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Future doctors show less interest in training in abortion-banning states

Future doctors show less interest in training in abortion-banning states
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The Supreme Court ruling that struck down the federal abortion law has created a patchwork of laws across the United States and widespread uncertainty. Among those with questions are the country’s future doctors.

Morgan Levy, a medical student at the University of Miami, said the impacts of the decision immediately became a topic of discussion among her peers. She will apply to residency training programs this fall, and must now assess whether the new laws will affect what and how she has taught.

“More than ever, I recognize the importance of quality, comprehensive, evidence-based reproductive health care,” said Levy, who plans to train as an obstetrician-gynecologist. In some states, however, it has become “almost impossible” to obtain formal training in family planning, including abortion practices.

“It’s definitely about making sure that the training programs I apply to will be able to provide the kind of training I’ll need to be able to do that for my patients,” she says.

And new data suggests these restrictions are impacting where — and what — future doctors plan to practice.

According to a new analysis from the Association of American Medical Colleges, the number of medical students who applied to residency training programs fell last year, and applications to programs in abortion-banning states increased. more fallen.

Interest in the obstetrics and gynecology specialty has dropped noticeably, with applications dropping 5% nationally and twice as much in states where abortion is banned. Emergency medicine has also seen a significant drop in claims.

Despite the decline in applications, all residency positions in obstetrics and gynecology and most of the others have been filled. So while there is no immediate shortage of doctors in training, experts say this shift is concerning.

“I worry about exacerbating these maternal healthcare and abortion deserts that already exist. We already have a gap,” said Dr. Kristyn Brandi, a New Jersey obstetrician-gynecologist and chair of the board of Physicians. for Reproductive Health.”For this reason, we need more obstetricians/gynecologists to join the field to help grow the practice in places where we are losing providers for other reasons.”

More than a third of U.S. counties have limited or no access to maternity care, according to a recent report — and there’s a notable overlap between maternity care deserts and states with limited abortion access. .

Most doctors stay in the region they trained. If curricula in abortion-banning states shift to less desirable educational plans, more students might prioritize residency in less restrictive states — and possibly practice.

In the long run, it could create a “multi-level health care system,” Brandi said.

However, experts say it will be important to track the preferences of medical students in the years to come. Last year’s graduating class applied for the residency programs just months after the Supreme Court ruling. They had to make decisions before seeing exactly how the programs would react and adjust.

“For the next year or two things are going to be really uncertain for people. And I think a lot of people didn’t want to get into that uncertainty, not knowing what they were getting into,” Brandi said.

For Levy and others, perhaps more important than a specific program location is evidence that there is a strong, well-established commitment to training around family planning.

“It’s really a green flag for me when programs have a really formal plan in place,” Levy said.

The Zucker School of Medicine in Hofstra/Northwell has a long history of participating in the Ryan residency training program, which focuses on abortion and family planning.

Dr. Nagaraj Gabbur, who runs the obstetrics and gynecology residency program there, said the specialist program is usually one of the main reasons applicants give for wanting to practice there – and especially during the last series of interviews.

For programs outside of “safe haven states” like New York, this could involve out-of-state rotation.

But for Brandi, rotation programs are just a “band aid” that doesn’t address the underlying issues that challenge reproductive health care — and doesn’t consider the livelihoods of each intern.

In addition, most doctors in the field of obstetrics and gynecology are women. Even if some training programs are sufficient, there might be personal concerns about living in states where abortion is banned, she says.

“It can impact not only the care they want to provide as physicians, but also the care they themselves can receive,” Brandi said.

As Levy and her peers consider a big step forward for their lives and careers, discussions about the subject are constant — and complicated.

“It’s not a black or white or red versus blue issue,” Levy said.

There are a lot of mixed emotions as people weigh in on many different factors, including clinical interests, logistics of the role, personal preference for location, and wider implications.

Some believe they should train in a state that has preserved access to abortion, while others, like Levy, believe there may be an opportunity for advocacy in more restrictive environments.

“It’s almost less about the state itself and more about the program’s attitudes and responses to the decision and how they have affirmed their commitment to ensuring that great care is provided in their states. “, said Levy.

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