Program Directors' Perspectives on the Impact of the Dobbs Supreme Court Decision on Adolescent Medicine Fellowships in the United States.

STUDY OBJECTIVE: To evaluate how the U.S. Supreme Court's Dobbs decision has affected the recruitment process and available training opportunities for abortion care among Adolescent Medicine fellowship programs. METHODS: Adolescent Medicine fellowship program directors across the United States were invited to participate in a survey gathering data regarding recruitment changes and fellow interest in and availability of abortion training, followed by qualitative interviews to contextualize program changes in the years after the Dobbs decision (2022). Results were compared between states with restrictive versus protective or permissive abortion legislation. RESULTS: Nine program directors or their designees from eight (n=8) Adolescent medicine fellowships participated in this study, representing nearly one-third of programs across the country. Programs in states with restrictive legislation quoted dwindling numbers of applicants to their programs, with very few trainees expressing interest in abortion provision. In contrast, programs in states with protective abortion legislation noted minimal changes in fellow recruitment. Arranging hands-on abortion training in crowded clinical spaces has been logistically difficult. CONCLUSION: Though most program directors in this study agreed that abortion provision is within the scope of Adolescent Medicine, the negative effects of restrictive state access in recruitment, variable interest of fellows in providing abortion care, and logistics of arranging training all posed significant barriers for training. Participants emphasized the need for widely accessible training for rising Adolescent Medicine physicians wishing to either include abortion counseling or abortion care in their practice.