Abortion Bans Are Driving Medical Residents Away and Deepening Doctor Shortages

Tens of thousands of medical students preparing to submit residency applications this September are factoring state abortion laws into where they will train, contributing to a growing doctor shortage in states that have restricted or banned abortion. Health care leaders and recent data point to fewer residency applications in states with bans, a decline most pronounced among prospective obstetrician-gynecologists.

A recent report from the Association of American Medical Colleges found that states with abortion bans saw lower rates of residency applications compared with states without bans. The discrepancy was larger for applicants to OB-GYN programs. Because nearly half of physicians eventually practice in the same state where they completed residency, fewer applicants choosing to train in restrictive states is likely to translate into fewer practicing physicians in those communities over time.

Medical school and hospital leaders say the overturning of Roe v. Wade and subsequent state bans have also reduced the breadth of reproductive health education available in some training programs. In several states that limited or banned abortion, medical schools and teaching hospitals curtailed clinical experiences and classroom instruction related to abortion care, they say, leaving students potentially less prepared to manage pregnancy complications that sometimes require an emergency termination to protect a patient’s health.

Residency capacity nationwide remains constrained: the number of applicants far outpaces available training positions, a structural factor contributing to the national physician shortage. Most residency slots are still filled, but program directors report that restrictive policies make it harder to recruit ideal candidates for the communities they serve, which can increase the likelihood residents later leave the state to practice.

The shortage is already acute in parts of the country that adopted strict abortion restrictions. States including Idaho, Mississippi, Oklahoma, Wyoming and Arkansas have roughly 200 physicians per 100,000 residents, compared with a national average of about 272 per 100,000. Those figures are driven in part by aging populations and higher local health needs in some states.

Idaho offers a stark illustration. Leaders in the state say the number of practicing OB-GYNs has fallen sharply since the state enacted an abortion ban in 2022; the state has lost more than a third of its OB-GYN workforce, according to local health officials. Outside the seven most populous counties, there are only 23 OB-GYNs to serve more than half a million residents, health system data show.

Physicians and hospital administrators cited legal uncertainty and the prospect of criminal and licensing penalties as factors in decisions to leave or avoid practicing in some states. In high-profile legal fights, some states have aggressively restricted clinicians’ ability to perform abortion care, and courts have been asked to consider whether those restrictions apply even in emergency medical situations. Hospital leaders said those disputes have led to delays in care while clinicians and legal teams sought clarity, and in some cases to airlifts of patients to hospitals in neighboring states.

States facing shortages have pursued programs to recruit and retain physicians, including loan repayment and incentive packages, and some of those programs have had success in the past. But program directors and academic leaders said restrictive reproductive health policies can undercut recruitment efforts by limiting clinical training opportunities and prompting potential recruits to look elsewhere.

The effects are being felt beyond OB-GYN departments. Rural hospitals have been closing for years, and experts say cuts to reproductive health training and physician departures can strain emergency departments, increase wait times, and force patients to travel longer distances for specialty care. Overcrowded emergency rooms, longer waits for appointments and reduced local access to specialists are among the practical consequences described by clinicians and health system officials.

Medical educators and hospital leaders urge policymakers to consider how laws governing reproductive health affect the medical workforce, medical education and health care access. They note that as residency application season approaches, the choices of where students apply and ultimately train will shape the distribution of physicians for decades.

Lawmakers in states with restrictive policies face a complex set of trade-offs, officials say: efforts to attract physicians through financial incentives may be undermined if clinical practice is constrained by law. Advocates for medical education stress that preserving comprehensive training is central to maintaining local access to emergency and routine care.

Experts caution that the full effects of recent policy changes will unfold over years. For now, residency application data and local workforce trends show a pattern: restrictions on abortion are one among several factors influencing where doctors choose to train and practice, and those choices are contributing to a widening gap between physician supply and community needs in parts of the country.