Elizabeth first realized that she wanted to become a doctor after her aunt was diagnosed with ovarian cancer. She saw just how little was known about the disease—and ob-gyn care in general—and wanted to make a difference. But after the Supreme Court overturned Roe v. Wade this past summer, she’s one of the countless aspiring physicians across the country forced to rethink their future.

Now a first-year medical student, Elizabeth learned about the leaked draft of the Dobbs v. Jackson Women’s Health Organization decision only a month before arriving on campus. Her stomach dropped. “I don’t wanna go to jail…. I don’t want to tell someone like, ‘Oh sorry, there’s nothing I could do. My hands are tied.’”

Many medical students now have to decide whether or not they want to continue working toward a profession that will be policed by the state and vilified by the increasingly powerful anti-abortion movement. Abortion is still protected in Virginia, where Elizabeth goes to college, but Governor Glenn Youngkin has repeatedly promised to sign a 15-week ban, while other Republicans have proposed an even more extreme “life at conception” bill.

Medical Students for Choice had been preparing for the end of Roe for years. The nonprofit is dedicated to increasing access by providing abortion training, family planning education, and opportunities for student organizing around the topic of reproductive justice. Concerned with the limited options medical students now have for rigorous abortion training—especially in states where bounty laws or potential travel restrictions could criminalize the very act of receiving it—the organization has focused on providing support to medical students caught in a rapidly shifting legal landscape.

Like Elizabeth, the gutting of national abortion rights with Dobbs has left other students concerned about their access to robust abortion training and their ability to act as good physicians in the places that need it most. “Many of our members are just horrified that they’re not going to be able to provide care in the South, the Deep South, or the Midwest, where there really is the greatest need,” said MSFC Executive Director Pamela Meritt.

Orlee Marini-Rapoport, an aspiring physician-scientist and college senior, sees Dobbs as fundamentally disrupting what it means to be a doctor. “I think that one of the primary goals of being a physician is to provide bodily autonomy to the extent they can.” That could mean treating a life-threatening illness, but it could also be providing patients the option to choose whether they want to be pregnant.

Still, many young people are pushing forward. “I find this to be really meaningful work, and this is what I want to spend my life dedicated to,” said Haley Lifrieri, a pre-med student at Harvard University, who became interested in ob-gyn care after going through a traumatic experience with an ovarian cyst. “Am I going to let [Dobbs] scare me off?”

Stephanie Toti, project director at the Lawyering Project, which advises Medical Students for Choice on the abortion laws in different states, provided some helpful suggestions. Students interested in a career in reproductive health should consider “what kinds of instruction about abortion their school offers or permits and if the school places any restrictions on a student’s ability to complete internships or other kinds of practical practical clinical experience providing abortion care.”

Residencies and medical schools in states unlikely to ban abortion will likely become more exclusive as students interested in ob-gyn care—an already competitive field—prioritize jump-starting their career in states that will support them.

“What we’re seeing, and I predicted this last year, and I’m not at all thrilled to see it, is a hyper-regionalization [in abortion training], and all of this is happening in the United States, where we have the worst pregnancy outcomes in the developed world and are experiencing a historic physician shortage,” said Meritt.

The burnout doctors experienced increased sharply during the pandemic. Jacob, a third-year medical student currently undergoing his clinical rotations in New York City, has had his own share of harassment as a former abortion clinic escort. Physical safety was a concern for years as he dealt with verbal and emotional harassment from anti-abortion protesters in both Minneapolis and Raleigh.

“You have a target drawn on you as an abortion provider. And that feeling comes from being a clinic escort and, in North Carolina at least, when the protesters would find out the clinic escorts’ names, they would put them up on all the websites, they would try and get them fired from their jobs,” said Jacob. “In a post-Roe environment, it’s even scarier, but it’s even more necessary. It feels almost like you’re signing up to be a martyr.”