P3.173: State abortion access and the Match

Background: The 2025 Match showed improvement in both the total number of residency spots filled and the percentage over the 2024 Match. However, the total number and percent of spots filled by US allopathic graduates (USMDs) declined as it has for most of the last decade. Students ranking pediatric residencies take into account many factors such as program specifics like reputation and competitiveness as well as student preferences such as geography and needs of a significant other. Pediatrics is a predominantly female specialty so it is possible that concerns such as reproductive rights may also impact residency preference. This year's Match was the 3rd since the Supreme Court Dobb's case overturned Roe and the subsequent institution of abortion restrictions or bans in many states. We examined Match results by state in 2 years preceding Dobb's (2015 and 2022, the last Match before Dobb's) and this year's Match to see if there were any differences in Match rates in states with some restriction (res) versus states without any restriction (nores).

Methods: We used publicly available Match data by state in the years 2015, 2022 (the last Match year before Dobb's), and 2025 to look at trends of filled residency spots in res and nores states. Data was compared using Fisher's exact Test and p-values of <.05 were considered significant.

Results: USMDs matching in pediatrics dropped significantly from 2015 to 2022 and then 2025. There was no significant difference in overall fill rates in 2015 and 2025 between res and nores states. However, in 2025 there was a statically significant difference in fill rates in res states versus nores states in favor of res states. When looking at USMDs alone, for each year, 2015, 2022, and 2025, the match rate to nores states was higher and it was significantly higher in 2022.

Conclusion: This data only suggests an association of decreased fill rates by USMDs in states with abortion restrictions and does not show causality. It does raise the question of whether potential Pediatric residents among USMDs are considering issues such as abortion access in their rank preferences, especially when programs are becoming less competitive. The next step will be to look at this issue by gender. We acknowledge that this is a politically hot topic and including questions about this in national surveys by the AAP or ABP may not be feasible, however, assessing the impact of societal factors can help better direct efforts to address shortfalls in filling Pediatric training programs.