Impact of abortion laws on OBGYN residency applications

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Recent research suggests strict abortion laws may deter applicants to obstetrics and gynecology residency programs, with implications for medical education and workforce diversity.

Impact of abortion laws on OBGYN residency applications | Image Credit: © Parilov - © Parilov - stock.adobe.com.

Impact of abortion laws on OBGYN residency applications | Image Credit: © Parilov - © Parilov - stock.adobe.com.

Strict abortion laws may decrease applications to obstetrics and gynecology (OBGYN) residency programs, according to a recent study published in JAMA Network Open.

Takeaways

  1. The study highlights a potential correlation between strict abortion laws and decreased applications to OBGYN residency programs, posing concerns for future healthcare workforce recruitment.
  2. States implementing abortion bans or restrictions, particularly following the Dobbs v Jackson decision, showed a notable decline in the number of applicants to OBGYN programs compared to states without such laws.
  3. While stability was observed in overall application rates, there was a significant decrease in applications from MD applicants, particularly among states with full abortion bans.
  4. The study underscores a pronounced decline in MD applicants applying to at least 1 OBGYN program in states with abortion bans or restrictions, indicating potential challenges in recruiting medical doctors to these regions.
  5. The findings emphasize the importance of ongoing monitoring to assess the impact of state abortion laws on medical education and workforce diversity.

Since the Dobbs v Jackson Women’s Health Organization decision on June 24, 2022, states have had the ability to implement abortion restrictions, with 43.9% of US OBGYN residents impacted by bans and restrictions. This has led to concerns about whether applications to programs would be impacted in states with these restrictions.

Interventions have been implemented to raise the number of applications to OBGYN programs, including allowing applicants to submit up to 18 signals relating to their preferred programs. A 62% increase in applications to OBGYN positions was observed between 2013 and 2023, from 1498 to 2433.

To evaluate the changes in rates of application to OBGYN programs based on state abortion restrictions after Dobbs v Jackson, investigators conducted a cross-sectional study. Data was obtained from the Electronic Residency Application Service during the months of September and October from 2019 to 2023.

Participant data included self-reported degree, permanent address, self-reported gender, and self-reported race and ethnicity. Program size was also included as a covariate. The number of available graduate medical education (GME) positions in 2022 were self-reported by programs using the 2022 National GME Census in GME Track.

States were categorized as abortion ban, gestational limit, or no ban. These categories were determined using legislation effective as of September 9, 2022. Additionally, underrepresented in medicine (URiM) status of participants was calculated using criteria from the Association of American Medical Colleges.

There were 2463 applicants across 292 OBGYN programs included in the final analysis, 14% of whom were men and 85.4% were women. URiM status was reported in 28.2% of participants, 14.5% of whom were Black, 13.6% Hispanic, 0.9% American Indian or Alaskan Native, and 0.2% Pacific Islander. Non-URiM status was reported in 54.9% of participants, 45.8% of whom were White and 20.1% Asian.

Full abortion bans were reported in 11 states in September 2023 and gestational limits in 6. Stability was observed in overall OBGYN applications between 2019 and 2023, but the number of applications decreased in states with these bans and restrictions compared to those without bans.

An increased difference in the number of applicants to programs was more significant among MD applicants, with a decrease to 81.9% in the number of applicants applying to at least 1 program in states with bans in 2023. In comparison, this rate remained stable from 85.9% to 88% in prior study years.

An association was found between abortion ban status in applicants’ home states and a decrease in unique applications from MD applicants, from 79.2% in 2022 to 73.3% in 2023. Program signals were provided by 95.5% of OBGYN applicants in the 2023 cycle.

These results indicated a decrease in applications to OBGYN programs in states with abortion bans or restrictions following the Dobbs v Jackson decision. Investigators concluded future monitoring for potential consequences of state bans should be conducted.

Reference

Hammoud MM, Morgan HK, George K, et al. Trends in obstetrics and gynecology residency applications in the year after abortion access changes. JAMA Netw Open. 2024;7(2):e2355017. doi:10.1001/jamanetworkopen.2023.55017

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