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Fewer doctors-in-training are applying to Kentucky programs, according to a new study

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The Association of American Medical Schools found that fewer U.S. medical school graduates are applying to Kentucky residency programs.

The study found that U.S. medical students were less likely to put in an application in states with abortion bans in place, including in Kentucky. The Commonwealth’s near-total abortion ban only allows exceptions if the mother is in imminent risk of death or permanent injury.

Dr. Atul Grover is the executive director for the Association of American Medical Schools Research and Action Institute. Through his research, Grover found that 15% fewer U.S. medical students applied to residency programs in Kentucky during the last academic year compared to the 2022-23 school year — that’s 1,050 fewer applicants across specialties.

In programs for obstetricians and gynecologists, there was an even sharper 23% decline, Grover said.

“We do see these trends across specialties though,” Grover said. “People get a little jittery around the idea that the state government is going to come in and tell you what is not appropriate care for a patient when you know otherwise.”

Grover noted that medical students overall applied to fewer schools, meaning students got pickier in where they applied. That accounts for some of the decrease in applications across states, but the remaining deficit, he said, is cause for concern — particularly to states with abortion bans.

“Health care shortages, across specialties, across a lot of states, are already being felt by patients,” Grover said. “If I think about Kentucky, Alabama, Mississippi, these are states that already have trouble attracting and recruiting, retaining physicians.”

Kentucky hospitals are already dealing with an “acute shortage” of health care workers, with nearly 13,000 job vacancies in hospitals at the end of 2022, according to the The Kentucky Hospital Association.

Grover said medical residency application numbers are one of the fastest ways to measure where doctors are moving or interested in moving. Other metrics are harder and take longer to track. Residents, the researcher said, have a tendency to stay in the state where they train.

Grover said lawmakers should understand the full implications of abortion bans, especially in a state that already suffers from several physician shortages, including in women and reproductive health fields. According to data from the U.S. Health Resources and Services Administration, more than half of Kentucky’s 120 counties don’t have a single OB/GYN specialist — whether an MD or an OD — in 2022-23.

Louisville Pediatrician Dr. Michelle Elisburg said she suspected the abortion ban would keep young doctors from training in or choosing to practice in Kentucky. Elisburg was part of a group of doctors called Kentucky Physicians for Reproductive Freedom who urged Frankfort lawmakers to end the state’s abortion bans earlier this year.

Elisburg said the bans keep students from receiving all the training they need to provide abortion care or require them travel out of state to get it.

“If there's such a ban, that restricts the kind of training that people are able to do,” Elisburg said. “They're not going to want to come to a state where they can't be completely trained in all the techniques in their field.”

She also noted that many doctors entering residency are in their mid to late 20s, and may be considering having children themselves. The bans may keep those women or their partners from considering moving to the state either.

“You wouldn't come if you're a young woman and know that if something happens to you, you might die because they aren't gonna let you get the health care you need,” Elisburg said. “That's where you are going to lose the doctors.”

Blair Wooten, who attended University of Louisville medical school, said the state’s abortion ban was one of the reasons she decided to leave the state. She ended up going to a program in Ohio for the last year.

“[Abortion medical training] is paramount to me,” Wooten said. “It's something I want to be in my practice.”

Wooten is now in the process of moving to Indiana for a different residency program, a state which has its own abortion ban. She said she’s apprehensive about returning to a place where she won’t be able to give or potentially receive medical care that she believes to be appropriate.

But her program gives students the opportunity to receive abortion training in a Detroit-based program, which eased some of her fears — and clinics in Ohio are just a few hours drive away.

“Even though I'll be in a hostile place, I'll be near places that have more open access to abortion so that people with fewer resources can still access that,” Wooten said.

Wooten said she’s not sure if she’d consider setting up a practice in a state without abortion access. She said the inability to immediately provide the care she believes is necessary would be painful, but she also wants to provide services in health care deserts.

“Family planning is something I want to be a big part of my practice, so I usually say, ‘No,’” Wooten said. “But I'm also keenly aware that people need resources in every place, especially places that are maybe a little more hostile. And they need providers who care and can help them even with limited resources.”

State government and politics reporting is supported in part by the Corporation for Public Broadcasting.

Sylvia is the Capitol reporter for Kentucky Public Radio, a collaboration including Louisville Public Media, WEKU-Lexington, WKU Public Radio and WKMS-Murray. Email her at sgoodman@lpm.org.
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