Residency applications declined in states with restrictive abortion laws during the post-Dobbs period, compared to states without restrictions, signaling a potential long-term physician workforce shortage in conservative states.

A cross-sectional study found measurable declines in residency program applications in abortion-restrictive states following the 2022 Dobbs Supreme Court decision, with the gap widening year-over-year. This pattern suggests young physicians—particularly women—are actively avoiding training in states where abortion access is limited, citing reproductive autonomy and career concerns. The effect is not uniform: specialty programs in conservative states (particularly obstetrics, emergency medicine, and family medicine) reported steeper application declines than surgical specialties. Over a 10-year horizon, this creates a compounding workforce deficit: fewer trainees means fewer physicians available for employment, which increases rural healthcare gaps, extends patient wait times, and drives up locum tenens costs in already-underserved regions.

Healthcare systems, hospital networks, and independent practices in restrictive states face a dual pressure: recruiting established physicians becomes more expensive and competitive, while building a pipeline of residents becomes harder. Hospitals in these states should expect to invest heavily in loan forgiveness programs, housing subsidies, and relocation incentives to attract talent. Dental and medical practices should factor physician scarcity into partnership and recruitment strategies—hiring timelines will lengthen, and compensation demands will rise. For DSO operators in conservative markets, this is a multi-year structural headwind: practices in restrictive states may command lower valuations due to recruitment and retention risk, while independent operators may seek DSO affiliation specifically for access to centralized physician search and incentive management. The workforce gap also creates opportunity for telehealth and hybrid care models that source physicians from unrestricted states.

Monitor residency application data for your region and specialty as the 2026-2027 match season unfolds—early trends will predict 2027-2028 physician availability in your market.