Attitudes among 2023 Urology Residency Applicants Regarding Dobbs v. Jackson Women's Health Organization
Chloe E. Peters, MD1, Casey A. Seideman, MD2, Sophie Kauderer, MPH3, John L. Gore, MD1, Akanksha Mehta, MD MS4, Eric A. Singer, MD5, Alexandra L. Tabakin, MD5, Simone Thavaseelan, MD6, Vijaya Vemnulakonda, MD7, Tasha Posid, PhD5, Danielle Velez, MD3.
1University of Washington, Seattle, WA, USA, 2Oregon Health & Science University, Portland, OR, USA, 3Robert Wood Johnson University Hospital, New Brunswick, NJ, USA, 4Emory University School of Medicine, Atlanta, GA, USA, 5The Ohio State University Wexner Medical Center, Columbus, OH, USA, 6Brown University, Providence, RI, USA, 7University of Colorado School of Medicine, Aurora, CO, USA.
BackgroundIn June 2022, the U.S. Supreme Court ruling Dobbs v. Jackson Women's Health Organization overturned Roe v. Wade and declared there is no constitutional right to abortion. Twelve states have subsequently passed total abortion bans. We surveyed applicants to the 2023 Urology Residency Match to examine attitudes towards the Dobbs decision and its impact on professional decision-making. Methods An IRB-exempt REDCap survey was distributed by the Society of Academic Urologists (SAU) following the rank list submission deadline on January 10, 2023. The survey closed on February 1, 2023. Participants were applicants to the 2023 Urology Match over age 18. Responses were anonymous, collected in aggregate, and characterized using descriptive statistics. Results Of 508 applicants, 215 (42%) completed the survey (Table 1). Notably, 88% of participants disapprove of the Dobbs ruling, with 25% of respondents reporting that the Dobbs verdict has factored into their decision to apply or not apply to certain programs. 20% of respondents (15% of male vs. 24% of female) eliminated programs in states where abortion is illegal and 34% (25% of male vs. 44% of female) considered doing so.
Overall, 59% (51% of male vs. 70% of female) reported they would be concerned for their or their partner's health and safety were they to match into a program in a state where abortion was illegal and 66% (55% of male vs. 82% of female) would want their program to assist them or their partner should they require abortion care during their residency. Although applicants' decisions on residency program selection are multifactorial, 36% reported access to reproductive healthcare as moderately/extremely important. Due to the competitive nature of urology, 68% of applicants reported feeling somewhat obligated to apply to programs in states where abortion legislation conflicts with the applicant's own beliefs.
Conclusion The Dobbs ruling is showing early impact on the urology workforce distribution by substantially affecting urology applicants' decision-making regarding residency selection and ranking. Although the competitiveness of Urology pressures applicants to apply broadly, many are still taking reproductive healthcare access into consideration. A majority of respondents want support from their program should they or their partner require abortion care during residency.
Table 1: Demographic information*Includes Native American/Alaska Native, Middle Eastern, multiracial, and other**Includes Buddhist, Hindu, and other
| Demographics | n (%) |
| Total Respondents | 215 |
| Age in years [median (IQR)] | 27 (26-29) |
| Gender | |
| Female | 84 (39.1) |
| Male | 126 (58.6) |
| Non-binary | 3 (1.3) |
| Decline to state | 2 (1.0) |
| Race/Ethnicity | |
| Asian/Pacific Islander | 36 (16.7) |
| Black | 10 (4.7) |
| White | 143 (66.5) |
| Hispanic/Latino | 18 (8.4) |
| Other* | 8 (3.7) |
| Relationship Status | |
| Single | 102 (47.4) |
| Married/partnered | 113 (52.6) |
| Religion | |
| Atheist/agnostic | 71 (33) |
| Christian (all denominations) | 74 (34.5) |
| Muslim | 11 (5.1) |
| Jewish | 19 (8.8) |
| Other** | 21 (9.8) |
| Decline to state | 19 (8.8) |
| Prior urology applicant? | |
| No | 178 (82.8) |
| Yes | 37 (17.2) |
| Applied to additional specialty? | |
| No | 172 (80) |
| Yes | 43 (20) |
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