I’m an Aspiring OB-GYN. Here Is Why I Won’t Do My Residency in Any State With an Abortion Ban.

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Half of U.S. counties have no OB-GYN, and post-Roe laws prevent new doctors from getting required training. (Nadzeya Haroshka / Getty Images)

This September, I will join thousands of medical students applying for OB-GYN residencies in states across the country. For students like me, applying to residency programs is supposed to be an exciting step towards a career in providing quality healthcare to patients in need. After four years of medical school, I am excited to put my skills to use and offer patients quality, comprehensive reproductive healthcare, including abortion care.

Unfortunately, the Supreme Court’s decision to strip away the right to safe and legal abortion has dramatically limited our opportunities to learn. As attacks on reproductive freedom and bodily autonomy escalate, it becomes ever more challenging to provide the patient care that we staunchly believe our patients need and deserve.

Applications for OB-GYN residency programs declined 5 percent nationwide after the Supreme Court struck down Roe, and more than 10 percent in states where abortion is banned.

Like many aspiring OB-GYNs, family medicine and emergency medicine physicians, I will not be applying to residency programs in states with stringent abortion bans. I need a residency program that will offer me an opportunity to build on what I have learned in medical school, and practice the skills needed to provide quality, evidence-based care—an opportunity that I would not get as a resident in any state that has banned or severely restricted abortion.

Abortion care is essential healthcare, and my training would be incomplete without the opportunity to provide these services to patients. I did not spend four years working hard in medical school to deprive myself as a resident of these essential learning opportunities. I worry that one of the many ripple effects of overturning Roe is how it undermines the education of a generation of medical students in our country. 

As president of the American Medical Student Association (AMSA), the oldest and largest independent association of physicians-in-training in the United States, I have the opportunity to connect with medical students across the country. I’m proud of the members I represent, and know our generation will continue to improve and advance the field of medicine.

However, our members are experiencing resistance from university administrators, as essential training in abortion care is discreetly eliminated from curricula. In one instance, an event featuring a local elected official that was organized by AMSA members in a state with an abortion ban was pushed to be canceled by the university. Suppressing crucial conversations—especially among constituents and future physicians with their representatives—poses a significant threat to the advancement of comprehensive and inclusive reproductive healthcare access. 

I worry that one of the many ripple effects of overturning Roe is how it undermines the education of a generation of medical students in our country. 

The U.S. faces a shortage of OB-GYNs and in fact all specialty doctors—and it’s only expected to get worse in the years ahead. I know how important access to reproductive healthcare is and I want to be part of the solution—but lawmakers in states like Georgia and Wisconsin are standing in the way.

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A protest in New York City on Nov. 6, 2021, following the passage of Texas’ six-week abortion ban the month prior. When Texas’ S.B. 8 took effect in September 2021, it was the strictest abortion ban on record. Today, more than a dozen states have banned abortions or no longer have facilities where women can receive abortions. (Lokman Vural Elibol / Anadolu Agency via Getty Images)

In states where abortion is banned or restricted, important medical decisions are guided by politics, not patients’ health and wellbeing, and providers are hamstrung by complicated and ever-changing legislation. This is not how medicine is meant to be practiced, and it puts patients and providers at risk.

In states where abortion has been banned after Roe was struck down, anti-abortion violence has surged and providers risk prosecution for providing care. Even organizations like the American Board of Obstetrics & Gynecology (ABOG), which certifies OB-GYNs across the country and supports reproductive rights, are putting providers at risk by forcing OB-GYNS to take their certifying exams in Texas, a state with severe civil and criminal penalties for those providing abortion care. Instead of preparing for their exams, providers in states across the country are concerned that they may be arrested or attacked upon arriving in Texas for the work they do in other states.  

While I want to be excited about the career ahead of me, I can’t help but struggle with the fear that I may face violent threats—even death threats—and relentless attacks on my medical and ethical integrity with little institutional support from organizations like ABOG.

As I prepare to apply for OB-GYN residency programs, I find myself disappointed with the state of reproductive freedom across the U.S., yet hopeful things will change. I know that anti-abortion extremists do not represent the majority of this country, and that four in five Americans believe abortion should be legal. I know that patients must come first, and I will proudly provide reproductive healthcare, including abortion care, to communities in need. I will not stop fighting until abortion is affordable, available and accessible to anyone who needs it.

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About

Rohini Kousalya Siva, MD, MPH, MS, is the president of the American Medical Student Association, and plans to practice obstetrics and gynecology.