Pregnancy and Residency — Overdue for Equity

Koven, Suzanne; Haberer, Jessica; Kwolek, Deborah Gomez

doi:10.1056/nejmp2215288

Cited by 9 publications

(10 citation statements)

References 3 publications

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“…Medical students were concerned about returning to work with young children due to long training hours, workload, extracurricular expectations, financial instability, and childcare. Strategies beyond paid parental leave are needed to truly support parenthood within medicine …”

Section: Discussionmentioning

confidence: 99%

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Medical Students’ Perspectives on Family Planning and Impact on Specialty Choice

Dason,

Maxim,

Gesink

et al. 2024

JAMA Surg

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ImportancePhysicians are known to delay childbearing compared with nonphysicians and to experience higher rates of age-related pregnancy complications. Delay of childbearing is more pronounced in surgical specialties, and family planning and building goals may influence specialty choice.ObjectiveTo assess medical students’ perspectives on the development of family planning goals and the timing of family building within a medical career to elucidate how these perceptions impact their choice of specialty.Design, Setting, and ParticipantsThis qualitative study included fourth-year medical students at the University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada, and was conducted between May and August 2021. Participants were purposively sampled to maximize diversity of gender and specialty choice. Interviews were conducted via videoconferencing software that were recorded, transcribed verbatim, and verified for accuracy. Thematic analysis was completed independently by 2 researchers and consensus on final themes was reached through discussion among study investigators. Data were analyzed between September and December 2021.Main Outcomes and MeasuresParticipants were asked to share their perceptions of personal family planning goals, support currently in place, family planning education in medicine and factors contributing to their choice of specialty and program. Thematic analysis was completed.ResultsA total of 34 fourth-year medical students (median [range] age, 26 [24-33] years; 23 females [67.6%]) were interviewed. Four main themes were identified: (1) there is no ideal time to family build in a medical career, (2) family planning is a taboo topic, (3) surgical specialties offer less support for family building, and (4) residents who have children are perceived to place a burden on their colleagues. Medical students considered their family planning while deliberating among specialty choices and their experiences were highly influential in shaping their specialty selection.Conclusions and RelevanceResults of this qualitative study suggest that medical students perceive that family building during training may have unfavorable implications for team dynamics and relationships with colleagues, and these perceptions may affect specialty choice and family planning goals. Integration of family planning discussions and support for family building into medical curricula is needed along with efforts to improve culture by supporting team dynamics and workload when students take parental leave.

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Section: Discussionmentioning

confidence: 99%

“…Strategies beyond paid parental leave are needed to truly support parenthood within medicine. 11 , 27 …”

Section: Discussionmentioning

confidence: 99%

Medical Students’ Perspectives on Family Planning and Impact on Specialty Choice

Dason,

Maxim,

Gesink

et al. 2024

JAMA Surg

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“…It is well-known that there are significant challenges combining parenthood and surgical training. A recent perspective piece in the New England Journal of Medicine calls for the importance of "acknowledging the biologic realities of pregnancy and committing to gender equity" [22]. Surgical trainees face unique challenges when considering starting a family in residency.…”

Section: Discussionmentioning

confidence: 99%

The double-edged scalpel: Experiences and perceptions of pregnancy and parenthood during Canadian surgical residency training

Peters,

Zhang,

Roffey

et al. 2024

PLoS ONE

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Introduction Only 34% of Canadian surgeons in 2022 were female. The protracted length of surgical residency training, concerns regarding infertility, and increased rates of obstetrical complications have been shown to contribute to the disproportionate lack of females in surgical specialties. Methods A novel online survey was sent to all surgical residents in Canada. Respondents were asked about perceptions of pregnancy and parenthood during surgical training, and parents were asked about parental leave, accommodations they received, and pregnancy complications. Chi squared tests were used to compare opinions of male and female residents. Results A total of 272/2,419 (11.2%) responses were obtained, with a high response from females (61.8%) and orthopaedic residents (29.0%). There were 56 women reporting 76 pregnancy events during training, 62.5% of which had complications. Notably, 27.3% of men and 86.7% of women ‘agreed’ or ‘strongly agreed’ that surgeons have higher pregnancy complication rates than the general population (p<0.001). Men were much less likely to believe that pregnant residents should be offered modified duties (74.2% of men, 90.0% of women, p = 0.003). Women were much more likely to experience significant stigma or bias due to their status as a parent (43% of women, 0% of men, p<0.001). Women reported negative comments from others at a higher rate (58.5% of women, 40.7% of men, p = 0.013). Women believe there is negative stigma attached to being pregnant during training (62.7% of women, 42.7% of men, p = 0.01). The limitations of our study include a small sample size and response bias. Conclusion Challenges and negative perceptions exist around pregnancy and parenthood in surgical residency, which disproportionately affect women trainees.

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“…2023;388:966-967. 4 Women in medicine face challenges when considering motherhood during training. Since the 1980s, advances have been implemented, yet current residents continue to struggle and frequently have to choose between pursuing a pregnancy with a grueling schedule, deferring pregnancy, or taking time off and accepting a stalled career trajectory.…”

Section: Jesse Chou MD University Of Virginia Healthmentioning

confidence: 99%

Spotlight in Plastic Surgery: October 2023

Phillips,

Bollard,

Chang

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Pregnancy and Residency — Overdue for Equity

Cited by 9 publications

References 3 publications

Medical Students’ Perspectives on Family Planning and Impact on Specialty Choice

Medical Students’ Perspectives on Family Planning and Impact on Specialty Choice

The double-edged scalpel: Experiences and perceptions of pregnancy and parenthood during Canadian surgical residency training

Spotlight in Plastic Surgery: October 2023

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