Survey: State abortion access impacted OB/GYN residency applications

The adoption of state-level restrictive abortion care laws following the Dobbs v. Jackson Women’s Health Organization Supreme Court ruling in 2022 significantly impacted the migration of obstetric and gynecologic (OB/GYN) residency applicants last year, according to new survey data.¹

In findings presented at the American College of Obstetrics & Gynecology (ACOG) 2024 Annual Clinical & Scientific Meeting in San Francisco, CA, this weekend, a team of North Carolina-based investigators reported national survey data that showed nearly all medical students applying to OB/GYN residencies ranked programs located in states that were less restrictive on abortion services higher than programs in states with restrictions. The survey also found that approximately three-fourths of respondents cited the Dobbs v. Jackson decision as an influencer on their residency application plans.

In what they report to be the first assessment of medical student perspective on OB/GYN residency applications following the controversial Supreme Court ruling, the team led by Brianna Frame, MD, an OB/GYN resident at the University of North Carolina Hospitals, showed how Dobbs v. Jackson potentially affected the career trajectory of aspiring specialists in the field.

Frame and colleagues conducted their national survey of medical students applying to OB/GYN residency to assess the role of the Supreme Court decision on application processes. While prior analyses have highlighted the demographic, racial and ethnic disparities of women affected by state-level abortion restrictions after the 2022,² little research has elucidated how it affects the geographic preferences of aspiring OB/GYN specialists.

At the time of their analysis, 21 US states carry laws at least restricting abortion access based on term; of those, 14 have fully banned abortion services.³

“Abortion restrictions affect not only provision of abortion care but also experience for trainees,” Frame and colleagues wrote.¹ “Data from the 2023 match showed a decrease in obstetrics and gynecology residency applications in restrictive states.”

The team’s survey included 178 medical school students from 39 US states who completed the survey. Mean respondent age was 27.8 years old; 89.0% were women and 80.9% reported at White.

Investigators noted that 72.7% of respondents stated the Dobbs v. Jackson decision influenced which residency programs they applied to. Of those respondents, 96.9% said the effect was that they applied to OB/GYN programs in states with fewer abortion restrictions at the time.

Another two-thirds (66.5%) of the overall respondents stated the Supreme Court ruling influenced their match rank list; among that group, 98.3% stated they ranked programs in states that are less restrictive on abortion services higher than programs in states where they are not.

Indeed, Frame and colleagues concluded access to abortion training was an important criteria for medical students applying for OB/GYN residency in the wake of the Supreme Court ruling.

“Students reported applying to states with less abortion restrictions and that access to abortion training influenced their rank list,” the team wrote. “Prior studies have surveyed third- and fourth- year students about predicted effects of the Dobbs decision on residency applications.”

References

1. ^{Frame B, Vrooman H, Beckham AJ. Effect of Dobbs v Jackson Women's Health on OBGYN Residency Applicants. Poster presented at: American College of Obstetrics & Gynecology 2024 Annual Clinical & Scientific Meeting. San Francisco, CA. May 17 – 19, 2024.}
2. ^{Kunzmann K. State abortion bans more frequently affect Black, White, American Indian women. Contemporary OB/GYN. Published May 3, 2024. https://www.contemporaryobgyn.net/view/state-abortion-bans-affect-black-white-american-indian-women}
3. ^{Tracking Abortion Bans Across the Country. The New York Times. Web page. Last updated May 1, 2024. Accessed May 17, 2024. https://www.nytimes.com/interactive/2024/us/abortion-laws-roe-v-wade.html}