Childbearing Decisions in Residency: A Multicenter Survey of Female Residents

Affiliations

¹ S.W. Stack is assistant professor of medicine, associate director, Medicine Student Programs, and director, Medical Student Scholarship, University of Washington School of Medicine, Seattle, Washington; ORCID: https://orcid.org/0000-0001-6586-9266.
² R. Jagsi is professor of radiation oncology, program director, Radiation Oncology Residency Program, and director, Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan; ORCID: https://orcid.org/0000-0001-6562-1228.
³ J.S. Biermann is professor of orthopedic surgery and associate dean of graduate medical education, University of Michigan Medical School, Ann Arbor, Michigan.
⁴ G.P. Lundberg is associate professor of medicine, Division of Cardiology, Emory University School of Medicine, and clinical director, Emory Women's Heart Center, Atlanta, Georgia; ORCID: https://orcid.org/0000-0002-8011-7094.
⁵ K.L. Law is associate professor of medicine, program director, Internal Medicine Residency Program, and associate vice chair of education, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
⁶ C.K. Milne is professor of medicine, program director, Internal Medicine Residency Program, and vice chair for education, University of Utah, Salt Lake City, Utah; ORCID: https://orcid.org/0000-0002-4782-1901.
⁷ S.G. Williams is assistant professor of reproductive medicine, University of California at San Diego, San Diego, California.
⁸ T.C. Burton is assistant professor of pediatrics, University of South Florida College of Medicine, Tampa, Florida.
⁹ C.L. Larison is research consultant, Department of Health Services, University of Washington School of Public Health, Seattle, Washington; ORCID: https://orcid.org/0000-0002-1412-5993.
¹⁰ J.A. Best is associate professor of medicine, associate program director, Internal Medicine Residency Program, and associate dean of graduate medical education, University of Washington School of Medicine, Seattle, Washington.

PMID: 32568852
DOI: 10.1097/ACM.0000000000003549

Multicenter Study

Childbearing Decisions in Residency: A Multicenter Survey of Female Residents

Shobha W Stack et al. Acad Med. 2020 Oct.

. 2020 Oct;95(10):1550-1557.

doi: 10.1097/ACM.0000000000003549.

Authors

Affiliations

¹ S.W. Stack is assistant professor of medicine, associate director, Medicine Student Programs, and director, Medical Student Scholarship, University of Washington School of Medicine, Seattle, Washington; ORCID: https://orcid.org/0000-0001-6586-9266.
² R. Jagsi is professor of radiation oncology, program director, Radiation Oncology Residency Program, and director, Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan; ORCID: https://orcid.org/0000-0001-6562-1228.
³ J.S. Biermann is professor of orthopedic surgery and associate dean of graduate medical education, University of Michigan Medical School, Ann Arbor, Michigan.
⁴ G.P. Lundberg is associate professor of medicine, Division of Cardiology, Emory University School of Medicine, and clinical director, Emory Women's Heart Center, Atlanta, Georgia; ORCID: https://orcid.org/0000-0002-8011-7094.
⁵ K.L. Law is associate professor of medicine, program director, Internal Medicine Residency Program, and associate vice chair of education, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
⁶ C.K. Milne is professor of medicine, program director, Internal Medicine Residency Program, and vice chair for education, University of Utah, Salt Lake City, Utah; ORCID: https://orcid.org/0000-0002-4782-1901.
⁷ S.G. Williams is assistant professor of reproductive medicine, University of California at San Diego, San Diego, California.
⁸ T.C. Burton is assistant professor of pediatrics, University of South Florida College of Medicine, Tampa, Florida.
⁹ C.L. Larison is research consultant, Department of Health Services, University of Washington School of Public Health, Seattle, Washington; ORCID: https://orcid.org/0000-0002-1412-5993.
¹⁰ J.A. Best is associate professor of medicine, associate program director, Internal Medicine Residency Program, and associate dean of graduate medical education, University of Washington School of Medicine, Seattle, Washington.

PMID: 32568852
DOI: 10.1097/ACM.0000000000003549

Abstract

Purpose: To characterize how female residents make decisions about childbearing, factors associated with the decision to delay childbearing, and satisfaction with these decisions.

Method: In 2017, the authors sent a voluntary, anonymous survey to 1,537 female residents enrolled across 78 graduate medical education programs, consisting of 25 unique specialties, at 6 U.S. academic medical centers. Survey items included personal, partner, and institutional characteristics, whether the respondent was delaying childbearing during residency, and the respondent's satisfaction with this decision.

Results: The survey response rate was 52% (n = 804). Among the 447 (56%) respondents who were married or partnered, 274 (61%) were delaying childbearing. Residents delaying childbearing were significantly more likely to be younger (P < .001), not currently a parent (P < .001), in a specialty with an uncontrollable lifestyle (P = .001), or in a large program (P = .004). Among self-reported reasons for delaying childbearing, which were not mutually exclusive, the majority cited a busy work schedule (n = 255; 93%) and desire not to extend residency training (n = 145; 53%). Many cited lack of access to childcare (n = 126; 46%), financial concerns (n = 116; 42%), fear of burdening colleagues (n = 96; 35%), and concern for pregnancy complications (n = 74; 27%). Only 38% (n = 103) of respondents delaying childbearing were satisfied with this decision, with satisfaction decreasing with increasing age.

Conclusions: Decisions to delay childbearing are more common in certain specialties, and many residents who delay childbearing are not satisfied with that decision. These findings suggest that greater attention is needed overall, and particularly in certain specialties, to promote policies and cultures that both anticipate and normalize parenthood in residency, thus minimizing the conflict between biological and professional choices for female residents.

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Comment in

We Must Normalize and Better Support Parenting During Medical Training.
Camero K. Camero K. Acad Med. 2021 Jul 1;96(7):935-936. doi: 10.1097/ACM.0000000000004100. Acad Med. 2021. PMID: 34183485 No abstract available.

References

1. Association of American Medical Colleges. Age of applicants to U.S. medical schools at anticipated matriculation by sex and race/ethnicity, 2014-2015 through 2017-2018. https://www.aamc.org/download/321468/data/factstablea6.pdf. Accessed August 13, 2019.
1. American College of Obstetricians and Gynecologists Committee on Gynecologic Practice. Female age-related fertility decline. Committee Opinion No. 589. Fertil Steril. March 2014;101:633–634.
1. Aghajanova L, Hoffman J, Mok-Lin E, Herndon CN. Obstetrics and gynecology residency and fertility needs. Reprod Sci. 2017;24:428–434.
1. Stentz NC, Griffith KA, Perkins E, Jones RD, Jagsi R. Fertility and childbearing among American female physicians. J Womens Health (Larchmt). 2016;25:1059–1065.
1. Davids JS, Scully RE, Melnitchouk N. Impact of procedural training on pregnancy outcomes and career satisfaction in female postgraduate medical trainees in the United States. J Am Coll Surg. 2017;225:411–418.e2.

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Childbearing Decisions in Residency: A Multicenter Survey of Female Residents

Affiliations

Childbearing Decisions in Residency: A Multicenter Survey of Female Residents

Authors

Affiliations

Abstract

Comment in

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources