Tennessee already faces a doctor shortage and a new
study by the Association of American Medical Colleges charted a sharp decline in residency applications.

Fewer rising doctors are interested in finishing their medical training in Tennessee, a concerning trend for a state already facing a physician shortage that is only projected to worsen over the next decade.

Tennessee last year saw a significant decrease in medical residency applications from medical school graduates entering the final phase of their training, according to a new study conducted by the Association of American Medical Colleges, which also found that states with strict abortion bans experienced significant decreases in applications.

These states experienced decreases specifically to obstetrics and gynecology programs, despite a slight uptick in OB-GYN interest on average nationwide. While abortion laws can vary from state to state, many can carry criminal charges for doctors and complicate required medical education in reproductive health, abortion and pregnancy care.

In 14 states with abortion bans, researchers charted a nearly 7% decrease in OB-GYN program applications.

The landscape significantly worsened in Tennessee. Tennessee’s overall residency applications declined by more than 12%. Even larger decreases were seen in the OB-GYN specialty, at a nearly 21% decrease, and pediatrics specialty, at nearly 20%.

“The primary issue is we’re already in a health care provider shortage,” said Dr. Kyla Terhune, who leads Vanderbilt University Medical Center’s graduate medical education.

Tennessee’s doctor shortage among worst

A 2020 study forecast Tennessee will be short nearly 6,000 needed doctors by 2030, one of the worst shortages in the nation. The state has made some efforts to reverse the slide, such as a 2023 law creating a pathway for international doctors to practice in the state, but it has not yet reversed the trend.

Though the AAMC study only reviewed a year of data, continued decreases in doctors looking to finish their medical training in Tennessee could exacerbate these shortages.

Legal arguments: Court hears challenge to Tennessee abortion ban for those with health risks

“Any drop at all is concerning, because that only perpetuates the shortage,” Terhune said. “Every drop is really critical.”

At the University of Tennessee Health Science Center, the pediatrics residency program saw a 10% decrease in residency applications. UTHSC pediatrics residency program director Dr. Bindiya Bagga said this mirrors a nationwide trends in pediatrics programs.

Bagga said through conversations with colleagues across the country, it seems local and state politics regarding access to reproductive health and transgender care “could certainly have played a significant role in applicant decisions, but it is hard to assign direct causality.”

Public policy plays role in recruitment

Terhune said local policies play a role in recruitment for young doctors in training who are looking not just for their future professional home, but a place to potentially start or grow their family.

“If you’re a young person at the beginning of your training, with a lot of uncertainty about your life and profession, it could impact our ability to recruit within the state,” Terhune said of Tennessee’s near-total abortion ban.

As rising doctors last year considered their residency options, Tennessee lawmakers were debating a small but significant change to the state’s abortion ban, which originally required doctors to knowingly commit a felony to perform an abortion, even to save a patient’s life. Tennessee doctors decried the state’s trigger ban as dangerous, and possibly deadly, for patients, and a severe legal burden for healthcare professionals.

Three women sue Tennessee over abortion law they say causes ‘catastrophic’ risks

In April 2023, the General Assembly passed a narrow legal exception allowing doctors to perform an abortion if their “reasonable” medical judgment finds it would prevent the death or severe injury of a pregnant patient.

“When providers face legal challenges when they’re trying to do their job, trying to provide care for individuals, that’s a very scary proposition. That’s very scary for someone beginning their training,” Terhune said. “If they have the option to be in a place where they will be protected and get the training they need for individuals they might encounter, they’re going to choose that place to train.”