Politics and Pediatrics: State political policies' impact on pediatrics residency application and future practice decisions.

Authors

Rebecca Hart
Ancil J Abney
Heather Haq
Joni Hemond
Miranda Hillard, Corewell Health West
Jennifer Hoefert
Rupa Kapoor
Jen Makrides
Lauren B Nassetta
Lauren Swift

Document Type

Article

Publication Date

2-10-2026

Publication Title

Academic Pediatrics

Abstract

BACKGROUND: Understanding whether political policies influence residents' training and career decision-making is critical to address pediatric workforce concerns.

METHODS: We surveyed pediatrics residents on factors influencing residency application/ranking decisions (interns only) and future practice plans (all). Respondents reporting "state political policies" as an influence identified which specific topics affected them, the degree and direction of influence, and reasons for this influence. Responses were analyzed using standard descriptive statistics and compared by respondent demographics; open-ended responses were analyzed for common themes.

RESULTS: 652 residents from 18 US programs received surveys; 215 (33.0%) responded. Of 66 interns, 35 (53.0%) reported that state political policies influenced their application/ranking decisions. Most were somewhat/much less likely to apply/rank programs in states restricting abortion (n = 24, 68.6%); reproductive healthcare (n = 23, 65.7%), or gender-affirming care (n = 22, 62.9%). Many respondents (81%) indicated at least one political policy would influence future practice decisions; most were less likely to practice in states restricting reproductive health (n = 134, 76.6%), abortion (n = 129, 73.7%), gender-affirming care (n = 118, 67.4%), and LGBTQIA+ rights (n = 118, 67.4%). Common reasons included access to care and physician autonomy. Residents who self-identified as more progressive (OR 0.11, 95% CI 0.02-0.49) or planned to start families within 3-5 years (OR 0.25, 95% CI 0.06-0.89) were less likely to plan future practice in states with restrictive policies.

CONCLUSIONS: State political policies significantly impact pediatrics residents' decision-making around residency applications and ranking, as well as future practice decisions.

First Page

103240

Last Page

103240

Recommended Citation

Hart R, Abney AJ, Haq H, Hemond J, Hillard M, Hoefert J, et al. Politics and Pediatrics: State political policies' impact on pediatrics residency application and future practice decisions. Acad Pediatr. 2026:103240. doi: 10.1016/j.acap.2026.103240. PMID: 41679542

Comments

Helen DeVos Children's Hospital

DOI

10.1016/j.acap.2026.103240

ISSN

1876-2867

PubMed ID

41679542