Opinion Summary
In a January 2025 Des Moines Register guest editorial, medical student (and now doctor) Aastha Chandra, an Iowa‑raised then-medical student at the University of Iowa’s Carver College of Medicine, explains why she and many of her peers will leave the state for their residency despite political leaders claiming they want to retain homegrown physicians.
She describes growing up in Iowa, attending its public schools and universities, and feeling deeply connected to the state – yet unable to envision practicing medicine here under current policy conditions.
Chandra argues that legislative actions, rather than the number of medical school seats or residency slots, are driving medical graduates away. She points to data showing that most Iowa medical students already leave for residency and that few residents stay after training.
She highlights Iowa’s severe shortage of OB/GYN physicians and the closure of rural maternity units, but notes that restrictive abortion laws and political interference in reproductive care make the specialty increasingly untenable for trainees.
And Chandra recounts witnessing emergency procedures such as D&Cs performed to save patients’ lives and expresses concern that lawmakers question whether such care should even be legal.
As a future pediatrician, she also raises alarm about declining vaccination rates, legislative efforts to weaken vaccine requirements, and political rhetoric that undermines trust in public health. She argues (rightfully) that these policies endanger children and contradict the scientific training physicians rely on.
Beyond clinical issues, Chandra warns that proposed federal limits on student loans for professional programs, combined with the elimination of Public Service Loan Forgiveness, will make medical education unaffordable for many and worsen Iowa’s shortage of primary‑care doctors. Cutting Medicaid and SNAP, she adds, will further harm vulnerable patients.
She concludes that Iowa’s political climate – not its medical infrastructure – is the primary driver of brain drain from the state. And she emphasizes that she loves caring for Iowa families and values her training, but without legislative support for evidence‑based medicine, public health, and patient welfare, she and many of her classmates feel compelled to leave the state they have long called home.
