Residency App Rates Fell in States That Restricted Abortion

After the Supreme Court struck down the constitutional right to abortion, 20 states passed new restrictions or intensified existing ones before the October 2022 residency application cycle started.

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Application rates to medical residency programs fell on average in states that passed new abortion restrictions after the overturning of Roe v. Wade compared to states that didn’t, a new scientific paper reveals.

“This is true for all medical specialties, so it’s not just women’s health that’s under threat,” said Anisha Ganguly, the study’s lead author and an assistant professor of medicine at the University of North Carolina at Chapel Hill.

Ganguly said the decrease is especially pronounced in primary care and emergency medicine. About half of medical residents go on to practice in the state where they receive their residency, she said.

In June 2022, the Supreme Court ended the constitutional right to an abortion in the Dobbs v. Jackson Women’s Health Organization ruling. A peer-reviewed article published Monday in JAMA Network Open said 20 states passed new abortion restrictions or intensified existing ones from the time of that ruling to the start of the October 2022 residency application cycle.

“There were many trigger laws in place,” Ganguly said, referring to legislation that states passed ahead of the Dobbs decision that would automatically increase abortion restrictions if Roe fell.

The study—which looked at more than 24 million applications across 4,315 residency programs—defined application rate as the number of applications to a particular program per 100,000 annual applications nationally. Comparing the 2018–19 application cycle to the 2022–23 cycle, states that increased abortion restrictions saw their programs’ average application rate from women drop from 22.2 to 21.3, while the application rate from men dropped from 23.2 to 22.2.

“Despite overall increases in the number of residency applications during the study period, existing disparities between application volume to programs in abortion-restricted and nonrestricted states widened for women applying to residency, and new disparities emerged for men applying to residency post-Dobbs,” concluded the authors from UNC Chapel Hill and the Universities of Washington and Arizona.

The authors added that medical “specialty type may influence differences, as effect sizes were increased among abortion-related specialties and decreased among the most competitive specialties.”