OB/GYN residents: Less desire to practice in states with abortion restrictions

Key takeaways:

• Among OB/GYN residents, 17.6% reported that Dobbs affected their practice or fellowship plans.
• Those planning to work in restrictive states were eight times more likely to change their plans after Dobbs.

OB/GYN residents graduating from schools with Ryan Program abortion training programs report less desire to practice or pursue a medical fellowship after residency in states with more abortion restrictions, according to survey findings.

“Documenting the effects of abortion policy and punitive legislative threat on the medical workforce can inform the public and legislators of the effects of these laws on a broad range of health care services,” Alexandra L. Woodcock, MD, a complex family planning fellow in the department of obstetrics and gynecology at the University of Utah School of Medicine, and colleagues wrote in a study published in Obstetrics & Gynecology. “Residents graduating from programs in June 2023 will be the first to have their career plans affected by the Dobbs decision.”

Woodcock and colleagues conducted a mixed-methods survey study of 349 OB/GYN residents graduating from 109 U.S. sites with Ryan Program abortion training programs. Through an online prospective cross-sectional survey conducted from March 8 to April 25, researchers asked residents how the Dobbs decision affected plans for post-residency jobs or fellowships.

Overall, 17.6% of OB/GYN residents reported that the Dobbs decision had changed the location of their intended future practice or medical fellowship plans. Before the Dobbs decision, those who planned to practice in states with more abortion restrictions were eight times more likely to switch their plans compared with those who already planned to practice in states with fewer restrictions (OR = 8.52; 95% CI, 3.81-21).

Researchers also conducted a thematic analysis of open-ended responses. In this, 90 OB/GYN residents gave responses related to “not living in a state with abortion restrictions.” In addition, 36 residents pursuing fellowships reported that they did not rank or ranked lower programs in states with abortion restrictions.

The researchers acknowledged several study limitations, including no limit on number of survey submissions, possible biases toward abortion access by Ryan Program participants, and retrospective responses submitted after matching.

“We hope these findings will be useful when providing evidence to state policymakers in states where there is a desire to have hospitals and institutions that are national leaders in health care,” the researchers wrote. “If they wish to retain and recruit physicians who can care for the population in their state, they must understand how important abortion access is to their health care workforce.”

Editors Note: This article was updated on Nov. 9, 2023, to include study limitations.