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Freudenberger DC, Riner AN, Herremans KM, Vudatha V, McGuire KP, Anand RJ, Trevino JG. A Gravid Situation: General Surgery Faculty Support for Pregnant Surgical Residents. J Surg Res 2024; 299:9-16. [PMID: 38677003 DOI: 10.1016/j.jss.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/05/2024] [Accepted: 03/11/2024] [Indexed: 04/29/2024]
Abstract
INTRODUCTION The perceptions of teaching faculty toward pregnant general surgery residents have been overlooked despite the daily interactions amongst these groups. METHODS A 32-question survey designed to measure general surgery teaching faculty perceptions toward pregnant residents was distributed electronically from March 2022 to April 2022 to general surgery teaching faculty in the United States. Descriptive statistics were used to characterize responses and differences in perceptions, and qualitative analysis identified recurring themes from free-text responses. RESULTS Among 163 respondents included in the final analysis, 58.5% were male and 41.5% were female. Despite 99.4% of surgeons feeling comfortable if a resident told them they were pregnant, 22.4% of surgeons disagreed that their institutions have supportive cultures toward pregnancy. Almost half (45.4%) have witnessed negative comments about pregnant residents and half (50.3%) believe that pregnant surgical residents are discriminated against by their coresidents. Nearly two-thirds of surgeons (64.8%) believe that someone should have a child whenever they wish during training. Given recent reports, 80.2% of surgeons recognized that female surgeons have increased risks of infertility and pregnancy complications. Recurring themes of normalizing pregnancy, improving policies, and creating a culture change were expressed. CONCLUSIONS In this national survey, although there appears to be positive perceptions of pregnancy in surgical training amongst those surveyed, there is acknowledged necessity of further normalizing pregnancy and improving policies to better support pregnant residents. These data provide further evidence that though perceptions may be improving, changes are still needed to better support pregnancy during training.
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Affiliation(s)
- Devon C Freudenberger
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Andrea N Riner
- Department of Surgery, University of Florida College of Medicine, Gainesville, Florida
| | - Kelly M Herremans
- Department of Surgery, University of Florida College of Medicine, Gainesville, Florida
| | - Vignesh Vudatha
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Kandace P McGuire
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Rahul J Anand
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Jose G Trevino
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
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Kling SM, Slashinski MJ, Green RL, Taylor GA, Dunham P, Kuo LE. Parental leave experiences for the non-childbearing general surgery resident parent: A qualitative analysis. Surgery 2024:S0039-6060(24)00287-3. [PMID: 38910045 DOI: 10.1016/j.surg.2024.04.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 03/22/2024] [Accepted: 04/24/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND Stigma surrounds parental leave during general surgery residency, yet 25% to 29% of general surgery residents have children. Parental leave experiences of non-childbearing general surgery resident parents have not been described. This study aimed to describe the non-childbearing population's parental leave experiences. METHODS Using a purposive sampling strategy, semi-structured interviews (n = 20) were conducted via Zoom (August 2021-March 2022) with current general surgery residents or fellows who had at least 1 child during residency as the non-childbearing parent. Interviews explored participants' experiences with parental leave policies, timing, structure, motivations/influences for taking leave, career/training impacts, and reflections on their experiences. Transcripts were analyzed using thematic content analysis. Participant demographics were analyzed using univariate analysis. RESULTS Of the 20 participants, there were 31 unique parental leave experiences. The following 6 themes were identified from interviews: program/professional policies, cultural climate, support (institutional and social), parental leave experiences, impact, and recommendations. Participants cited needing to rely on informal support (eg, the assistance of other residents) to arrange leave and feeling compelled not to take the full time allowed in order to not burden co-residents or because others took less time. Overall, participants felt dissatisfied with their parental leave experiences. CONCLUSION Non-childbearing general surgery resident parents underuse parental leave due to perceived or actual lack of access to leave and stigma. This results in dissatisfaction with their parental leave experiences and has the potential to lead to negative professional and personal outcomes. There is a critical need for improved support through cultural change and policy revision, implementation, and adherence.
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Affiliation(s)
- Sarah M Kling
- Temple University Hospital, Department of Surgery, Philadelphia, PA
| | - Melody J Slashinski
- Temple University College of Public Health, Department of Social and Behavioral Sciences, Philadelphia, PA
| | - Rebecca L Green
- Temple University Hospital, Department of Surgery, Philadelphia, PA
| | - George A Taylor
- Temple University Hospital, Department of Surgery, Philadelphia, PA
| | - Patricia Dunham
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Lindsay E Kuo
- Temple University Hospital, Department of Surgery, Philadelphia, PA.
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Gaffley M, Hernandez S, Riera KM, Anzola S. Survey on the Perceptions of Pregnancy and Parenthood in Trainees: Advances, Obstacles, and Growth Opportunities. J Surg Res 2024; 295:477-486. [PMID: 38070262 DOI: 10.1016/j.jss.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 10/06/2023] [Accepted: 10/27/2023] [Indexed: 02/25/2024]
Abstract
INTRODUCTION Despite national policy changes, perspective changes on pregnancy and parenting in training are often lacking. We evaluated current viewpoints regarding pregnancy, parenthood, leave needs, and perceptions of support across trainees at our institution. METHODS A cross-sectional survey was sent to all residents and fellows at a tertiary care academic center with >700 trainees. Demographic information, opinions on maternity and paternity leave, and opinions on institutional support and career goals were collected. The survey was sent via the Graduate Medical Education Office listserv -- 66 Accreditation Council for Graduate Medical Education (ACGME) programs and 40 non-ACGME programs. RESULTS Seven hundred and forty-seven house officers received the survey with a response rate of 21.9% (n = 164). Of respondents, 81% were residents and 99 respondents were female (representing 31% of female trainees at our institution). Thirty-seven point two percent of respondents reported being parents. Twenty-five point three percent of respondents had been pregnant while a trainee with no statistical difference by specialty type (P = 0.0817). Statistically significant difference was noted in having children based on sex with men becoming parents at twice the rate of women (56% vs 26%, P < 0.001). No difference was noted between specialties on perceived support while pregnant and peripartum. Thirty percent of parent respondents reported thinking about leaving medical training after having children given family stressors. Statistical difference in thoughts of leaving medicine overall between females (46%) and males (17.6%; P = 0.0238). CONCLUSIONS Men and women need support as they navigate becoming parents at a naturally stressful transition period. Females consider leaving medicine at twice the rate of males after becoming parents. Our institution and other ACGME programs need greater transparency and consistent leave practices that reflect changing times.
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Affiliation(s)
- Michaela Gaffley
- Wake Forest School of Medicine, General Surgery, Winston-Salem, North Carolina; Orlando Health, Colorectal Surgery, Orlando, Florida.
| | - Sean Hernandez
- Wake Forest School of Medicine, Internal Medicine, Winston-Salem, North Carolina; Orlando Health, Internal Medicine, Orlando, Florida
| | - Katherine M Riera
- Wake Forest School of Medicine, Acute Care Surgery, Winston-Salem, North Carolina
| | - Saskia Anzola
- Wake Forest School of Medicine, Anesthesiology, Winston-Salem, North Carolina
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Freudenberger DC, Herremans KM, Riner AN, Vudatha V, McGuire KP, Anand RJ, Trevino JG. General Surgery Faculty Knowledge and Perceptions of Breast Pumping Amongst Postpartum Surgical Residents. World J Surg 2023; 47:2092-2100. [PMID: 37103559 PMCID: PMC10387458 DOI: 10.1007/s00268-023-07005-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND There is a lack of data regarding the knowledge and perceptions teaching faculty possess about breast pumping among general surgery residents despite breast pumping becoming more common during training. This study aimed to examine faculty knowledge and perceptions of breast pumping amongst general surgery residents. METHODS A 29-question survey measuring knowledge and perceptions about breast pumping was administered online to United States teaching faculty from March-April 2022. Descriptive statistics were used to characterize responses, Fisher's exact test was used to report differences in responses by surgeon sex and age, and qualitative analysis identified recurrent themes. RESULTS 156 responses were analyzed; 58.6% were male and 41.4% were female, and the majority (63.5%) were less than 50 years old. Nearly all (97.7%) women with children breast pumped, while 75.3% of men with children had partners who pumped. Men more often than women indicated "I don't know" when asked about frequency (24.7 vs. 7.9%, p = 0.041) and duration (25.0 vs. 9.5%, p = 0.007) of pumping. Nearly all surgeons are comfortable (97.4%) discussing lactation needs and support (98.1%) breast pumping, yet only two-thirds feel their institutions are supportive. Almost half (41.0%) of surgeons agreed that breast pumping does not impact operating room workflow. Recurring themes included normalizing breast pumping, creating change to better support residents, and communicating needs between all parties. CONCLUSIONS Teaching faculty may have supportive perceptions about breast pumping, but knowledge gaps may hinder greater levels of support. Opportunities exist for increased faculty education, communication, and policies to better support breast pumping residents.
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Affiliation(s)
- Devon C Freudenberger
- Department of Surgery, Virginia Commonwealth University School of Medicine, 1200 E. Broad St., PO Box 980011, Richmond, VA, 23219, USA
| | - Kelly M Herremans
- Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Rd., Gainesville, FL, 32608, USA
| | - Andrea N Riner
- Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Rd., Gainesville, FL, 32608, USA
| | - Vignesh Vudatha
- Department of Surgery, Virginia Commonwealth University School of Medicine, 1200 E. Broad St., PO Box 980011, Richmond, VA, 23219, USA
| | - Kandace P McGuire
- Department of Surgery, Virginia Commonwealth University School of Medicine, 1200 E. Broad St., PO Box 980011, Richmond, VA, 23219, USA
| | - Rahul J Anand
- Department of Surgery, Virginia Commonwealth University School of Medicine, 1200 E. Broad St., PO Box 980011, Richmond, VA, 23219, USA
| | - Jose G Trevino
- Department of Surgery, Virginia Commonwealth University School of Medicine, 1200 E. Broad St., PO Box 980011, Richmond, VA, 23219, USA.
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Castillo-Angeles M, Stucke RS, Rosenkranz KM, Smink DS, Rangel EL. Paternity Leave During Surgical Training: Perspectives of Male Residents. JOURNAL OF SURGICAL EDUCATION 2022; 79:e85-e91. [PMID: 35595628 DOI: 10.1016/j.jsurg.2022.04.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/19/2022] [Accepted: 04/26/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Recent literature on parental leave during residency has focused on the importance of supporting new mothers, but the needs and challenges faced by expectant nonchildbearing residents are less well described. Male residents are more likely than their female counterparts to have children during surgical training, and they experience similar stressors including childcare and conflicts between work and home priorities. As nonchildbearing parents of this generation become more involved in childrearing, the need to establish inclusive parental leave policies is essential. The aim of this study was to provide a deeper understanding of the perspectives of male residents about parental leave. DESIGN A semi-structured interview guide was developed using a literature search and an expert panel. Interviews were audio-recorded and transcribed verbatim and emergent themes were identified using content analysis. SETTING Four academic institutions. PARTICIPANTS Four focus groups were held with of a total of 15 male resident-parents. These were selected using convenience sampling. RESULTS Multiple themes emerged: 1) male residents perceive greater stigma attached to taking leave compared to female colleagues; 2) paternity leave policies are vague and sometimes non-existent; 3) male residents experience a high burden of guilt related to burdening peers with clinical coverage while on leave; 4) male residents face internal conflict between surgical and parental responsibilities; 5) male residents have little mentorship on successful work-life integration and feel compelled to model the behavior of their attendings who often prioritize career before family; and 6) shifts in family values and priorities are common following childbirth and impact how male resident-parents view other new parents in training. CONCLUSIONS Significant challenges exist for residents who become fathers during their surgical training. Key stressors include poorly defined leave policies, historic paradigms of prioritizing professional duties before personal duties, stigma against taking time off for parental bonding in the absence of medical need, and guilt related to extra work imposed on colleagues by time away. Establishment of formal parental leave policies for both genders, programmatic support to offset the increased workload on colleagues, and greater mentorship on balancing family and career are needed to foster a culture of work-life integration.
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Affiliation(s)
- Manuel Castillo-Angeles
- Division of Trauma, Burn, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
| | - Ryland S Stucke
- Department of Surgery, Oregon Health Services University, Eugene, Oregon
| | - Kari M Rosenkranz
- Department of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
| | - Douglas S Smink
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts; Division of General and Gastrointestinal Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Erika L Rangel
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts; Division of General and Gastrointestinal Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
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