Almost two-thirds of residents in US family medicine programs are training in states that have abortion restrictions

Researchers performed an analysis to assess the proportion of accredited U.S. family medicine residency programs and trainees in states with abortion restrictions. Of 693 accredited family medicine residency programs in the U.S., 201 programs (29%) were in states where abortion was banned or heavily restricted as of August 2, 2023. Fourteen of the 17 states in this category had complete abortion bans.

While most (63.8%) family medicine residency programs were in states with at least some abortion restrictions, 251 programs (36.2%) were in states with laws protecting abortion. Of the

13,541 residents in accredited U.S. family medicine programs, 3,930 (29%) were training in states that had banned abortion or where abortion was very restricted and 5,020 residents

(37.1%) were in states with protective policies. Most residency programs with abortion training (85%) were in states with protective abortion policies. 

What We Know: There is substantial evidence that abortion training in family medicine residency is safe and appropriate. Additionally, there has been increased appreciation of a family physician’s role in abortion provision, especially because family physicians practice in communities where they may be the only doctor. Though state-level abortion restrictions likely impact family medicine residency training in abortion, post-abortion care, pregnancy options counseling, and early pregnancy loss (EPL) management, the extent of this impact was previously unknown.

What This Study Adds: Nearly one-third of residents in accredited U.S. family medicine programs are training in states that banned abortion or where abortion was very restricted. The overturning of Roe v. Wade will impact family medicine residency training and have long-term effects on family physicians’ ability to provide abortion and follow-up care, manage EPL, and care for patient and community reproductive health needs. The researchers suggest that the Accreditation Council for Graduate Medical Education may be able to mitigate this effect by establishing explicit family medicine requirements for developing skills in comprehensive reproductive health care, regardless of policy environment. They also assert that individual residency program leadership teams, as well as family medicine organizations, must work to optimize training in restrictive states and expand abortion training where possible to promote high-quality, equitable reproductive health care in the context of abortion restrictions.

Implications of Overturning Roe v Wade on Abortion Training in US Family Medicine Residency Programs

Sarah Wulf, MPH, et al

Person-Centered Reproductive Health Program, Department of Family and Community Medicine, University of California, San Francisco, California

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