US Medical Student Geographic Preferences for Residency Applications in Light of the Dobbs Decision.

Abstract

Background The Dobbs v Jackson Women's Health Organization decision has affected postgraduate medical education training programs. However, the degree to which it impacts residency location preferences is unknown. Objective To explore how background characteristics and psychological priming for abortion access influence medical students' residency location preferences. Methods From October to December 2023, US medical students at all training levels completed an online survey with (primed) or without (control) information emphasizing abortion access. The survey was distributed to 14 schools and via the social media platform X. Likelihood of applying to residency in 10 selected states (representing 4 abortion legality categories) was compared between primed and control groups and based on background characteristics using bivariate analysis and linear regression. Results The study was completed by 282 students. Response rate was not calculated due to unknown denominator. Mean likelihood of applying to residency where abortion is legal and protected (65.5±21.8) versus unprotected (47.3±30.1), gestationally limited (37.3±24.8), and banned (24.4±21.5) significantly differed from each other (P=.001). Control and primed groups did not differ in mean likelihood of applying to these legality categories (P>.05). Higher likelihood was observed among men applying to "gestationally limited" (34.7±23.4 vs 42.6±26.9, P<.01) and "banned" (21.5±18.2 vs 29.8±25.5, P<.01) states, and among those morally opposed to abortion (gestational limit, 34.8±23.7 vs 46.7±26.7, P<.001; banned, 20.5±18.4 vs 39±25.7, P<.001) or uninterested in reproductive medicine (gestational limit, 39.5±25.1 vs 30.1±22.4, P<.01; banned, 25.9±21.8 vs 19.2±19.7, P<.05). Higher likelihood of applying to "legally protected" states was observed among democrats (69.4±18.9 vs 57.7±25.4; P<.001) and fourth-year students (69.03±22.09; P<.05). Conclusions State preferences for residency applications were impacted by various background characteristics, but not by psychological priming.