Effects of the Dobbs v Jackson Women's Health Organization Decision on Obstetrics and Gynecology Graduating Residents' Practice Plans.

To explore the association of the Dobbs v Jackson Women's Health Organization ( Dobbs ) decision on future practice locations of graduating obstetrics and gynecology residents. This is a mixed-methods survey study of obstetrics and gynecology residents graduating from sites with Ryan Program abortion training programs (109 sites) between March 8, 2023, and April 25, 2023. We conducted both univariate and multivariable logistic regression analyses to identify factors that were associated with post- Dobbs change in career plans, particularly location. We also performed a thematic analysis using responses to the survey's optional, open-ended prompt, "Please describe how the Dobbs v Jackson Women's Health Organization decision impacted your professional plans." Of an estimated 724 residents graduating from residencies with Ryan Program abortion training programs, 349 participated in the survey (48.2% response rate); 17.6% of residents indicated that the Dobbs decision changed the location of intended future practice or fellowship plans. Residents who before the Dobbs decision intended to practice in abortion-restrictive states were eight times more likely to change their practice plans than those who planned to practice in protected states before the Dobbs decision (odds ratio 8.52, 95% CI 3.81-21.0). In a thematic analysis of open-ended responses, 90 residents wrote responses related to "not living in a state with abortion restrictions." Of residents pursuing fellowship, 36 indicated that they did not rank or ranked lower programs in restrictive states. These findings demonstrate reduced desire of residents in obstetrics and gynecology to practice or pursue fellowship in restrictive states after residency. This reduction in obstetrics and gynecology workforce could significantly exacerbate maternity care deserts.

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Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

Déclaration de conflit d'intérêts

Financial Disclosure David K. Turok reports money was paid to his institution from Sebela Pharmaceuticals and Myovant. The Division of Family Planning in the University of Utah's Department of Obstetrics and Gynecology (which he directs) receives research funding from Bayer Women's Health Care, Merck & Co. Inc, Cooper Surgical, Sebela Pharmaceuticals, Femasys, Myovant, and Medicines 360. Lori M. Sawron reports the University of Utah Department of Obstetrics and Gynecology receives research funding from Sebela, Femasys, Medicines360, and Organon for studies where she serves as site PI. Jennifer E. Kaiser reports money was paid to her from the Kenneth J. Ryan residency program for an invited lecture and from the National Clinical Training Center for Family Planning. The other authors did not report any potential conflicts of interest.