Shobha W Stack1, Reshma Jagsi2, J Sybil Biermann3, Gina P Lundberg4, Karen L Law5, Caroline K Milne6, Sigrid G Williams7, Tracy C Burton8, Cindy L Larison9, Jennifer A Best10. 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.
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.
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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