Access to Abortion Training Important to Ob/Gyn Residency Applicants Post-Roe

SAN FRANCISCO — Access to abortion training was an important consideration among those applying to ob/gyn residency in the match cycle after the Dobbs v. Jackson Women’s Health Organization Supreme Court decision — which overturned Roe v. Wade and led to a patchwork of abortion access — according to results from a survey of 178 medical students.

For students applying in the 2022-2023 cycle, 72.7% said the Dobbs decision influenced which programs they applied to, and within that group, 96.9% said they applied to programs in states that had fewer abortion restrictions, reported Brianna Frame, MD, of the University of North Carolina Hospitals in Durham, during an oral presentation at the American College of Obstetricians and Gynecologists (ACOG) annual meeting.

“These applicants were forced to weigh the current laws and potential restrictions in providing abortion care in each state,” Frame said.

Two-thirds (66.5%) of respondents said that the Dobbs decision influenced how they ranked programs, and of those, 98.3% said they ranked programs in states that are less restrictive higher.

Other findings of note:

• 80.3% agreed that it was important to them to train at a Ryan Residency program
• 89.6% agreed that they intended to be involved with providing abortion care during residency

In addition, 84% said the program they matched to aligned with their goals of either providing or not providing abortion care. Of the 16% who said their program did not align with their goals, most said they would like to provide abortion care but their program does not offer it.

“I think the first thing that’s important to know is that the Dobbs decision itself is impacting the residency application process,” Frame told MedPage Today. “We have seen that from the other lens, from the data of where people are applying to in terms of numbers, but it was really helpful to hear from the perspectives of students.”

Frame said she aimed to assess the impact of Dobbs on medical students applying to ob/gyn residencies. In the years after Dobbs, ob/gyn has remained competitive in the Match with all slots being filled, though Frame noted there was a dip in applications to restrictive states. Abortion laws don’t just impact training, but residents’ experience of living in those states, she said.

For this study, fourth-year medical students who applied to ob/gyn residency for the 2023 Match were surveyed with an electronic questionnaire, which was distributed to ob/gyn clerkship directors, residency program coordinators, and on social media. Respondents were asked about their experiences in medical school and applying to ob/gyn residency programs after the Dobbs decision.

Respondents represented 39 states and 10 respondents were international applicants. The average age was 27.8, 89% were women, 71% were white, 11% Black, and 59.6% were from suburban areas. Most (92%) attended an MD program and 90% of those medical schools did not have a religious affiliation. There was an equal split between students who went to public versus private medical schools and most had an ob/gyn residency at their medical school.

Frame noted a few limitations, including a small sample size of about 10% of ob/gyn resident applicants and possible selection bias, though the respondents’ demographics were representative of the national pool of ob/gyn applicants. In the future, Frame wants to analyze the data and see if there are trends between an applicant’s geographic location and residency considerations and preferences.

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