The Match Day ceremony at the University of California, Irvine, March 15. Match Day is the day when medical students seeking residency positions and training fellowships learn about their options. More and more medical students are choosing to go to states that do not restrict abortion.
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Jeff Gritchen/MediaNews Group via Getty Images
The Match Day ceremony at the University of California, Irvine, March 15. Match Day is the day when medical students seeking residency positions and training fellowships learn about their options. More and more medical students are choosing to go to states that do not restrict abortion.
Jeff Gritchen/MediaNews Group via Getty Images
Isabella Rosario Blum was finishing medical school and considering residency programs to become a family doctor when she received some blunt advice: If she wanted to be trained to perform abortions, she shouldn’t stay in Arizona.
Blum has turned to programs primarily in states where abortion access — and, by extension, abortion education — will likely remain protected, such as California, Colorado and New -Mexico. Arizona passed a law banning most abortions after 15 weeks.
“I really would have liked to have had all the training I could get,” she said, “so of course it still would have been a limitation.”
In June, she will begin her residency at Swedish Cherry Hill Hospital in Seattle.
For the second year in a row, students graduating from U.S. medical schools were less likely to apply this year for residency positions in states that ban abortion, according to new statistics from the Association of American Medical Colleges (AAMC). other significant restrictions on abortion.
Since the Supreme Court struck down the constitutional right to abortion in 2022, interstate fights over abortion access have created much uncertainty for pregnant patients and their doctors. But that uncertainty has also spilled over into the world of medical education, forcing some new doctors to consider state abortion laws in their decisions about where to begin their careers.
Fourteen states, mostly in the Midwest and South, have banned almost all abortions. The new AAMC analysis — reviewed exclusively by KFF Health News ahead of its public release — found that the number of applicants to residency programs in states where abortion is virtually banned decreased by 4.2 percent, compared with a drop of 0.6% in states where abortion is prohibited. remains legal.
The AAMC’s findings notably highlight the broader problems that abortion bans can create for a state’s medical community, particularly in an era of provider shortages: The organization observed a decline more significant interest in residencies in states where abortion is restricted, not only among those in the most important specialties. likely to treat pregnant patients, such as obstetrician-gynecologists and emergency room doctors, but also among aspiring doctors in other specialties.
“It should be concerning for states with severe restrictions on reproductive rights that so many new doctors – across all specialties – are choosing to apply to other states for training,” wrote Atul Grover, executive director of the AAMC Institute for Research and Action.
The AAMC analysis found that the number of applicants to obstetrics-gynecology residency programs in states with abortion bans fell 6.7 percent, compared with a 0.4 percent increase in states where abortion was prohibited. Abortion remains legal. For internal medicine, the decline observed in states banning abortion was five times greater than in states where abortion is legal.
“Geographic misalignment”
In its analysis, the AAMC said a continued decline in new physician interest in states with abortion bans “could ultimately negatively affect access to care in these states.”
Dr. Jack Resneck Jr., immediate past president of the American Medical Association, said the data demonstrate yet another postwar consequence.Roe v. Wade time.
The AAMC analysis notes that even in states where abortion is banned, residency programs are filling their slots — primarily because there are more students graduating from medical school in the United States and abroad. foreigner that there are places in residence.
Still, Resneck said, “we are extremely concerned.” For example, doctors without adequate training in abortion might not be able to manage miscarriages, ectopic pregnancies, or potential complications, such as infection or hemorrhage, that could arise from a miscarriage.
Those who work with students and residents say their observations support the AAMC’s findings. “People don’t want to go to a place where evidence-based practice and human rights in general are restricted,” said Beverly Gray, an associate professor of obstetrics and gynecology at the University’s medical school. Duke University.
In North Carolina, abortion is prohibited in almost all cases after 12 weeks. Women who experience unexpected complications or discover that their baby has life-threatening birth defects later in pregnancy may not be able to receive care there.
Gray said she worries that even though Duke is a highly sought-after training destination for medical residents, the abortion ban “has an impact on bringing the best and brightest to Carolina North”.
Rohini Kousalya Siva will begin her residency in obstetrics and gynecology at MedStar Washington Hospital Center in Washington, DC this year. She said she was not considering programs in states that have banned or severely restricted abortion, but instead applied to programs in Maryland, New Hampshire, New York and Washington, DC.
“We’re doctors,” said Kousalya Siva, who attended medical school in Virginia and was previously president of the American Medical Student Association. “We are supposed to provide the best evidence-based care to our patients, and we can’t do that if we don’t have abortion education.”
Another consideration: Most graduating medical students are in their 20s, “the age when people start thinking about putting down roots and starting a family,” said Gray, who added that she notices that many more of students asked questions about politics during their residency interviews.
And because most young doctors build their careers in the state where they do their residency, “people don’t feel safe having their own pregnancies living in those states” with severe restrictions, Debra Stulberg said. , chair of the Department of Family Medicine at the University of Chicago.
Stulberg and others worry that this self-selection away from states with abortion restrictions could exacerbate doctor shortages in rural and underserved areas.
“The geographic mismatch between where the need is and where people are choosing to go is really problematic,” she said. “We don’t need people to concentrate more in urban areas where there is already good access.”
From Tennessee to California
After attending medical school in Tennessee, which passed one of the most sweeping abortion bans in the United States, Hannah Light-Olson will begin her residency in obstetrics and gynecology at the University of California, San Francisco.
It wasn’t an easy decision, she said. “I feel a bit of guilt and sadness leaving a situation where I feel like I could be helpful,” she said. “I feel deeply indebted to the program that trained me and to the patients of Tennessee.”
Light-Olson said some of her fellow students have applied to programs in states that ban abortion “because they think we need pro-choice providers in restrictive states more than ever.” In fact, she said, she also applied to programs in states that banned abortion when she was convinced the program could provide abortion training.
“I felt like there was no 100% perfect guarantee. We’ve seen how quickly things can change,” she said. “I’m not particularly convinced that California and New York won’t be equally threatened.”
As a condition of getting a medical school scholarship, Blum said, she will have to return to Arizona to practice, and it’s unclear what access to abortion will look like then. But she worries about the long-term consequences.
“Residents, if they can’t get training in the state, then they’re probably less likely to move in and work in the state as well,” she said.
KFF Health News is a national newsroom that produces in-depth journalism on health issues and is one of the major operating programs of KFF — the independent source for health policy research, polling and journalism.
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