Medical students say strict abortion laws prevent them from pursuing a career in medicine in states where the procedure is banned.
The finding comes from a survey of third- and fourth-year medical students conducted August through October last year — shortly after the Supreme Court’s Dobbs decision in June 2022 overturning Roe V. Wade, who was nearly 50 years old long the right to have an abortion granted throughout the United States
A reluctance to be residents in abortion-ban states — young doctors who train in hospitals or clinics after completing medical school — could further exacerbate health care shortages in many parts of the country.
The survey results reflect the feelings of future obstetricians and gynecologists, as well as physicians planning to move into other specialties, such as surgery or internal medicine, said Ariana Traub, a third-year medical student at Emory University School of Medicine, who is the poll conducted poll.
“The key data we found was that the changes as a result of Dobbs would impact where in the US medical students would apply for residency,” Traub said.
Most respondents (57.9%) were unlikely or very unlikely to apply for a single residency program in an abortion-restricted state.
The findings, due to be presented this weekend at an annual meeting of the American Congress of Obstetricians and Gynecologists, have the “potential to change the geographic makeup of healthcare delivery,” Traub and her fellow researchers wrote.
The survey included responses from 494 medical students in 32 states. Most were women. More than three-quarters, 76.9%, said access to abortion care would affect where they would pursue their residency.
According to the USA, there is already a risk of a serious doctor shortage of between 37,800 and 124,000 doctors in the coming years American Association of Medical Schools. Of most concern for women’s health, separated AAMC The data revealed a significant decrease in the number of medical students pursuing residency in ob-gyn and gynecology residency in states with strict abortion policies.
The 5.2% decrease in OB/GYN residency applications was seen in all states, regardless of abortion laws. For applications in states with near-total abortion bans, that percentage almost doubled — to a 10.5% decrease.
If the polls are true, states with the toughest abortion restrictions could face a serious shortage of gynecologists. In these countries, maternal and child mortality tends to be higher.
“I’m concerned that this will impact who will want to apply for an apprenticeship in our state,” said Dr. Beverly Gray, director of residency at Duke University School of Medicine. North Carolina this week became the latest state to tighten abortion restrictions, making it illegal in most cases from the 12th week of pregnancy.
Aside from worrying about having enough residents in hospitals, Gray said her medical school could potentially force her to send her medical students to other states for proper gynecology training, which also includes abortion treatment.
“Abortion care is part of comprehensive obstetric and gynecological care. If you don’t have the ability to get that basic training, skill, technique, and counseling and care for complex patients, I don’t think you’re adequately trained,” Gray, also an associate professor of obstetrics and gynecology, said.
For a similar reason, Ian Peake is leaving his home state of Oklahoma. He graduates from the University of Oklahoma College of Medicine in Tulsa with his medical degree on Friday. On Monday, he will fly to New York City, where he will begin his residency in OB/GYN at SUNY Downstate Health Sciences University.
Dobbs was a key factor in the decision to practice somewhere other than Oklahoma, which last year enacted the country’s toughest ban on abortion.
“For me, after the Dobbs ruling and the subsequent ban in Oklahoma, it was very clear that this is not where I want to train,” Peake said, preferring instead to reside in a state where he could legally “do all of this.” exercise spectrum” of healthcare when it comes to obstetrics/gynaecology.”
Nell Mermin-Bunnell, a third-year medical student at Emory School of Medicine who also took part in the new survey, explained that abortion procedures are often performed in emergency situations to save lives.
The vast majority of procedures performed in the second or third trimester are medical emergencies where either the fetus is no longer viable and it is dangerous for the pregnant patient to continue the pregnancy, or the pregnant patient is medically unstable and this the case is dangerous to their long-term health or life,” said Mermin-Bunnell. “It happens frighteningly often.”
“It’s hard to go into work every day and learn that you can’t provide a patient with the care that could save their life,” said Gray of Duke University School of Medicine. “It’s a tremendous moral violation to be put in this situation when you have to take care of people and you’re not allowed to do the right thing.”
Where to start a family
Many of the female students interviewed are in the middle of childbearing age and may be considering planning their own pregnancy.
In fact, 72.7% of respondents said changes in access to abortion were likely or very likely to affect where they would start a family.
Traub and Mermin-Bunnell still have several years of medical school to go before they have to decide where and for what specialty to apply for residency. The Dobbs decision prompted both of them to consider a career in obstetrics/gynaecology.
Traub isn’t sure whether to stay in Georgia, where abortions after the sixth week of pregnancy are banned, or return to California, where there are fewer restrictions on abortion treatment.
“Part of me thinks that if I leave this state and if other medical professionals leave the state, we’re leaving the population that needs help so badly,” Traub said.
A move back to California would give her more experience in providing abortion care to her patients.
“I want to have reproductive health care for myself or my eventual family,” she said.