This September, tens of thousands of medical students will submit applications for their residency, a chance to apply the skills they learned in medical school to real-life hospital and clinic settings across the country. This is a major milestone not just for the new doctors, who will start to hone their specialties and plant roots in the states in which they could spend the rest of their lives, but also for the communities they enter, which depend on the next generation of physicians for quality health care.
These students factor in a wide range of criteria when deciding where to do their residency, but over the past few years, they’ve started to consider something else: the state’s abortion laws. Since the Supreme Court overturned Roe v. Wade, about half of the states have imposed abortion bans, with 12 banning abortion entirely. These bans are causing established doctors to leave and future doctors to increasingly steer clear of those states. There’s a brewing doctor shortage—often worse in states that ban abortion—and if lawmakers continue to double down on banning health care instead of investing in it, millions of people across the country will feel the pain for years to come.
As a leader in academic medicine for nearly three decades, I’ve seen firsthand how the recent wave of abortion bans has influenced where future doctors choose to learn and train. Abortion bans have forced medical schools in some states to pare back the range of health education in the classroom and in teaching hospitals and clinics, leaving students potentially unprepared not just for a career as an OB-GYN, but also for common emergency room situations, like a pregnancy complication requiring an emergency abortion to save the patient’s life.
Beyond the four years of medical education it takes to earn an MD, abortion bans are also influencing where prospective doctors choose to get their specialty training, and where they potentially choose to practice. A recent report from the Association of American Medical Colleges showed that states with abortion bans saw fewer residency applications compared to states with no bans. The discrepancy was even greater for prospective OB-GYNs. These numbers don’t just impact the lives of the medical residents, they directly harm communities in states with abortion bans.
Nearly half of doctors practice in the same state where they completed their residency. So for every student who’s deterred from practicing in a banned state, a community likely loses out on a caring, passionate medical expert. Because the number of residency applicants far outpaces available training positions (which is a key driver of the national physician shortage), most residency positions are still being filled, but not necessarily with the ideal candidate for the communities they will serve, which potentially drives up their likelihood of leaving the state to establish their practices.
The states that most heavily restrict abortion are also the ones already experiencing an acute shortage of doctors. States like Idaho, Mississippi, Oklahoma, Wyoming, and Arkansas have around 200 physicians per 100,000 residents. Nationally, that number is 272, while states with aging and complex populations need far more. This trend has been years in the making, with rural hospitals across the country steadily closing, and the overturning of Roe is only accelerating it.
Look no further than Idaho for an example of how rural states are hit especially hard. Idaho has lost over a third of its OB-GYNs since enacting an abortion ban in 2022. Outside of the seven most populous counties, there are only 23 OBGYNs to serve over half a million residents. This exodus shouldn’t be shocking, considering Idaho has been ground zero for some of the most extreme anti-abortion policies in the nation.
The state infamously went all the way up to the Supreme Court to prevent even emergency abortions, denying pregnant patients crucial care when they needed it most. This forced doctors to waste precious time trying to interpret this vaguely defined law instead of delivering the best care for their patients. Hospitals had to start regularly airlifting women to nearby states where health care was not so arbitrarily policed, and many patients needlessly suffered waiting for their condition to cross the fuzzy boundary of “life-threatening.”
Doctors don’t want to work where their judgment is constantly questioned and they face ruinous consequences—including losing their license and being sentenced to prison—just for trying to do right by their patients.
Ironically, several of these states experiencing a shortage have launched programs designed to attract and retain doctors, which have proven successful. But by limiting the ability of doctors to provide needed care to their patients, these states are discouraging many potential new doctors.
Statistics hardly paint the full picture of what a doctor shortage looks like. Overcrowded emergency rooms, being forced to drive hundreds of miles to the nearest specialist, and long wait times are just some of the realities millions of Americans already face, and that many more will start to experience because of abortion bans.
As medical students submit their residency applications over the coming weeks, lawmakers urgently need to look at the full impact of abortion bans—including the doctor shortage that is only getting worse—and take immediate action to help new doctors serve their communities.
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