When Georgia’s restrictive abortion law took effect a year ago Thursday, opponents said it would deter medical students from applying to the state’s schools for their residency programs and potentially drive out obstetrician-gynecologists.
A study by Emory University medical students found that more than three-quarters of third- and fourth-year medical students surveyed across the country said changes to abortion laws would influence where they applied for residency programs.
The unlikelihood of medical students applying to states with strict abortion laws was nearly the same for students specializing in obstetrics-genecology as it was for students planning to specialize in other fields, with OB-GYN students being slightly less likely.
The abortion law that took effect July 20 last year bans the procedure in most cases once a doctor can detect fetal cardiac activity, which is typically about six weeks into a pregnancy and before many know they are pregnant. A federal appeals court allowed the 2019 law to take effect after the U.S. Supreme Court overturned Roe v. Wade, the nearly 50-year-old ruling that allowed abortions nationwide.
It’s unclear how many — if any — OB-GYNs have left Georgia since the law took effect. The most recent data available from the Georgia Board of Healthcare Workforce, which tracks physicians in the state, is from 2020.
Emory medical students Ariana Traub and Nell Mermin-Bunnell conducted the survey last year in the days after Georgia’s abortion law took effect. The duo — along with other medical researchers from Emory, Harvard University, the University of Michigan and the Icahn School of Medicine at Mount Sinai in New York — surveyed about 500 medical students who were in their third or fourth year between Aug. 2 and Oct. 22.
Nearly 77% of those surveyed said a state’s abortion laws affected where they would apply for residency. Medical students apply to residency programs in their fourth year of medical school.
About 58% of those surveyed said they did not expect to seek residency in states with strict abortion laws, with about 31% saying they were “very unlikely.” About 31% of those surveyed said they would prefer to apply to residency programs in states with abortion restrictions, with about 16% saying they were “very likely” to apply.
Abortion laws weren’t only a large factor for students deciding where to apply for educational purposes. More than 72% of those surveyed said the laws affect where they would start a family.
“There are many personal aspects coming into play for new physicians,” Mermin-Bunnell said. “Residents are not just thinking about their ability to train and take care of patients as OB-GYN residents, but also as physicians in general — as human beings.
“The majority of medical students and residents now are women, so for both themselves and for their families and partners, they want to feel like they have access to comprehensive reproductive health care.”
Traub said the likelihood of someone applying to work in a state with restrictive abortion laws also depended on where they were currently attending medical school.
“We found that students who were already in states that did not have abortion restrictions or bans in place were much more likely to stay in those states and apply to states that did not have abortion restrictions,” Traub said.
The 494 survey responses came from medical students in 32 states. There are about 35,000 third- and fourth-year medical students in the country. About 69% of those who responded were women. According to a 2021 report from the American Medical Association, women made up about 54% of students admitted to medical school.
During the 2019 General Assembly debate over the abortion law, opponents said anything that could deter OB-GYNs from wanting to practice in Georgia would further exacerbate the state’s problem with maternal mortality. As of 2020, 82 of Georgia’s 159 counties have no OB/GYNs, while an additional 15 only have one.
Georgia has consistently ranked among the states with the worst maternal mortality rates in the nation. Earlier this month, the state Department of Public Health reported that there were 30 deaths related to pregnancy per 100,000 live births from 2018 through 2020, a 20% increase from the last report.
Dr. Tamika Sea, an OB-GYN and CEO at Advanced Women’s Care Center in Stockbridge, said the law is concerning for her and her colleagues who worry that patients who leave the state to get an abortion may have complications or not get the necessary follow-up care.
“As Georgia continues to have a major shortage of obstetricians, this does place the state at risk for residents shying away due to the restrictions, which further places strain on the existing obstetricians in the state that still practice,” she said. “Currently, I plan to reside and practice in Georgia because the need is ever-present.”
Mike Griffin, a lobbyist with the Georgia Baptist Mission Board and supporter of the law, said he didn’t think the restrictions should deter medical students from pursuing their education in Georgia.
“Abortion should not be labeled as health care anyway, in light of the Hippocratic Oath (to ‘do no harm’),” he said. “Furthermore, students who are genuinely interested in medical care should want the Hippocratic Oath honored at the highest level possible, which would necessarily include both the lives of pregnant mothers and that of their preborn children.”
Traub said she planned to apply to Emory for residency but may also apply in states with fewer abortion restrictions, such as California, where she is from.
“I would be training in a state with one of the highest maternal mortality rates in the country while having the fewest OB-GYNs as a ratio. The need is so huge,” she said. “But, also, I have family (in California) and want to have access to those reproductive health services for myself and also want to be trained in those services.
“It’s something I’m still grappling with — staying in a state where I’m very much needed like Georgia or going to a state that doesn’t have restrictions.”
About the Author
