Woodcock Alexandra L, Carter Gentry, Baayd Jami, Turok David K, Turk Jema, Sanders Jessica N, Pangasa Misha, Gawron Lori M, Kaiser Jennifer E
Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah; and Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, Bixby Center for Global Reproductive Health, San Francisco, California.
Obstet Gynecol. 2023 Nov 1;142(5):1105-1111. doi: 10.1097/AOG.0000000000005383. Epub 2023 Sep 28.
To explore the association of the Dobbs v Jackson Women's Health Organization ( Dobbs ) decision on future practice locations of graduating obstetrics and gynecology residents.
This is a mixed-methods survey study of obstetrics and gynecology residents graduating from sites with Ryan Program abortion training programs (109 sites) between March 8, 2023, and April 25, 2023. We conducted both univariate and multivariable logistic regression analyses to identify factors that were associated with post- Dobbs change in career plans, particularly location. We also performed a thematic analysis using responses to the survey's optional, open-ended prompt, "Please describe how the Dobbs v Jackson Women's Health Organization decision impacted your professional plans."
Of an estimated 724 residents graduating from residencies with Ryan Program abortion training programs, 349 participated in the survey (48.2% response rate); 17.6% of residents indicated that the Dobbs decision changed the location of intended future practice or fellowship plans. Residents who before the Dobbs decision intended to practice in abortion-restrictive states were eight times more likely to change their practice plans than those who planned to practice in protected states before the Dobbs decision (odds ratio 8.52, 95% CI 3.81-21.0). In a thematic analysis of open-ended responses, 90 residents wrote responses related to "not living in a state with abortion restrictions." Of residents pursuing fellowship, 36 indicated that they did not rank or ranked lower programs in restrictive states.
These findings demonstrate reduced desire of residents in obstetrics and gynecology to practice or pursue fellowship in restrictive states after residency. This reduction in obstetrics and gynecology workforce could significantly exacerbate maternity care deserts.
探讨多布斯诉杰克逊妇女健康组织（多布斯案）的裁决与妇产科住院医师未来执业地点之间的关联。
这是一项对2023年3月8日至2023年4月25日期间从设有瑞安项目堕胎培训项目的机构毕业的妇产科住院医师进行的混合方法调查研究。我们进行了单变量和多变量逻辑回归分析，以确定与多布斯案后职业规划变化相关的因素，尤其是地点因素。我们还对调查问卷中可选的开放式问题“请描述多布斯诉杰克逊妇女健康组织的裁决如何影响了你的职业规划”的回答进行了主题分析。
在估计724名从设有瑞安项目堕胎培训项目的住院医师培训项目毕业的住院医师中，349人参与了调查（回复率为48.2%）；17.6%的住院医师表示，多布斯案的裁决改变了他们未来执业或进修计划的地点。在多布斯案裁决前打算在限制堕胎州执业的住院医师改变执业计划的可能性是那些在多布斯案裁决前打算在有保障州执业的住院医师的8倍（比值比8.52，95%置信区间3.81 - 21.0）。在对开放式回答的主题分析中，90名住院医师撰写了与“不住在有堕胎限制的州”相关的回答。在追求进修的住院医师中，36人表示他们没有将限制堕胎州的项目列入排名或列为较低排名。
这些发现表明，妇产科住院医师在完成住院医师培训后，在限制堕胎州执业或追求进修的意愿降低。妇产科劳动力的减少可能会显著加剧产科护理荒漠问题。
