Nav: Home

Challenges around childbearing owe to dissatisfaction among surgical residents

August 01, 2018

Despite constituting half of United States medical school graduates, women continue to be underrepresented in the field of surgery, accounting for only one-third of general surgery residency applicants. Research suggests female medical students are deterred by the perception that surgeons have difficulty balancing professional and personal pursuits. Nevertheless, in recent years, female surgeons have become more likely to begin families during residency rather than waiting until their completion of training as they might have in the past. Previous research has found that women who have children during residency often find it challenging to balance pregnancy and parental responsibilities with professional aspirations and the demands of their residency program.

A new study published today in JAMA Surgery and led by Erika Rangel, MD, MS, a general surgeon and surgical intensivist at Brigham and Women's Hospital, investigated what structural and cultural factors influence professional dissatisfaction in childbearing residents. Professional satisfaction was based on agreeing with statements indicating the desire to leave residency training, whether participants would counsel medical students against entering the specialty, and whether they would choose the specialty again given the chance. The researchers found that participants were more likely to express dissatisfaction if their program's culture and policies were biased against pregnancy or if that bias led them to alter their training plans.

Rangel and colleagues analyzed responses to a 2017 national survey of women who delivered one or more children during surgical residency. Participants were recruited from the Association of Women Surgeons, through the Association of Program Directors in Surgery, and via social media platforms including Twitter and Facebook. There were 347 respondents who reported 452 pregnancies. Participants were asked to rate their agreement or disagreement with statements using a 4-point Likert scale. The statements touched on the various aspects of the culture and structure of surgical residency programs.

Upon analyzing the data, Rangel and her team found that 52 percent of the participants agreed with at least one statement indicating residency or career dissatisfaction. The researchers found three main risk factors associated with residency and career dissatisfaction: a change in training plans due to the struggle of balancing pregnancy and parenting with original subspecialty choice; perceived stigma around pregnancy in the training culture; and a lack of established maternity leave policies. These findings suggest the need to refine mentorship programs, according to Rangel.

"Multiple mentors may be necessary to address different facets of a resident's career," she said. "Female mentors may be able to provide experience-based advice on balancing professional responsibilities with those of childbearing. In addition, role models in the preferred subspecialty can support the resident's desire to pursue a particular fellowship, since sacrificing career aspirations following pregnancy may reduce enthusiasm to continue training."

The study suggested that collaboration between surgical training program directors and national board and graduate medical education organizations was also necessary to establish comprehensive, consistent maternity leave policies. In addition, a deeper understanding of factors contributing to negative perceptions of pregnancy during residency was deemed necessary to ensure positive experiences for childbearing trainees. The study pointed out that these adjustments are crucial to making the cultural and institutional structures of surgical training programs conducive to a healthy work-life balance.

Brigham and Women's Hospital

Related Pregnancy Articles:

Medication use during pregnancy is common in women with preeclampsia
Use of medications during pregnancy is more common in women with preeclampsia than in those without, according to a British Journal of Clinical Pharmacology analysis of women who gave birth at a hospital in Finland in 2002-2016.
Going to sleep on your back in late pregnancy
This study looked at whether going to sleep on your back in the third trimester of pregnancy was associated with average lower birth weights.
Opioid use disorder in pregnancy: 5 things to know
Opioid use is increasing in pregnancy as well as the general population.
Medical imaging rates during pregnancy
Researchers looked at rates of medical imaging (CT, MRI, conventional x-rays, angiography, fluoroscopy and nuclear medicine) during pregnancy in this observational study that included nearly 3.5 million pregnant women in the United States and Canada from 1996 to 2016.
New research on diet and supplements during pregnancy and beyond
The foods and nutrients a woman consumes while pregnant have important health implications for her and her baby.
Obesity in early pregnancy linked to pregnancy complications
In a prospective study published in Obesity of 18,481 pregnant women in China who had never given birth before, obesity in early pregnancy was linked to higher risks of spontaneous abortion, preterm birth, and large birth weight in newborns.
Possible link between autism and antidepressants use during pregnancy
An international team led by Duke-NUS Medical School has found a potential link between autistic-like behaviour in adult mice and exposure to a common antidepressant in the womb.
Immigrant women more likely to be overweight during pregnancy
A new study in the Journal of Public Health finds that women in Norway from immigrant backgrounds are more likely to be overweight during pregnancy.
Stillbirths more likely if diabetes in pregnancy not diagnosed
Women who develop diabetes in pregnancy but are not diagnosed are much more likely to experience stillbirth than women without the condition, according to new research.
Do economic conditions affect pregnancy outcomes?
Economic downturn during early pregnancy was linked with modest increases in preterm birth in a Paediatric and Perinatal Epidemiology analysis.
More Pregnancy News and Pregnancy Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

Accessing Better Health
Essential health care is a right, not a privilege ... or is it? This hour, TED speakers explore how we can give everyone access to a healthier way of life, despite who you are or where you live. Guests include physician Raj Panjabi, former NYC health commissioner Mary Bassett, researcher Michael Hendryx, and neuroscientist Rachel Wurzman.
Now Playing: Science for the People

#544 Prosperity Without Growth
The societies we live in are organised around growth, objects, and driving forward a constantly expanding economy as benchmarks of success and prosperity. But this growing consumption at all costs is at odds with our understanding of what our planet can support. How do we lower the environmental impact of economic activity? How do we redefine success and prosperity separate from GDP, which politicians and governments have focused on for decades? We speak with ecological economist Tim Jackson, Professor of Sustainable Development at the University of Surrey, Director of the Centre for the Understanding of Sustainable Propserity, and author of...
Now Playing: Radiolab

An Announcement from Radiolab