Abstract
Using national data on outcomes of the National Resident Matching Program between 2019-2024 and a difference-in-differences approach, this study examines the effects of state abortion restrictions enabled by the US Supreme Court Decision in Dobbs v. Jackson on the supply of medical residents to training programs located in states restricting abortion. There was a significant decline in the supply of medical residents to abortion restricting states, primarily among those training in obstetrics and gynecology. Less able to fill quotas for new residents, residency programs entered subsequent Match cycles with smaller quotas and relied on comparatively less-competitive applicants to fill them. The share of female residents practicing in restrictive states also declined with the exception of more prestigious hospitals, which maintained similar cohort sex composition pre-post restriction. Findings carry both short and long-term implications for care access. Residents are a key provider for vulnerable populations, commonly staffing free and student-run clinics and taking on large shares of Medicaid and charity care patients in hospital settings, and, residency location is highly predictive of future practice patterns, so impacts on resident labor can drive long term consequences for future provider availability. Incentive programs such as loan repayment and location-specific subsidies may be useful tools in correcting reductions in the resident workforce across states where abortion is illegal.
Benjamin D. Thornburg, PhD
Postdoctoral Fellow in Health Economics
I am a health economist and fellow of the Center for Health Systems Effectiveness at Oregon Health & Science University. I use quasi-experimental methods, claims data, surveys, and other administrative information to study market structure, provider labor, and policy in behavioral and maternal healthcare.