Priorities of a Pro-Abortion OB/GYN Applicant:
How the Dobbs Decision Has Shaped the Match
Written by Elissa Cleland, AMSA Vice President for Internal Affairs, and M4 at Eastern Virginia Medical School
When I applied to medical school in 2021, I applied broadly. From California to Florida, geographic location mattered far less in my checklist for my education than early patient exposure and a free-run clinic. Four years later, I am applying to OB/GYN residency with a very different set of parameters.
Will I receive evidence-based medical training?
Will I be protected by my institution if I make a life-saving clinical decision for my patient in an extreme, anti-abortion state?
Will I be criminalized for providing patient-centered care?
These are not questions I anticipated having to consider at this point in my education. The hostile political environment has narrowed my options tremendously. As I scour the residency Instagrams and applicant reddits, I am noting programs’ stances on advocacy, LGBT+ support, and comprehensive abortion training. I thought I would be looking for culture between co-residents, but instead I’m ensuring programs uphold bodily autonomy. This has made the northeast and west coast programs sanctuaries for pro-abortion, aspiring OB/GYNs. They are supersaturated with applicants, providers, and also patients.
Not only do I have to be aware of state laws and institutional policies,
but even states that are safely blue are not unaffected by the overturning of Roe v. Wade.
New York City hospitals have been inundated with medical refugees, pregnant people fleeing from their totalitarian home states to receive comprehensive prenatal care. Anecdotally, residents have even warned prospective applicants away from some of these programs as they are overworked and underpaid, suffering from the undue burden of an increased patient load.
From my own experience at the start of this application cycle, abortion care is a highly-discussed topic. Attending a meet and greet for one religious institution, I was surprised that one slide was wholly dedicated to how residents still receive abortion training despite their hospital’s restrictions. The residents were emphatic that the culture was unequivocally pro-choice even amongst faculty. During the ACOG OB/GYN virtual showcase this past week, the sentiment seems to be a theme. As important as research opportunities and fellowship support, programs are equally emphasizing advocacy and DEI efforts. They seem to know this is an important priority amongst students and are catering to this shift in focus.
Another transition for OB/GYN applicants is how competitive this specialty has become. During my very first medical school lecture, OB/GYN was labeled as a mildly competitive specialty in terms of match rates and average step scores. However, in the wake of the 2025 match with only 10 unfilled positions nationwide1, my advisor has taken on a different sense of urgency and caution. Applicants that might have seemed to be safe in the past, had reportedly low interview offers this past cycle. I speculate this could be partially influenced by the switch from ERAS to ResidancyCAS in 2023 and the learning curve of program signaling. However, studies have shown that OB/GYN residencies have been increasingly competitive over the last two decades in terms of program standards and applicant metrics.
Post Dobbs v. Jackson Women’s Health Organization, states with stricter abortion bans have seen a statistically significant decrease in OB/GYN residency applicants2.
Alabama has the lowest number of women’s health providers in the nation3. Not only are they losing practicing physicians, they are also losing prospective residents. The state saw a 21.2% decrease in OB/GYN residency applicants from 2023-2024 post Dobbs, a drastic drop from the year prior4. There is an undeniable connection between abortion restrictions and OB/GYN providers and trainees. Therefore, it seems OB/GYN as a whole has not become statistically more competitive, but certain geographic regions have become highly competitive. A program that was once mid-tier might be elevated in status if the state is pro-abortion. This change in topography has been difficult to trend and has made the match highly unpredictable for OB/GYN applicants.
As the interview cycle begins, it is obvious the lasting impact the current societal conservatism has had on the landscape of medicine. Not only has it created a disparity in applicants by region, but also exacerbated health inequities across the nation. The administration has sounded the alarm for declining birth rates, yet continues to pass legislation that drives out obstetricians and limits prenatal care. Abortion is prenatal care. It ensures a birthing person won’t have to choose between motherhood and her own life. Abortion ensures a mother might have the chance to become a mother again. Although I am outraged for the women who will be abandoned in these women’s health deserts, I feel an obligation to pursue my education in a state that will expose me to comprehensive abortion training. Evidently, I am not alone in this ideal.
The burden to make these states hospitable to physicians falls solely on the shoulders of the politicians embracing religious
fanaticism and puritanism, not prospective clinicians clinging to medical ethics.
The next generation of OB/GYNs has clearly indicated what we prioritize, but will politicians hear us?
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- National resident matching program® releases the 2025 Main Residency Match® results, celebrates the next generation of Physicians. NRMP. (2025, March 21). https://www.nrmp.org/about/news/2025/03/national-resident-matching-program-releases-the-2025-main-residency-match-results-celebrates-the-next-generation-of-physicians/
- Hammoud MM, Morgan HK, George K, et al. Trends in Obstetrics and Gynecology Residency Applications in the Year After Abortion Access Changes. JAMA Netw Open. 2024;7(2):e2355017. doi:10.1001/jamanetworkopen.2023.55017
- America’s Health Rankings analysis of U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, National Plan and Provider Enumeration System, United Health Foundation, AmericasHealthRankings.org, accessed 2025.
- Rocha, A. (2024, May 21). Alabama OB-GYN residencies dropped over 20% after Dobbs, state abortion ban, says analysis. Alabama Reflector. https://alabamareflector.com/2024/05/21/alabama-medical-residencies-dropped-over-20-after-dobbs-state-abortion-ban-says-analysis/
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