Zaira Chavez Jimenez applied to 100 OB-GYN residencies after graduating from USC Keck School of Medicine in 2023. Her applications spanned the nation, from Washington state to Washington D.C.
She did not send any to the 14 states with total abortion bans.
“I’m Latina, I’m Spanish speaking, I would’ve loved to have applied to programs in Florida or Texas or Arizona but, like, I’m not going to go there because [abortion] is a very important part of my training,” Jimenez said.
Aspiring OB-GYN physicians pursuing an education in total-ban states can be denied the practices required to complete residency programs and enter the workforce with crucial experience.
One fall application cycle has passed since the repeal of Roe v. Wade in 2022, but medical school and residency application rates in abortion ban states have already decreased significantly.
Choosing a residency
Postgraduates must complete a residency program — a full-time training curriculum — to obtain a medical license, and more than half of post-grads end up practicing medicine in the location they complete their residency. Some physicians won’t be able to receive the full breadth of their training in states with abortion bans.
“I think the counseling, the decision making and the surgical skills are all necessary, and then if you don’t have those you’re missing a pretty significant toolkit,” Pooja Patel, a complex family planning fellow at USC’s Keck School of Medicine, told Annenberg Media.
In September 2022, the Accreditation Council for Graduate Medical Education reaffirmed that OB-GYN residency programs must provide abortion training in order to maintain accreditation. If the residency program resides in a state where abortion is illegal, arrangements must be made to receive the training in a state where it is allowed, according to the ACGME’s requirements.
“The failure to provide residents with access to clinical experience in induced abortion may lead to a citation or an Area for Improvement,” an ACGME spokesperson said in an email statement to Annenberg Media.
Jimenez, who ultimately enrolled in Keck’s OB-GYN residency program, says the conflicting regulations put patients and providers in a tough bind.
“There are patients that are being turned away and their lives are being put at risk because the doctors don’t want to be litigated,” Jimenez said.
Restrictions on abortion education have resulted in decreases in residency application rates, according to an Association of American Medical Colleges study. The declines in application rates are most prevalent among women, as reproductive freedom is both a personal and professional concern.
More women applied to OB-GYN programs, but the average number of applications per individual dropped in 2024 after four years of consistent growth.
“We had a drop of about 100,000 applications, meaning applicants are being more selective in their choices,” AAMC researcher Kendal Orgera said. “So the states that do have these restrictions in place, they [had] much bigger impacts than we originally anticipated.”
Jimenez is also a resident at Los Angeles General Medical Center. She says the hospital is receiving more out-of-state patients, and in some cases, abortion bans are actually causing the later-week abortions the laws sought to end.
“[A patient] has wanted to get an abortion since they were five weeks pregnant and they’ve gotten tossed around from state to state to state … And now they’re finally here and they’re 23 weeks [pregnant], and it’s super complicated for us to then be able to give them the care they need,” Jimenez said.
The OB-GYN specialty isn’t the only residency program that experienced application declines following the overturn of Roe v. Wade. The same study showed that emergency medicine had a 21% overall decrease in applicants in 2023 — with lower rates in many ban states — while pediatrics had a 9% decrease this year.
“Something I’ve noticed in healthcare is that usually there’s a … trickle effect, or if something happens in one [field] it tends to spread over everywhere,” Orgera said.
Trickling down to medical school
Sophia Doyle applied to 41 medical schools in June 2022, weeks before the Dobbs v. Jackson Women’s Health Organization decision said the U.S. Constitution does not confer the right to an abortion. Doyle, unsure what specialty she wanted to pursue but interested in OB-GYN training and gender-affirming care, also excluded states banning abortion from her applications.
“If something that had already gone through the Supreme Court and was protected for so long could be overthrown, what was next?” Doyle said. “There was a lot of rhetoric with birth control changes as well as gender queer rights being thrown around, which made me worry.”
Of the thirteen total-ban states included in the AAMC application data, eight of them saw a decrease in women applicants by 8% or more compared to the previous fall. Missouri experienced the greatest decline with 15%.
Florida and South Carolina enforce abortion bans at six weeks when most women are unaware they’re pregnant. In 2023, both states saw a dip in women applicants by 7% and 10%, respectfully.
Although Utah prohibits abortion after 18 weeks, it saw the greatest application drop of any state. The state had implemented a “trigger ban” to automatically outlaw abortion when Roe v. Wade was repealed, but the trigger ban and a recent law banning abortion clinics are both facing temporary injunctions and are not in effect.
Most states with abortion protections saw much smaller decreases in female applications. California, Pennsylvania and New York — home to many of America’s most competitive universities — all experienced losses of 3% or less.
Doyle, an Arizona native, enrolled at the University of Nevada, Reno. The school is located in a state that allows abortion until viability and saw a 4% increase in women applicants in 2023. This summer, she completed a gender-affirming care research program at Children’s Hospital Los Angeles, a Keck Medicine affiliate.
The second-year medical student said she faces “staggering amounts of stress, long hours and panic,” and she doesn’t want to live in fear regarding her future education and practice.
“We are taught this over and over in medical school — autonomy of the patient is sacred,” Doyle said. “Laws prohibiting abortion prohibit this autonomy and create fear for doctors to be advocates for their patients.”
The ambiguity of state laws and program curricula is leaving many women in STEM uncertain about their next step, but Doyle said she urges her peers not to get discouraged.
“I have some hope that the pendulum might swing the other way as well, because most political battles are won in cycles,” Doyle said. “We are fighting for our patients, often for their lives.”