In September, tens of thousands of aspiring doctors will apply for residencies, an opportunity to implement the knowledge acquired in medical school within actual hospital and clinic environments nationwide. This marks a significant turning point, not only for these emerging physicians who will begin to specialize and establish themselves in their chosen states, but also for the communities they join, which rely on these future generations of medical professionals for high-quality healthcare.
While selecting residency locations, these students weigh numerous factors; however, in recent years, an additional consideration has emerged: the abortion legislation within each state. Since the Supreme Court’s decision to overturn Roe v. Wade, states have implemented abortion prohibitions, with 12 imposing complete bans. Such restrictions are prompting current practitioners to and prospective doctors to progressively avoid these states. A growing physician shortage is becoming apparent—frequently more severe in states with abortion bans—and should legislators persist in restricting healthcare rather than funding it, millions nationwide will suffer the consequences for decades.
Having served as a leader in academic medicine for almost thirty years, I have directly observed the impact of recent abortion prohibitions on where aspiring doctors opt to pursue their education and training. These bans have compelled medical schools in certain states to alter the scope of health education provided in academic settings and clinical training facilities, potentially leaving students inadequately prepared not solely for a career in OB-GYN, but also for typical emergency department scenarios, such as a pregnancy complication necessitating an urgent abortion to preserve the patient’s life.
In addition to the four years of medical school required to obtain an MD, abortion restrictions are also affecting the choices prospective physicians make regarding their specialized training and potential practice locations. A recent study by the Association of American Medical Colleges indicated that states with abortion bans received fewer residency applications than states without such prohibitions. This disparity was particularly pronounced for aspiring OB-GYNs. These statistics not only affect the careers of medical residents but also directly disadvantage communities in states with abortion bans.
A significant portion of doctors establish their practice in the same state where they finished their residency. Therefore, for each student discouraged from working in a state with abortion bans, a community potentially forfeits a dedicated and compassionate medical professional. While the number of residency applicants significantly exceeds available training spots (a primary contributor to the national physician deficit), most residency positions are still filled, though not always by the most suitable candidate for the communities they will serve, which could increase their propensity to depart the state to establish their careers.
States with the most stringent abortion regulations are also those already contending with a scarcity of doctors. For instance, Idaho, Mississippi, Oklahoma, Wyoming, and Arkansas report approximately 200 physicians per 100,000 residents. The national average stands at 272, yet states with older and more intricate populations require substantially more. This pattern has been developing over many years, with , and the reversal of Roe is merely intensifying it.
Idaho serves as a prime illustration of the severe impact on rural states. Idaho has experienced a departure of its OB-GYNs since implementing an abortion prohibition in 2022. Beyond the seven most populated counties, merely 23 OBGYNs are available to care for more than half a million inhabitants. This departure is hardly surprising, given that Idaho has been a focal point for some of the country’s most stringent .
The state controversially brought a case to the Supreme Court seeking to even emergency abortions, thereby withholding essential medical attention from pregnant patients in their time of greatest need. This compelled physicians to spend valuable time attempting to decipher this ambiguously worded legislation rather than providing optimal patient care. Hospitals were obliged to frequently transfer women to adjacent states where healthcare was not subjected to such arbitrary regulation, and numerous patients endured unnecessary suffering awaiting their condition to reach the vague threshold of “life-threatening.”
Physicians are reluctant to practice in environments where their professional judgment is routinely scrutinized and where they risk severe repercussions—such as license revocation and imprisonment—simply for attempting to provide appropriate care for their patients.
Paradoxically, several of these states facing a deficit of medical professionals possess initiatives aimed at drawing in and keeping doctors, which have shown success. However, by curtailing physicians’ capacity to offer necessary patient care, these states are deterring numerous prospective new doctors.
Mere statistics scarcely convey the complete reality of a physician shortage. Overburdened emergency departments, the necessity of traveling hundreds of miles to consult the closest specialist, and extended waiting periods represent just some of the circumstances already encountered by millions of Americans, and which many more will begin to experience as a direct result of abortion prohibitions.
With medical students submitting their residency applications in the upcoming weeks, it is imperative that lawmakers thoroughly assess the complete ramifications of abortion bans—including the exacerbating physician deficit—and promptly implement measures to assist new doctors in serving their communities.
