Perceptions of Surgery Residents About Parental Leave During Training

Abstract

IMPORTANCE To our knowledge, there has been little research conducted on the attitudes of residents toward their pregnant peers and parental leave. OBJECTIVE To examine the perceptions of current surgery residents regarding parental leave. DESIGN, SETTING, AND PARTICIPANTS A 36-item survey was distributed to current US general surgery residents and residents in surgical subspecialties through the Association of Program Directors in Surgery listserv and social media platforms. Questions were associated with general information/demographics, parental leave, having children, and respondents' knowledge regarding the current parental leave policy as set by the American Board of Surgery. The study was conducted from August to September 2018 and the data were analyzed in October 2018. MAIN OUTCOMES AND MEASURES Main outcomes included the attitudes of residents toward pregnancy and parental leave, parental leave policy, and the association of parental leave with residency programs. RESULTS A total of 2188 completed responses were obtained; of these, 1049 (50.2%) were women, 1572 (75.8%) were white, 164 (7.9%) were Hispanic/Latinx, 75 (3.6%) were African American, 2 (0.1%) were American Indian or Alaskan Native, 263 (12.7%) were Asian, and 5 (0.2%) were Native Hawaiian or Pacific Islander. From the number of residents who had/were expecting children (581 [28.6%]), 474 (81.6%) had or were going to have a child during the clinical years of residency. Many residents (247 [42.5%]) took fewer than 2 weeks of parental leave. Many residents did not feel supported in taking parental leave (177 [30.4%] did not feel supported by other residents and 190 [32.71%] did not feel supported by the faculty). Only 83 respondents (3.8%%) correctly identified the current American Board of Surgery parental leave policy. Residents who took parental leave identified a lack of a universal leave policy, strain on the residency program, a loss of education/training time, a lack of flexibility of programs, and a perceived or actual lack of support from faculty/peers as the top 5 biggest obstacles to taking leave during the clinical years of residency. CONCLUSIONS AND RELEVANCE Most of the modifiable factors that inhibit residents from having children during residency are associated with policies (eg, a lack of universal leave policy and lack of flexibility) and personnel (eg, a strain on the residency program and lack of support from peers/faculty). These data suggest that policies at the level of the Accreditation Council for Graduate Medical Education or Resident Review Committee (RRC), as well as education and the normalization of pregnancy during training, may be effective interventions.

Factors Associated with Attrition and Performance Throughout Surgical Training: A Systematic Review and Meta‐Analysis

“…It additionally reported that those who had graduated from medical school more recently were more likely to have a pregnancy during training than their older counterparts. The finding that childrearing does not affect attrition or performance should encourage residency programmes to develop clear guidance regarding parental leave, as in a recent study only 3.8% of residents were able to correctly identify the American Board of Surgery policy and felt unsupported [ 45 ].…”

Parental health in fellowship trainees: Fellows’ satisfaction with current policies and interest in innovation

“…[14][15][16][17] Trainees often report a perception of stigma and a lack of support for prospective and new parents, both by other trainees and by faculty. 18,19 Larger studies of parental leave policies across multiple specialties and institutions have similarly described a lack of standardized/formal GME parental leave policy across specialties and lack of specific references about the impact of parental leave on clinical training (length and eligibility for specialty boards). 6,[20][21][22] While it has been established that parenthood during GME is an important component of trainee well-being, 23 specific barriers to implementation of standardized policies that have been identified include: stigma, financial concerns, workforce and duty hour challenges, as well as the rigidly specified timeline of progression from one stage of medical training to the next.…”

“… 14 – 17 Trainees often report a perception of stigma and a lack of support for prospective and new parents, both by other trainees and by faculty. 18 , 19 …”

Medice, cura te ipsum: A first‐person experience with male infertility

“…Infertility is seemingly more prevalent in physicians than in the general population, at least among females 4 . This condition is also worsened by several factors, such as excessive stress, frequent night shifts and, in many cases, lacking support from peers and faculty or the need to delay pregnancy or fatherhood in order to achieve economic stability 5 …”

“…4 This condition is also worsened by several factors, such as excessive stress, frequent night shifts and, in many cases, lacking support from peers and faculty or the need to delay pregnancy or fatherhood in order to achieve economic stability. 5 My story with infertility begins a few years ago. At the time I had already been "working" as an andrologist for almost 8 years, between med school, training and residency; my wife, two years younger than me, was at the time a resident in paediatrics.…”