Assessing the Impact of Senate Bill 8 on Texas Medical Students’ Future Specialty Choice and Intended Location of Practice

Purpose On June 24, 2022, the Supreme Court overturned their 1973 ruling on Roe v. Wade, spurring Texas to enact "trigger law” 170A, extending the ban on abortion beginning at fertilization. The goal of our research is to evaluate whether Texas medical students’ choices of women’s health related specialties such as OB-Gyn and Family Medicine (FM) and/or intended location of practice have been impacted in response to these legal changes. Although many professional organizations released statements in response to these law changes, the impact this legislature has on medical students has not been summarized. It is important to understand how medical students are influenced by legal changes in healthcare, as the future distribution and availability of physicians is dependent on their choices. Methods An anonymous, Qualtrics survey consisting of six multiple choice and one free response question was dispersed via email list-serves to all current students at the Texas College of Osteopathic Medicine in Fort Worth, Texas. Only responses from students who indicated they have ever been interested in Ob-Gyn and/or FM specialties were included in the final data set. Data was collected for four weeks and then analyzed. Results We received 200 total responses, with 163 qualifying for our final data set. Of the total respondents (n=163), 89.57% answered they intended to practice medicine in Texas prior to the overturning of Roe v. Wade, and 84.05% answered they are currently interested in practicing medicine in Texas. Regarding the decision to pursue Ob-Gyn and/or FM specialties in response to the law change, our survey shows 28.83% of students were deterred, 26.99% were encouraged, and 44.17% were not impacted. Out of those indicating their specialty choice was impacted, 51.65% (n=91) were deterred. Regarding their decision to practice in Texas, our survey shows 45% were deterred by the law changes, 18.75% were encouraged, and 36.25% were not impacted. Out of those indicating their location of choice was impacted, 70.59% (n=102) were deterred from practicing in Texas. The alternative desired locations were Colorado (10), California (17), New York (7), New Jersey (2), Illinois (2), Washington (2) or abroad. Conclusions Our data shows the majority of students’ decisions to pursue Ob-Gyn and/or FM and to practice in Texas were impacted by the overrule of Roe v. Wade, with higher percentages of students being deterred than encouraged for both decisions. Overall, there was a decrease in students who currently want to practice in Texas compared to before the legislative changes. Per answers to our free-response question, one motivation for practicing outside of Texas is wanting to practice somewhere with less limitations on women’s health care and abortion. Alternatively, some students indicated they were encouraged to remain in Texas, as an advocate for reproductive rights. Although there are many variables that influence where one practices medicine, such as family, military commitment, etc., our survey shows that the recent changes in Texas legislation play a strong role in this decision for some students.