Fewer U.S. medical school graduates are applying to residency programs, but the drop is more striking in states that ban abortion compared with other states.

Figures released Thursday by the Association of American Medical Colleges showed continuing declines after the group first spotted the difference in an analysis last year.

“It looks even more pronounced. So now, I’m looking at a trend,” said Dr. Atul Grover, a co-author of the latest report.

The number of applicants to these post-graduate training programs dropped slightly across the board from spring of 2023 to spring of 2024, with larger decreases seen in states with abortion bans. Those states saw a drop of 4.2% from the previous application cycle, compared with 0.6 % in states where abortion is legal.

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Similarly, states with abortion bans saw a 6.7% drop in OB-GYN applicants year over year, while states without abortion restrictions saw a 0.4% increase in OB-GYN applicants. The group only looked at graduates from U.S. medical schools, not those from osteopathic or international medical schools.

More study is needed to understand why medical students aren’t applying to certain residency programs. “But it certainly looks like this change in reproductive health laws and regulations is having an effect on where new physicians are choosing to train,” Grover said.

In 2022, the Supreme Court overturned Roe v. Wade, paving the way for abortion bans in states.

Dr. AnnaMarie Connolly, chief of education and academic affairs for the American College of Obstetricians and Gynecologists, said in a statement that patients may ultimately suffer.

Medical students choosing where to apply to residency programs “are making a commitment to the community to work and to live there for years while they train,” she said, adding that they will care for thousands of patients during that time and may wind up practicing there.