Apr 18, 2023 - Health

New doctors avoid residencies in states with abortion bans

Change in U.S. M.D. seniors applying to medical residency programs, 2022 to 2023
Data: AAMC analysis of ERAS data and KFF abortion ban status; Note: No OB/GYN residency programs in Alaska, Idaho, Montana, North Dakota, South Dakota and Wyoming. States with enforceable abortion bans are Alabama, Arkansas, Idaho, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, South Dakota, Tennessee, Texas, West Virginia and Wisconsin. States with gestational limits (6 weeks - 22 weeks) are Arizona, Florida, Georgia, Indiana, Iowa, Kansas, Nebraska, North Carolina, North Dakota, Ohio, South Carolina and Utah; Chart: Simran Parwani/Axios

New doctors applying to medical residency programs were likelier to avoid practicing in states with the most stringent abortion restrictions, an analysis from the Association of American Medical Colleges found.

Why it matters: The drop in applications, particularly for OB-GYN residencies, could exacerbate the lack of maternal health care in those states, which already have the highest maternal mortality rates in the U.S.

  • AAMC found that states with near-total abortion bans saw a 10.5% decrease in OB-GYN applicants who were M.D. seniors this year.

The big picture: Doctors tend to wind up practicing in the locations they train in, and health experts say that it is unlikely that OB-GYNs will relocate to red states, fearing they could run afoul of a rash of new reproductive care restrictions.

  • Nearly half of programs to train students in obstetrics and gynecology are in states with abortion restrictions or proposed bans in place.
  • That means students' only learning experience could come responding to medical emergencies or going to out-of-state rotations.

Zoom in: Rural areas are particularly vulnerable to cutbacks in maternal care services.

  • Two rural hospitals in Idaho, which has a near-total ban in place, said that they would stop labor and delivery services due to staffing shortages as more providers leave the state.

By the numbers: The overall number of newly minted M.D.'s who applied to residency programs fell by about 2% from 2022, and states with abortion bans saw a 3% decline, per the AAMC report.

  • Emergency medicine and OB-GYN residencies saw the largest nationwide declines, with 21.4% and 5.2% drops respectively.

Yes, but: Of the 412 available fellowships in obstetrics and gynecology in the country, just seven positions went unfilled in 2023, per data from the National Resident Matching Program.

Details: "U.S. M.D. applicants may be selectively reducing their likelihood of applying to states with more state-imposed restrictions on health care regardless of the number of available residency programs," the AAMC analysis says.

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