Laura Baecher-Lind, Jeffrey B Bird, Samara B Ginzburg, Stephanie Mann, Elizabeth M Petty, Courtney A Schreiber, Amy S Gottlieb
{"title":"国家生殖健康法律与医科毕业生的专业选择和居住地选择。","authors":"Laura Baecher-Lind, Jeffrey B Bird, Samara B Ginzburg, Stephanie Mann, Elizabeth M Petty, Courtney A Schreiber, Amy S Gottlieb","doi":"10.1097/ACM.0000000000006092","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To explore the relationship between state restrictions on reproductive health access and students' decision-making regarding specialty choice and residency location.</p><p><strong>Method: </strong>The authors analyzed 2024 Graduation Questionnaire (GQ) data from medical students graduating from U.S. MD-granting medical schools pursuing all specialties. Abortion restrictiveness classifications were based on the Guttmacher Institute's US Abortion Policies and Access After Roe map.</p><p><strong>Results: </strong>Over half (7,855/15,513; 50.6%) and one-third (5,255/15,520; 33.9%) of all students reported state laws about reproductive health services influenced where they applied for residency and their choice of specialty, respectively, to some degree. Women were approximately twice as likely to report reproductive laws influenced their decisions, compared with men (specialty choice: relative risk [RR], 2.04; 95% confidence interval [CI], 1.94-2.15; residency location: RR, 1.70; 95% CI, 1.64-1.77; both P < .001). Students completing medical school in abortion protective (RR, 1.15; 95% CI, 1.12-1.19) or intermediate (RR, 1.14; 95% CI, 1.07-1.21) states were more likely to report being influenced by state laws when deciding where to pursue residency, compared with students in restrictive states (both P < .001). Students pursuing obstetrics and gynecology (ObGyn), family medicine (FM), or emergency medicine (EM) residencies were more influenced by state laws when choosing their specialty (ObGyn: RR, 2.45; 95% CI, 2.35-2.56, P < .001; FM: RR, 1.65; 95% CI, 1.56-1.74, P < .001; EM: RR, 1.11; 95% CI, 1.02-1.20, P = .02) and where to apply for residency (ObGyn: RR, 1.87; 95% CI, 1.83-1.93, P < .001; FM: RR, 1.30; 95% CI, 1.25-1.36, P < .001; EM: RR, 1.08; 95% CI, 1.02-1.15, P = .01), compared with students pursuing other specialties.</p><p><strong>Conclusions: </strong>This study provides further evidence that restrictions on abortion care are likely to impede efforts to develop a future physician workforce capable of reducing health care inequities and improving maternal health outcomes.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":""},"PeriodicalIF":5.3000,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"State Laws on Reproductive Health and Graduating Medical Students' Choice of Specialty and Residency Location.\",\"authors\":\"Laura Baecher-Lind, Jeffrey B Bird, Samara B Ginzburg, Stephanie Mann, Elizabeth M Petty, Courtney A Schreiber, Amy S Gottlieb\",\"doi\":\"10.1097/ACM.0000000000006092\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To explore the relationship between state restrictions on reproductive health access and students' decision-making regarding specialty choice and residency location.</p><p><strong>Method: </strong>The authors analyzed 2024 Graduation Questionnaire (GQ) data from medical students graduating from U.S. MD-granting medical schools pursuing all specialties. Abortion restrictiveness classifications were based on the Guttmacher Institute's US Abortion Policies and Access After Roe map.</p><p><strong>Results: </strong>Over half (7,855/15,513; 50.6%) and one-third (5,255/15,520; 33.9%) of all students reported state laws about reproductive health services influenced where they applied for residency and their choice of specialty, respectively, to some degree. Women were approximately twice as likely to report reproductive laws influenced their decisions, compared with men (specialty choice: relative risk [RR], 2.04; 95% confidence interval [CI], 1.94-2.15; residency location: RR, 1.70; 95% CI, 1.64-1.77; both P < .001). Students completing medical school in abortion protective (RR, 1.15; 95% CI, 1.12-1.19) or intermediate (RR, 1.14; 95% CI, 1.07-1.21) states were more likely to report being influenced by state laws when deciding where to pursue residency, compared with students in restrictive states (both P < .001). Students pursuing obstetrics and gynecology (ObGyn), family medicine (FM), or emergency medicine (EM) residencies were more influenced by state laws when choosing their specialty (ObGyn: RR, 2.45; 95% CI, 2.35-2.56, P < .001; FM: RR, 1.65; 95% CI, 1.56-1.74, P < .001; EM: RR, 1.11; 95% CI, 1.02-1.20, P = .02) and where to apply for residency (ObGyn: RR, 1.87; 95% CI, 1.83-1.93, P < .001; FM: RR, 1.30; 95% CI, 1.25-1.36, P < .001; EM: RR, 1.08; 95% CI, 1.02-1.15, P = .01), compared with students pursuing other specialties.</p><p><strong>Conclusions: </strong>This study provides further evidence that restrictions on abortion care are likely to impede efforts to develop a future physician workforce capable of reducing health care inequities and improving maternal health outcomes.</p>\",\"PeriodicalId\":50929,\"journal\":{\"name\":\"Academic Medicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.3000,\"publicationDate\":\"2025-05-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Academic Medicine\",\"FirstCategoryId\":\"95\",\"ListUrlMain\":\"https://doi.org/10.1097/ACM.0000000000006092\",\"RegionNum\":2,\"RegionCategory\":\"教育学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"EDUCATION, SCIENTIFIC DISCIPLINES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Academic Medicine","FirstCategoryId":"95","ListUrlMain":"https://doi.org/10.1097/ACM.0000000000006092","RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"EDUCATION, SCIENTIFIC DISCIPLINES","Score":null,"Total":0}
State Laws on Reproductive Health and Graduating Medical Students' Choice of Specialty and Residency Location.
Purpose: To explore the relationship between state restrictions on reproductive health access and students' decision-making regarding specialty choice and residency location.
Method: The authors analyzed 2024 Graduation Questionnaire (GQ) data from medical students graduating from U.S. MD-granting medical schools pursuing all specialties. Abortion restrictiveness classifications were based on the Guttmacher Institute's US Abortion Policies and Access After Roe map.
Results: Over half (7,855/15,513; 50.6%) and one-third (5,255/15,520; 33.9%) of all students reported state laws about reproductive health services influenced where they applied for residency and their choice of specialty, respectively, to some degree. Women were approximately twice as likely to report reproductive laws influenced their decisions, compared with men (specialty choice: relative risk [RR], 2.04; 95% confidence interval [CI], 1.94-2.15; residency location: RR, 1.70; 95% CI, 1.64-1.77; both P < .001). Students completing medical school in abortion protective (RR, 1.15; 95% CI, 1.12-1.19) or intermediate (RR, 1.14; 95% CI, 1.07-1.21) states were more likely to report being influenced by state laws when deciding where to pursue residency, compared with students in restrictive states (both P < .001). Students pursuing obstetrics and gynecology (ObGyn), family medicine (FM), or emergency medicine (EM) residencies were more influenced by state laws when choosing their specialty (ObGyn: RR, 2.45; 95% CI, 2.35-2.56, P < .001; FM: RR, 1.65; 95% CI, 1.56-1.74, P < .001; EM: RR, 1.11; 95% CI, 1.02-1.20, P = .02) and where to apply for residency (ObGyn: RR, 1.87; 95% CI, 1.83-1.93, P < .001; FM: RR, 1.30; 95% CI, 1.25-1.36, P < .001; EM: RR, 1.08; 95% CI, 1.02-1.15, P = .01), compared with students pursuing other specialties.
Conclusions: This study provides further evidence that restrictions on abortion care are likely to impede efforts to develop a future physician workforce capable of reducing health care inequities and improving maternal health outcomes.
期刊介绍：
Academic Medicine, the official peer-reviewed journal of the Association of American Medical Colleges, acts as an international forum for exchanging ideas, information, and strategies to address the significant challenges in academic medicine. The journal covers areas such as research, education, clinical care, community collaboration, and leadership, with a commitment to serving the public interest.
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