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Association of State Legislation Restricting Reproductive and LGBT Rights With Infectious Diseases Fellowship Match
Michael Z Chen1, Aniruddha Hazra2, Alan L Hutchison3
1Department of Internal Medicine, University of Chicago Medical Center, Chicago, Illinois, USA.
Open Forum Infectious Diseases
|September 25, 2025
Summary
State legislation restricting reproductive and/or LGBT rights is linked to lower infectious diseases (ID) fellowship match rates in academic programs. Community-based programs were not significantly affected by these state-level restrictions.
Area of Science:
- Medical Education
- Public Health Policy
- Infectious Diseases Fellowship
Background:
- Infectious diseases (ID) fellowship match rates have seen a decade-long decline.
- Factors influencing ID interest and match rates are known, but the impact of state legislation on reproductive and/or LGBT rights remains unexamined.
Purpose of the Study:
- To investigate the association between state legislation restricting reproductive and/or LGBT rights and infectious diseases fellowship match rates in the United States.
Main Methods:
- Adult ID fellowship programs (2017-2025) were classified by location in states with or without reproductive/LGBT rights restrictions.
- Programs were further categorized by academic status: academic, university-affiliated community, or pure community.
- Match rates were compared using chi-squared tests, stratifying by state restrictions and academic status.
Main Results:
- Academic ID fellowship programs in states with restrictions had significantly lower match rates compared to those in permissive states across multiple years (P = .002 to P = .02).
- No significant differences in match rates were observed for university-affiliated community or pure community programs based on state restrictions.
Conclusions:
- Restrictive state legislation on reproductive and/or LGBT rights is associated with decreased match rates for academic infectious diseases fellowship programs.
- This finding is crucial for academic programs, which constitute the majority of ID fellowships, to consider during fellow recruitment.
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