Pregnancy in Orthopaedic Residents

Ruse, Stacia; Bergman, Rachel; Crawford, Eileen A.

doi:10.2106/jbjs.oa.22.00098

Cited by 5 publications

(10 citation statements)

References 10 publications

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“…A total of 18 articles were included from the 2580 articles initially retrieved from the database search. 5,6,8,9,[14][15][16][17][18][19][20][21][22][23][24][25][26][27] Refer to Figure 1 for the PRISMA diagram depicting the search process of this systematic review. males, which represented 1017 residents, 114 fellows, 2283 attending physicians, and 143 program directors (PDs).…”

Section: Search and Literature Selectionmentioning

confidence: 99%

“…Six papers evaluated pregnancy trends and factors for delaying childbearing 5,6,8,22,23,27 with two papers highlighting sex differences amongst respondents 8,22 (Table 1). The average age for a female orthopedic surgeon at the time of first delivery was 34.0 (�3.2) years as compared to 31.6 (�3.8) years for male colleagues (p < 0.001).…”

Section: Delayed Childbearing Trendsmentioning

confidence: 99%

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Pregnancy and infertility in orthopedics: A review of the current state

Kermanshahi,

Hartman,

Matzkin

et al. 2024

World j. surg.

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BackgroundOrthopedic surgery continues to have one of the lowest rates of female trainees among all medical specialties in the United States. Barriers to pursuing a surgical residency include the challenges of family planning and work–life balance during training.MethodsA systematic literature search of articles published between June 2012 and December 2022 in the MEDLINE, EMBASE, and Cochrane databases was performed in January 2023 according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analysis). Studies were included if they evaluated pregnancy and peripartum experience and/or outcomes amongst orthopedic surgeons or trainees.ResultsEighteen studies were included. Up to 67.3% of female orthopedic surgeons and trainees and 38.7% of their male counterparts delayed childbearing during residency. The most reported reasons for this delay included career choice as an orthopedic surgeon, residency training, and reputational concerns among faculty or co‐residents. Infertility ranged from 17.0% to 30.4% in female orthopedic surgeons and up to 31.2% suffered obstetric complications. Assisted Reproductive Technology (ART) resulted in 12.4%–56.3% of successful pregnancies. Maternity and paternity leaves ranged from 1 to 11 weeks for trainees with more negative attitudes associated with maternal leave.ConclusionsFemale orthopedic trainees and attending delay childbearing, experience higher rates of obstetric complications, and more stigma associated with pregnancy compared to their male colleagues. Program and institutional policies regarding maternity and paternity leave are variable across programs, and therefore, attention should be directed toward standardizing policies.

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Section: Search and Literature Selectionmentioning

confidence: 99%

Section: Delayed Childbearing Trendsmentioning

confidence: 99%

Pregnancy and infertility in orthopedics: A review of the current state

Kermanshahi,

Hartman,

Matzkin

et al. 2024

World j. surg.

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“…Residents have been reported to take less leave than fellows or surgeons in practice, suggesting a pressure to return to work earlier 56 . The pressure to return to work may limit the ability of new parents to provide optimal postpartum care for their children and may result in female surgeons deferring childbearing until after training 57 . Some of the highest rates of female orthopaedic representation have been found in Sweden and Estonia, countries that have generous parental leave, whereas poor maternity and parental benefits have appeared to deter women from orthopaedic surgery residency in the Gulf Cooperation Council (GCC) 33 .…”

Section: Global Diversity In Orthopaedicsmentioning

confidence: 99%

Overcoming the Barriers to Diversity in Orthopaedic Surgery

Rama,

Ekhtiari,

Thevendran

et al. 2023

Journal of Bone and Joint Surgery

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Background: Diversity in orthopaedics continues to lag behind that in other surgical specialties. This pattern exists globally and is not unique to gender or race. This review offers a global perspective on overcoming the barriers to diversity in orthopaedics. Methods: A literature search of MEDLINE and Embase was conducted and a narrative review was undertaken. Publications that discussed any aspect of diversity or solutions to diversity within orthopaedics or academic orthopaedics were identified. Results: A total of 62 studies were included. Studies showed that diversity in orthopaedic training is limited by structural barriers such as long hours, requirements to relocate during training, training inflexibility, and a lack of exposure to orthopaedics. Implicit bias during the selection process for training, discrimination, and a lack of role models are additional barriers that are experienced by both minority and female surgeons. The global lack of diversity suggests that there are also inherent “cultural barriers” that are unique to orthopaedics; however, these barriers are not uniformly experienced. Perceptions of orthopaedics as promoting an unhealthy work-life balance and the existence of a “boys’ club” must be addressed. Strong, committed leaders can embed cultural norms, support trainees, and act as visible role models. Targeted efforts to increase diverse recruitment and to reduce bias in selection processes for medical school and specialty training will increase diversity in the “training pipeline.” Conclusions: Diversity in orthopaedics continues to lag behind that in other specialties. Increasing diversity is important for providing a more inclusive training environment, improving patient care, and reducing health disparities. Structural and cultural barriers need to be addressed to improve diversity in orthopaedics. Promoting a culture supportive of all surgeons is essential to reframing perceptions that may prevent individuals from even considering a career as an orthopaedic surgeon. Changing attitudes require focused efforts from committed leadership in a “top-down” approach that prioritizes diversity. The efforts from national bodies seeking to tackle the lack of diversity, as well as the establishment of organizations committed to diversity, such as the International Orthopaedic Diversity Alliance, provide reasons to be optimistic for the future.

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“…While not a direct comparison to the figure mentioned above, a 2022 publication investigating pregnancy in orthopedic residents in the US determined that 42% of female residents wished to have a child during residency. Only 22% of residents had children during residency, and 69% of residents deliberately delayed childbearing due to the demands of their residency program [ 4 ]. From these figures, one could infer that considerably more than 24% of female orthopedic residents in the US do not have children.…”

mentioning

confidence: 99%

“…From these figures, one could infer that considerably more than 24% of female orthopedic residents in the US do not have children. Fear of not being able to balance maternal and clinical duties has been reported as a barrier to pursuing a career in orthopedics for US female residents and could partially account for underrepresentation rates there [ 4 ]. In the Israeli cohort representation is also low.…”

mentioning

confidence: 99%