Training by Travel: Medical Education for OB/GYN Residents after Dobbs

After Dobbs v. Jackson Women's Health Organization, the United States Supreme Court decision that overturned Roe v. Wade in 2022, OB/GYN residents' access to abortion training, which is required in all accredited programs, has come under pressure. To receive the foundational training doctors in the field need, many residents in ban states travel to out-of-state programs where abortion is legal. But demand is high, travel for multiple weeks is expensive, and the capacity to train at host sites is limited.Training by travel could have ripple effects for the quality of patient care. As the number of OB/GYNs continues to decrease, newly-trained providers will have different, and arguably diminished, skills in delivering not just elective but also medically necessary abortion care. And as exceptions for life and health become how legal, procedural terminations take place in one-third of the United States, there is no guarantee that the doctors in those states will feel comfortable providing that care.This article explores the residency training provided today, providers' and institutions' navigation of abortion bans, and what changes in residency programs might mean for patient care in the coming years. Part I surveys the landscape of abortion law after Dobbs; even the strictest bans contemplate instances when abortion is medically required and legally permitted. Part II summarizes the pre- and post-Dobbs expectations for abortion training for OB/GYN residents, describing how graduate medical education has changed for residents in ban states. Part III assesses shorter and longer-term effects of a system that relies on travel and simulation (the use of models) or is out of compliance with national accreditation standards. Part IV concludes with potential paths forward that depend on state and national organizations supporting and funding the networks of health care professionals that facilitate training across the country.