A matter of choice: a cross-sectional study examining the impact of the overturning of Roe v Wade on U.S. medical students' perceptions and career decisions

Abstract

Background: In June 2022, the Dobbs decision by the U.S. Supreme Court overturned federal abortion protections. In states with restrictive abortion laws such as Indiana, which also has the country's largest medical school and the third worst maternal mortality rate, the impact of this ruling may have a significant impact on healthcare in the state. The purpose of this study was to analyze perceptions of medical students in Indiana in their third and fourth years of education after the Dobbs decision to assess if the state's current abortion restrictions impact their career choice.

Methods: Between December 2022 and March 2023, an anonymous survey was carried out at Indiana University School of Medicine, which included questions about personal beliefs on abortion and the current abortion laws in Indiana, as well as priorities when choosing residency training and practice locations.

Results: Our survey found that four-fifths of medical students in Indiana disagreed with the Dobbs decision. While most students (71.4%) had not considered state abortion laws when selecting a medical school, since the Dobbs decision, 66.3% of third-year and 40.3% of fourth-year students indicated that they would take abortion laws into account when choosing a residency program. 47.5% of women students stated that they will be seeking residency in a state where abortion is legal and 55.3% of single students were more likely to leave Indiana to practice medicine.

Conclusion: Our research suggests that physicians who are more liberal in their views on abortion may now be much less likely to practice in conservative states which will compound the healthcare outcomes secondary to the Dobbs decision. We emphasize the role that abortion laws have in shaping the landscape of healthcare workforce and the need for a more nuanced understanding of how societal structures impact women's reproductive decisions and career paths in medicine.

Keywords: abortion; career choices; education.

Figure 1.. Impact of Dobbs Ruling on Medical Students’ Intention to Practice in Indiana After Completing Training.

A. Plans of 3 ^rd-Year Students Before the Overturning of Roe v. Wade. B. Plans of 3 ^rd-Year Students After the Overturning of Roe v. Wade. C. Plans of 4 ^th-Year Students Before the Overturning of Roe v. Wade. D. Plans of 4 ^th-Year Students After the Overturning of Roe v. Wade.