State-Level Disparities in Residency Applications After Dobbs v Jackson Women's Health Organization

Area of Science:

• Medical Education
• Public Health Policy
• Healthcare Workforce Analysis

Background:

• State-level abortion policies, particularly after the Dobbs v Jackson Women's Health Organization decision, may influence healthcare professionals, including residency applicants.
• Preliminary data suggested a potential impact on residency applications based on state abortion policies.

Purpose of the Study:

• To assess gender-based disparities in residency application rates to programs in states with abortion restrictions versus non-restricted states post-Dobbs.
• To compare how these disparities vary across different medical specialties.

Main Methods:

• Cross-sectional study utilizing interrupted time-series analysis of anonymized residency application data from the Association of American Medical Colleges Electronic Residency Application Service (ERAS) (2019-2023).
• Included 4315 residency programs across all medical specialties with complete data.
• Base year for analysis was the 2020-2021 application cycle, prior to the Dobbs decision.

Main Results:

• A total of 24,193,864 applications were analyzed (43.9% from women, 56.1% from men).
• Residency applications to programs in abortion-restricted states decreased significantly for both women (-0.38) and men (-0.56) compared to non-restricted states.
• These decreases were more pronounced in abortion-related specialties and less significant in highly competitive fields.

Conclusions:

• The Dobbs decision was associated with a significant reduction in residency applications in states with abortion restrictions for both male and female applicants.
• Findings suggest that the Dobbs decision may contribute to state-level disparities within the healthcare training pipeline and future workforce.