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• Posted December 6, 2023

State Abortion Bans Have New Doctors Staying Away

States that ban abortion could be headed to a brain drain when it comes to up-and-coming medical professionals.

Three out of four future U.S. doctors say state access to abortion is a key factor in choosing where they'll apply for their residency training, according to a survey published Dec. 5 in the journal Medical Ethics.

Responses indicate that the quality of care they'll be able to provide, as well as options for their own health, are motivating medical students to consider access to abortion.

"The next generation of physicians must grapple with this insult to the core of what it means to be a doctor, and this is reflected in their choices of where to complete residency,"conclude a team led by Kellen Mermin-Bunnell of Emory University School of Medicine in Atlanta.

In 2022, the U.S. Supreme Court overturned the constitutional right to abortion that had been enshrined in law by the 1970 Roe v. Wade decision.

Dubbed Dobbs, the latest ruling allows each state to set its own regulations for abortion.

"Respondents in our study highlighted Dobbs as a major factor impacting their decision on where to apply for residency, indicating the significant influence abortion access is having on where the next generation of physicians will be training,"the researchers wrote in a journal news release.

For the study, the team surveyed third- and fourth-year students at 125 medical schools, all of whom were applying for residencies between August and October 2022.

Nearly 500 medical students answered fully all the survey questions, which related to factors that would influence their choice of residency.

Factors like lifestyle and hobbies (90%), being near family or significant others (90%), likelihood of being accepted to a program (85%), patient population (80%) and state healthcare policies (63%) played a major role in choosing a residency program, the students said.

But the students also said changes in abortion access would likely influence where they will apply (77%), where to start a family (72%), contraception service provision (58%), and which specialty they would pursue (54%).

Abortion access would also influence their decision about when to start a family (37%) and whether to start a family during their residency (42%).

Participants were given the option to provide additional comments. Of 74 comments provided, 56 reflected support for abortion rights and 12 opposition.

Well over half (58%) said they were unlikely to apply to a state with abortion restrictions, but 69% had in fact applied to at least one of those states -- a contradiction that indicates the fierce level of competition for residency programs located in states that do permit abortion, researchers said.

Medical students who were female, not heterosexual and not Catholic were most motivated to apply to states where abortion is protected.

"When medical students become residents, they assume the responsibility to fulfill the ethical duties of medical practice,"the researchers wrote. "As a result of Dobbs, physicians across the USA are now being prevented from upholding these duties -- physicians must advocate for their patients when policies directly cause harm by contradicting best practices as determined by evidence-based guidelines."

More information

The World Health Organization has more about abortion.

SOURCE: BMJ, news release, Nov. 5, 2023