Florida records drop in doctor residency applicants post-Roe v. Wade

Ritu Sidgal volunteered at a hospice in California in high school, reading to patients and offering bedside comfort.

After attending college in Missouri to study biology and global health, she applied to medical schools and eventually moved to Tampa, enrolling at the University of South Florida. She won’t graduate until 2027 but she’s already thinking of specializing in women’s reproductive health care as an obstetrician-gynecologist.

“I did very early on fall in love with the idea of healing and medicine and helping others through service,” said Sidgal, 23.

To become an OB-GYN, Sidgal must complete a postgraduate program known as residency, where new doctors gain hands-on experience in a particular field. Whether she tries to stay in Florida for residency may hinge on the state’s strict abortion rules, which bar the procedure after six weeks of pregnancy with limited exceptions.

“If I were able to practice in a state like New York or California, that would be the most ideal,” Sidgal said, because she would get “the best form” of training.

Early data suggest Sidgal might not be alone in weighing abortion restrictions when deciding where to apply for residency, sparking concern that communities in Florida and similar states could face challenges in recruiting young doctors.

In the two residency application cycles following the U.S. Supreme Court’s overturning of Roe v. Wade in 2022, states with near-total abortion bans saw larger year-over-year declines in residency applicants compared to states where the procedure is legal — and states with gestational limits, such as Florida, saw a greater decrease in applicants compared to legal states during the second cycle but not the first, according to an analysis by researchers at the nonprofit Association of American Medical Colleges.

States with complete bans logged drops of 3.3% in the 2022-23 application cycle and 4.2% in the past year, while states where abortion remains legal reported declines of 1.9% and 0.6%. Gestational limit states saw downturns of 1.9% for both application cycles. Florida recorded decreases of 0.7% in 2022-23 and 9.7% in the past year. The analysis was conducted before the Sunshine State’s six-week abortion ban took effect in May. It focused on graduates from U.S. medical schools and didn’t include osteopathic physicians.

The majority of doctors stay in the states where they complete residency, and the researchers warned that “continued decreased interest” in training in states with abortion bans or restrictions “may negatively affect access to care,” especially in communities that already have limited options for medical treatment, such as in rural areas and in marginalized racial and ethnic groups.

‘Far-reaching consequences’ or ‘assumptions’?

The analysis has drawn different reactions from those on opposite sides of the abortion debate.

State Sen. Lauren Book, the Senate minority leader, in a statement to the Tampa Bay Times said the findings are “deeply concerning and highlight the far-reaching consequences of abortion bans.”

“When medical professionals choose not to practice in certain states due to restrictive laws, it creates a ripple effect, diminishing access to quality care for all residents and lowering our quality of life,” said Book, D-Davie, who opposed Florida’s six-week ban.

She said it’s “yet another reason” to vote yes on Amendment 4 in November, which would protect abortion access in Florida until viability, which is estimated to be at about 24 weeks of pregnancy.

Barbara Zdravecky, interim chief executive officer of Planned Parenthood of Southwest and Central Florida, said it’s a “natural reaction” for new doctors to avoid Florida and states with bans because of a “lack of opportunity to practice what they have been taught and to take care of patients.”

But state Senate President Kathleen Passidomo, R-Naples, in an email noted a key limitation of the analysis: the researchers didn’t survey medical school students to understand their motivations for applying to certain residency programs.

“It is completely irresponsible to suggest to Floridians that laws which protect the lives of children lost through abortion would lead to fewer practitioners in our state,” Passidomo said.

The authors’ conclusions, she said, are based “purely on assumptions, not facts.”

“This is a scare tactic being pushed by radical pro-abortion advocates to gain support for Amendment 4,” she said.

Passidomo championed a package of bills this past legislative session, known as “Live Healthy,” that sought to bolster Florida’s health care workforce, in part by paying for at least 500 new residency slots in the state.

A spokesperson for Gov. Ron DeSantis declined to comment on the analysis.

Florida is facing a doctor shortage. In 2030, the supply of family medicine and pediatric doctors is expected to meet only 62% and 75% of demand, respectively, according to a report from the nonprofit Florida TaxWatch, a taxpayer advocacy group in Tallahassee. And the state is projected to have a shortfall of almost 500 OB-GYNs by 2035, according to a report commissioned by the Safety Net Hospital Alliance of Florida and the Florida Hospital Association. Both reports were released before DeSantis signed the Live Healthy legislation.

During the 2023-24 residency application cycle, Florida saw a year-over-year decrease of 23.3% in OB-GYN applicants, according to the analysis from the Washington, D.C.-based Association of American Medical Colleges. Alabama, Arizona, California, Missouri and Tennessee recorded similar declines.

Still, the number of residency applicants continued to exceed available positions nationally, and match rates remained high, including in Florida.

The next residency application cycle begins in September. With the state’s six-week ban now in effect, “this is something we will be looking at closely,” Jessica Heft, the OB-GYN residency program director at the University of Florida College of Medicine, said in an email.

A complicated decision

Kendal Orgera, one of the authors of the Association of American Medical Colleges analysis, acknowledged that it’s still unclear why medical students made the choices they did. A separate survey of graduates should provide insight, with findings expected to be released in September, Orgera said.

Deciding where to apply for residency can be complicated.

Sidgal, the University of South Florida student, said she will keep an open mind, noting that residency is highly competitive and she will factor in things like proximity to family and cost of living. “I do want to maximize my chances of matching,” she said.

For now, she aims to avoid states with near-total abortion bans such as Alabama, Oklahoma and Texas, but might be open to training in states that have gestational limits, including Florida and Utah. States such as California and New York are preferable, she said.

Not everyone is wary of staying in Florida. Julyssa Renteria, 24, is interested in becoming an OB-GYN and feels compelled to remain in the state for residency because of its abortion restrictions.

Renteria grew up near Los Angeles and studied biology during college. She volunteered at a California hospital and enjoyed the experience of talking to patients and handing out food and water. She applied to medical schools and got accepted at the University of South Florida.

“A lot of people are like, ‘Julyssa, are you crazy? Why don’t you just try to get back to California?’ or ‘Why would you stay in Florida?’” said Renteria, who will graduate in 2027. “Ultimately, it just comes down to the need. ... If there’s no OB-GYNs, it doesn’t just extend to abortion care, it extends to maternal care. It extends to things like uterine fibroids or cancer.

“Patients need you to be there for them.”