State abortion bans are driving away future doctors

Since the Supreme Court overturned Roe v. Wade last year, there have been clear aftereffects, not just for people actively seeking abortions but also for those who want to live in states that protect abortion access. Advocates have long talked about the economic implications of securing access to abortion; beyond the individual impact on abortion seekers, state-level restrictions cost the U.S. economy more than $105 billion annually, according to a 2021 report by the Institute for Women’s Policy Research. Over the past year, the issue of abortion rights has also started driving talent away from states where abortion has been banned or severely restricted.

The findings from a study published today in the Journal of Medical Ethics indicate that this upheaval is taking hold among budding physicians: In a survey of nearly 500 third- and fourth-year students across 125 medical schools, an overwhelming majority reported that state-level abortion access would be a major factor in their decision to apply to a residency program. Many of them pointed to the quality of their medical training and ability to serve patients, as well as personal access to abortion care. (Women account for nearly 54% of all U.S. medical students and almost half of all residents, according to the Association of American Medical Colleges; in this study, however, just over 68% of respondents identified as women.)

Nearly all respondents said their choice of residency would be influenced by personal considerations, including their lifestyle preferences and proximity to family. But most of them also cited concerns like the patient population and state healthcare policies, with 77% saying abortion access, in particular, would likely impact their decision on where to apply for residency. More than half (58%) said they were unlikely to apply for a residency program in a state with abortion restrictions. (That said, only about 31% of respondents did not apply to programs in states with abortion restrictions—which the study’s authors note may be because of the intense competition for residency spots and the rapid pace at which state abortion laws were evolving in late 2022, when they were surveyed.)

These responses signal a looming brain drain across medicine—one that has already been set into motion in states like Idaho, which has reportedly seen an exodus of OB-GYNs and other doctors after the state banned abortion last year. A recent report published in Obstetrics & Gynecology, which surveyed nearly 350 obstetricians and gynecologists in 37 states who graduated this year, found that more than 17% had changed their plans for where they would practice or pursue fellowships, following the Supreme Court’s decision.

It’s not just the healthcare workforce that is being shaped by the fallout from Roe being overturned. Major corporations from Google to Salesforce have offered to pay for abortion care for their employees or even foot relocation costs if they live in a state hostile to abortion rights, and governors in more progressive states have tried to court businesses by using their strong abortion rights as a selling point. It may take a few years to see the long-term impact on the labor force and business community in states with the most extreme anti-abortion laws—but it’s safe to say the fall of Roe has led to consequences that many anti-abortion activists did not anticipate.