The Association of American Medical Colleges (AAMC) Research and Action Institute released a report revealing a continued decrease in U.S. MD applicants to residency programs in states with abortion bans. The report analyzed data from the 2020 to 2024 application cycles and compared the trends across states with varying abortion policies.
According to the analysis, from 2020 to 2022, the percent change in senior applicants across all specialties increased overall. From 2022 to 2024, the percent change in applicants decreased across all specialties. States with abortion bans experienced a more significant decrease in applicants compared with states with gestational limits or where abortion remains legal.
The report also highlighted the impact on ObGyn residency programs. From 2020 to 2021, the percent change in ObGyn applicants remained relatively small across all states, with an increase observed in 2022. However, from 2023 to 2024, states with abortion bans showed larger decreases in ObGyn applicants compared with states with gestational limits or where abortion remains legal.
Year over year, the decrease in ObGyn applicants was -6.7% in states with complete abortion bans, while states with no bans saw a 0.4% increase.
In response to the new data, AnnaMarie Connolly, MD, FACOG, chief of education and academic affairs of the American College of Obstetricians and Gynecologists, expressed concern about the effects of abortion bans and restrictions on ObGyn residency programs and the communities they serve.
"Legislative interference that imposes restrictions on full-scope reproductive health care, including abortion care, discourages medical students from pursuing residency training in states with restrictions, directly hurting patients by reducing the physician workforce in the communities that often need clinicians the most," said Dr. Connolly.
Residency programs in impacted states are working to provide comprehensive, evidence-based training to their residents. Some programs are incorporating the Patient-Centered Abortion Education curriculum or creating processes for residents to receive abortion training out of state.
The expertise of residency program directors, staff, and educators should not be overridden by legislative interference posed by abortion bans, she noted. "Training to provide the best in evidence-based reproductive health care should never be illegal."
Medical students who avoid residency training in states where abortion is illegal may be making these decisions based on both professional and personal interests. They are subject to the same laws as their patients and may not want to face restrictions to full-scope reproductive health care for themselves or their families.
ACOG "is thankful for the passion and the commitment of those future obstetrician–gynecologists who have demonstrated a fierce dedication to the field in the face of dangerous legislative interference," said Dr. Connolly.
The analysis authors noted the trends "do not provide definitive information about U.S. MD seniors’ motivations and reasons for applying to specific programs." A future analysis will focus on the impact of reproductive health laws on applicant selections.
Currently 14 states have complete abortion bans: Alabama, Arkansas, Idaho, Indiana, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, and West Virginia.
