In survey results that should surprise no one: most third- and fourth-year medical students planning to practice in obstetrics and gynecology as well as prospective surgeons and specialists in internal medicine say they do not plan to practice in states that have banned or restricted abortion.
As reported by Erika Edwards for NBC News, the survey of 494 medical students in 32 states was conducted by third-year medical student Ariana Traub, currently attending Emory University’s School of Medicine. The survey revealed 57.9% of respondents “were unlikely or very unlikely to apply to a single residency program in a state with abortion restrictions,” while over 76% said that access to abortion care would influence their decision on where they would pursue their residencies.
As Edwards reports:
The reluctance to be a medical resident — young doctors who train in hospitals or clinics after graduating medical school — in states with abortion bans could further strain health care shortages in many parts of the country.
Edwards notes that the studies’ findings dovetail with a prior survey conducted by the Association of American Medical Colleges which had already documented a “significant drop” in medical students pursuing OB-GYN residencies in forced-birth states.
Faced with the prospect of being told they cannot practice medicine the way they were taught—or even worse, face fines or imprisonment for doing so—students are naturally electing to leave or avoid those states that have criminalized or otherwise prohibited abortion care. Edwards interviewed Dr. Beverly Gray, residency director at Duke University’s School of Medicine, who explains the dilemma facing these future doctors:
"It is hard to walk into work every day and be told that you can't provide the care that might save a patient's life," Gray, of Duke University School of Medicine, said. "There's tremendous moral injury with being put in that situation, to be asked to care for people and not allowed to do the right thing."
As Edwards notes, these (mostly younger) students also weigh their own personal circumstances when deciding where to practice: “In fact, 72.7% of respondents said that abortion access changes would likely or very likely influence where they would start a family.”
Idaho’s punitive abortion restrictions, for example, have already driven many of its OB-GYNS out of the state. As the chief physician executive at Boise’s St. Luke’s Medical Center told Randi Kaye and Stephen Samaniego, reporting for CNN, “We’re at the beginning of the collapse of an entire system of care.” As NPR reporter Kamila Kudelska reports, Wyoming already has a shortage of doctors. If abortion bans currently passed by the Republican-dominated legislature take effect (pending court challenges) later this year, hospitals expect recruiting to be even harder than it already is. The same decision-making and soul-searching by prospective and current physicians described in Traub’s survey is prompting the same dire warnings right now in Kansas, Indiana, Georgia, Louisiana, South Carolina, Florida, and of course, Texas.
Ian Peake, interviewed for Edwards' article, is one of the budding OB-GYN physicians citing his state’s abortion ban as his reason for leaving:
Ian Peake is leaving his home state of Oklahoma for a similar reason. He graduates medical school Friday from the University of Oklahoma College of Medicine in Tulsa. On Monday, he'll fly to New York City, where he'll begin his OB/GYN residency at SUNY Downstate Health Sciences University.
"For me, it was very clear after the Dobbs decision and the subsequent ban in Oklahoma that this is not the place I would like to train," Peake said, preferring instead a residency in a state where he can legally "practice the full range of health care when it comes to OB/GYN."
Women and pregnant people living in these states are simply going to be on their own—or reduced to receiving substandard care—as these uniquely qualified professionals and specialists make their inevitable exodus, or, as Traub’s survey demonstrates, decide at the outset never to practice in such states at all. That is true not only for those seeking abortion care, but for those in need of medical treatment for any of a multitude of medical conditions commonly treated by these types of physicians.
There is an old principle called the “law of unintended consequences.” As explained here by Rob Norton, formerly the economics editor for Fortune magazine:
The law of unintended consequences, often cited but rarely defined, is that actions of people—and especially of government—always have effects that are unanticipated or unintended. Economists and other social scientists have heeded its power for centuries; for just as long, politicians and popular opinion have largely ignored it.
The staggering cost in terms of human suffering of this forced transformation in America’s health care system is incalculable, let alone its potentially devastating economic and social impact. It’s obvious that the conservative paladins of the United States Supreme Court never considered the real-world, medical consequences of what would actually happen when they, in their wisdom, blithely decided to eliminate the constitutional right to abortion permitted under Roe v. Wade. Nor did their Republican collaborators ever stop to consider the ramifications to people actually living in their own states when they eagerly signed on to this abominable experiment in human engineering.
But they’re all going to find out, and very soon.