctors say ambiguities in laws have resulted in medically necessary abortions being delayed or denied and caused confusion in emergency rooms.
“It really ties peoples’ hands,” said Sharon, 31. “I didn’t want to be in a situation of letting that decision dictate what type of care I could give.”
She decided against applying to residencies in Texas, despite it being home to multiple coveted emergency medicine programs, because of the state’s ban on abortion. And she no longer saw West Virginia, where she also received her bachelor’s degree and master’s in public health, as suitable for the final leg of her education after lawmakers passed a near-total ban on abortion.
“The way health care has been treated here with this ban and the politics of it all just don’t align with my values,” said Sharon, who will head to Stanford Medicine in California this summer. “I would love to come back and take care of West Virginians, but for right now, this is not a place that’s going to advance my training.”
The fall of Roe scrambles abortion training for university hospitals
The Accreditation Council for Graduate Medical Education requires OB/GYN residency programs to offer education and training in comprehensive family planning — including clinical experience in induced abortion — to maintain accreditation, prompting programs in states with bans to send residents to other jurisdictions for training.
“Clinical experience in performing induced abortions is essential to the evidence-based practice of obstetrics and gynecology, and the decision was made to preserve the integrity of the requirement for preparing physicians to practice anywhere in the United States,” the council said in a statement by spokesman Justin Dreyfuss.
