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Agarwal I, MacVane CZ. Shift Scheduling and Overnight Work Among Pregnant Emergency Medicine Residents. Ann Emerg Med 2024; 83:598-602. [PMID: 38402481 DOI: 10.1016/j.annemergmed.2024.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 01/11/2024] [Accepted: 01/22/2024] [Indexed: 02/26/2024]
Affiliation(s)
- Isha Agarwal
- Department of Emergency Medicine, Maine Medical Center, Portland, Maine.
| | - Casey Z MacVane
- Department of Emergency Medicine, Maine Medical Center, Portland, Maine
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2
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Ben M'Barek I, Tuil R, Holmström E, Ceccaldi PF. Pregnancy care among French physicians: A national survey. Int J Gynaecol Obstet 2024; 165:832-834. [PMID: 38189104 DOI: 10.1002/ijgo.15353] [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: 03/16/2023] [Revised: 09/20/2023] [Accepted: 12/22/2023] [Indexed: 01/09/2024]
Abstract
SynopsisPhysicians in France have less regular obstetrical follow‐up compared to women in the general population. The main risk factors were multiparity and high workload.
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Affiliation(s)
- Imane Ben M'Barek
- Department of Gynecology Obstetrics, Assistance Publique des Hôpitaux de Paris-Beaujon, Clichy, France
- Université de Paris Cité, Paris, France
- Health Simulation Department, iLumens, Université Paris Cité, Paris, France
| | - Rebecca Tuil
- Department of Gynecology Obstetrics, Assistance Publique des Hôpitaux de Paris-Beaujon, Clichy, France
- Université de Paris Cité, Paris, France
| | - Emilia Holmström
- Department of Gynecology Obstetrics, Assistance Publique des Hôpitaux de Paris-Beaujon, Clichy, France
- Université de Paris Cité, Paris, France
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3
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Yau A, Lentskevich MA, Ahmed KS, Rangel EL, Gosain AK. Female Surgeons and Physicians Experience Greater Infertility Rates and Pregnancy Complications Than Other Professional Women. Am Surg 2024; 90:494-501. [PMID: 37975740 DOI: 10.1177/00031348231216489] [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] [Indexed: 11/19/2023]
Abstract
BACKGROUND Long years of school/training have shown to be associated with infertility and pregnancy complications. Rates of infertility and pregnancy complications were compared among women in demanding professional careers to better understand career differences impacting family planning. METHODS Inclusion criteria : English-speaking, childbearing professional women in surgery, medicine, law, and engineering. Exclusion criteria: men and women not in professional careers mentioned and non-childbearing women. Male-dominated fields identified to select non-medical female professionals. Top medical, law, and engineering schools' female faculty were surveyed from October 2022 to December 2022. Descriptive analysis and chi-squared tests were performed. RESULTS 2302 surveys were distributed and 268 responses were obtained (11.6%): 121 non-surgeon physicians, 120 lawyers/other doctorate degree holders, and 27 other/unknown. Data analysis included prior study's surgeon data. The median age (IQR = 25%, 75%) of the surgeons was 40y (36,45), non-surgeon physicians 43y (37,50), and law/other doctorates 38y (35,46). Delayed childbearing was observed in 65.0% surgeons, 66.1% non-surgeon physicians, and 57.5% law/other doctorates (P < .001). Pregnancy loss <10wks was observed in 35.3% surgeons, 33.9% non-surgeon physicians, and 30.8% law/other doctorates (P < .001). Infertility testing was performed in 43.0% non-surgeon physicians and 34.2% law/other doctorates (P < .001). Assisted reproductive technology was utilized by 24.9% surgeons, 43.0% non-surgeon physicians, and 21.7% law/other doctorates (P < .001). DISCUSSION Surgeons/physicians suffer more childbearing complications than other professional women.
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Affiliation(s)
- Alice Yau
- Division of Plastic Surgery, Ann and Robert H. Lurie Children's Hospital, Chicago, IL, USA
| | - Marina A Lentskevich
- Division of Plastic Surgery, Ann and Robert H. Lurie Children's Hospital, Chicago, IL, USA
| | - Kaleem S Ahmed
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, USA
| | - Erika L Rangel
- Division of General and Gastrointestinal Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Arun K Gosain
- Division of Plastic Surgery, Ann and Robert H. Lurie Children's Hospital, Chicago, IL, USA
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4
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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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Vayssiere P, Broekman M, Cavallo C, Engel D, Hadelsberg UP, Hatipoglu Majernik G, Hoellig A, Ilic T, Janz C, Jeltema HR, Mielke D, Rodríguez-Hernández A, Ryang YM, Fozia S, Syrmos N, Vanchaze K, Hernandez-Duran S. Parenthood and neurosurgery in Europe a white paper from the European Association of Neurosurgical Societies' Diversity in Neurosurgery Committee Part I - Family Planning and Practice during Pregnancy. BRAIN & SPINE 2023; 3:102690. [PMID: 38021011 PMCID: PMC10668082 DOI: 10.1016/j.bas.2023.102690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 10/04/2023] [Accepted: 10/06/2023] [Indexed: 12/01/2023]
Abstract
Introduction Family and work have immensely changed and become intertwined over the past half century for both men and women. Additionally, alongside to traditional family structures prevalent, other forms of families such as single parents, LGBTQ + parents, and bonus families are becoming more common. Previous studies have shown that surgical trainees regularly leave residency when considering becoming a parent due to the negative stigma associated with pregnancy during training, dissatisfaction with parental leave options, inadequate lactation and childcare support, and desire for greater mentorship on work-life integration. Indeed, parenthood is one of the factors contributing to attrition in surgical specialities, neurosurgery not being an exception. Research question The Diversity in Neurosurgery Committee (DC) of the European Association of Neurosurgical Societies (EANS) recognizes the challenges individuals face in parenthood with neurosurgery and wishes to address them in this white paper. Materials and methods In the following sections, the authors will focus on the issues pertaining to family planning and neurosurgical practice during pregnancy in itemized fashion based on an exhaustive literature search and will make recommendations to address the matters raised. Results Potential solutions would be to further improve the work-family time ration as well as improving working conditions in the hospital. Discussion and conclusion While many obstacles have been quoted in the literature pertaining to parenthood in medicine, and in neurosurgery specifically, initiatives can and should be undertaken to ensure not only retention of colleagues, but also to increase productivity and job satisfaction of those seeking to combine neurosurgery and a family life, regardless of their sexual identity and orientation.
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Affiliation(s)
- Pia Vayssiere
- Department of Neurosurgery, Hôpitaux Universitaires de Genève (HUG),
Geneva, Switzerland
- Faculty of Medicine, Université de Genève (UNIGE), Geneva,
Switzerland
| | - Marike Broekman
- Dept of Neurosurgery, Haaglanden Medical Center, The Hague and Dept of
Neurosurgery, Leiden University Medical Centre, Leiden, the
Netherlands
| | - Claudio Cavallo
- Department of Neurosurgery, Neurocenter of Southern Switzerland, Regional
Hospital of Lugano, Lugano, Switzerland
| | | | | | - Gökce Hatipoglu Majernik
- Department of Clinical Neurological Sciences, Schulich School of Medicine
and Dentistry, Western University, London, Ontario, Canada
| | - Anke Hoellig
- Department of Neurosurgery, University Hospital RWTH Aachen,
Germany
| | - Tijana Ilic
- National Department of Neurosurgery, Centre Hospitalier de Luxembourg,
Europe
| | - Claudia Janz
- Städtisches Klinikum Solingen, Neurochirurgische Klinik, Gotenstrasse 1,
42563, Solingen, Germany
| | - Hanne-Rinck Jeltema
- Department of Neurosurgery, University Medical Center Groningen,
Groningen, the Netherlands
| | - Dorothee Mielke
- Department of Neurosurgery, University Hospital Göttingen, Göttingen,
Germany
| | - Ana Rodríguez-Hernández
- Dept. of Neurological Surgery, Germans Trias i Pujol University Hospital,
Universidad Autónoma, Barcelona, Spain
| | - Yu-Mi Ryang
- Dept. of Neurosurgery &Center for Spinetherapy, Helios Klinikum
Berlin-Buch, Germany
| | - Saeed Fozia
- Department of Neurosurgery at Leeds General Infirmary, Leeds, United
Kingdom
| | | | | | - Silvia Hernandez-Duran
- Klinik für Neurochirurgie, Universitätsmedizin Göttingen,
Robert-Koch-Straße 40, 37075, Göttingen, Germany
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6
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Wang CN, Kurtzman JT, Ratan RB, Brady PC, Badalato GM. Oocyte cryopreservation during graduate medical training: A survey of trainees. Am J Surg 2023; 226:717-720. [PMID: 37321891 DOI: 10.1016/j.amjsurg.2023.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/24/2023] [Accepted: 05/18/2023] [Indexed: 06/17/2023]
Affiliation(s)
- Connie N Wang
- Columbia University Irving Medical Center, Department of Urology, New York, NY, USA.
| | - Jane T Kurtzman
- Columbia University Irving Medical Center, Department of Urology, New York, NY, USA.
| | - Rini B Ratan
- Columbia University Irving Medical Center, Department of Obstetrics and Gynecology, New York, NY, USA.
| | - Paula C Brady
- Columbia University Irving Medical Center, Department of Obstetrics and Gynecology, New York, NY, USA.
| | - Gina M Badalato
- Columbia University Irving Medical Center, Department of Urology, New York, NY, USA.
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7
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Berical KA, Vogel TS, Robinson JM, Ward AM, Wiener-Kronish J. Championing the Mom: The Role of a Mother's Support Group in Academic Anesthesia Practice. Anesth Analg 2023; 137:777-781. [PMID: 37712469 DOI: 10.1213/ane.0000000000006575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Affiliation(s)
- Kinza A Berical
- From the Harvard Medical School, Boston, Massachusetts
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Talia S Vogel
- From the Harvard Medical School, Boston, Massachusetts
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Jill M Robinson
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Anna M Ward
- Mayo Clinic College of Medicine and Science, Phoenix, Arizona
- Department of Anesthesiology, Mayo Clinic Hospital, Phoenix, Arizona
| | - Jeanine Wiener-Kronish
- From the Harvard Medical School, Boston, Massachusetts
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts
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8
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Levy MS, Kelly AG, Mueller C, Brown AD, Caban-Martinez AJ, Arora VM, Salles A. Psychosocial Burdens Associated With Family Building Among Physicians and Medical Students. JAMA Intern Med 2023; 183:1018-1021. [PMID: 37486671 PMCID: PMC10366942 DOI: 10.1001/jamainternmed.2023.2570] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/13/2023] [Indexed: 07/25/2023]
Abstract
This survey study uses responses from physicians and medical students to assess psychosocial burdens of family building in the physician workforce.
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Affiliation(s)
- Morgan S. Levy
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Florida
| | - Amelia G. Kelly
- Division of Reproductive Endocrinology and Infertility, New York University Langone Health, New York
| | - Claudia Mueller
- Department of Surgery, Stanford University, Palo Alto, California
| | - Alyssa D. Brown
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Vineet M. Arora
- Department of Medicine, University of Chicago Pritzker School of Medicine, Illinois
| | - Arghavan Salles
- Department of Medicine, Stanford University, Palo Alto, California
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9
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Christian N, Acker S. Gestating Healthy Policies for Young Parents. JAMA 2023; 330:689-690. [PMID: 37535360 DOI: 10.1001/jama.2023.12104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
This Viewpoint discusses the need for modernized national and program-level policies that foster a culture to support early-career physicians balancing their professional growth and personal family desires.
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Affiliation(s)
| | - Shannon Acker
- Department of Surgery, University of Colorado, Aurora
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10
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Lee AG, Maley J, Hibbert K, Akgün KM, Hauschildt KE, Law A, Kaminski N, Hayes M, Gesthalter Y, Bosslet GT, Santhosh L, Witkin A, Hills-Dunlap K, Çoruh B, Gershengorn HB, Hardin CC. Medical Societies Must Choose Professional Meeting Locations Responsibly in a Post- Roe World. Ann Am Thorac Soc 2023; 20:781-784. [PMID: 36812378 PMCID: PMC10257035 DOI: 10.1513/annalsats.202211-928ip] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/22/2023] [Indexed: 02/24/2023] Open
Affiliation(s)
- Alison G. Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jason Maley
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Kathryn Hibbert
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Kathleen M. Akgün
- Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Connecticut Healthcare System, New Haven, Connecticut
- Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Katrina E. Hauschildt
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Anica Law
- The Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts
| | - Naftali Kaminski
- Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Margaret Hayes
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Yaron Gesthalter
- Division of Pulmonary, Critical Care, Allergy and Sleep, University of San Francisco, San Francisco, California
| | - Gabriel T. Bosslet
- Division of Pulmonary, Critical Care, Sleep, and Occupational Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Lekshmi Santhosh
- Division of Pulmonary, Critical Care, Allergy and Sleep, University of San Francisco, San Francisco, California
| | - Alison Witkin
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
- The Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts
| | - Kelsey Hills-Dunlap
- Pulmonary Sciences and Critical Care, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Başak Çoruh
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, Washington
| | - Hayley B. Gershengorn
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Miami Miller School of Medicine, Miami, Florida; and
- Division of Critical Care Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - C. Corey Hardin
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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11
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High Infertility Rates and Pregnancy Complications in Female Physicians Indicate a Need for Culture Change. Ann Surg 2023; 277:367-372. [PMID: 36250327 DOI: 10.1097/sla.0000000000005724] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This survey study aims to determine the prevalence of pregnancy complications and infertility in female physicians in comparison to the general population. Risk factors, workplace environment, and education are also examined. BACKGROUND Physicians undertake long training and have stressful work environments during optimal childbearing years. While growing literature indicates increased rates of pregnancy complications and infertility in female surgeons, the prevalence in female physicians of all specialties is unknown. METHODS An anonymous, voluntary survey was distributed to female physicians via private physician social media groups. It queried pregnancy demographics and complications, infertility diagnosis and treatment, workplace environment, and prior education on these topics. Results were compared with general population data, between medical and surgical subspecialties, and between physicians who were and were not educated on the risks of delaying pregnancy. RESULTS A total of 4533 female physicians completed the survey. Compared with the general population, female physicians were older at first pregnancy, more often underwent infertility evaluation and treatment, and had higher rates of miscarriage and preterm birth. During training, only 8% of those surveyed received education on the risks of delaying pregnancy. Those who were educated were significantly less likely to experience miscarriage or seek infertility evaluation or treatment. Compared with physicians in nonsurgical specialties, surgeons had fewer children, were older at first pregnancy, had more preterm births and fetal growth problems, and were more likely to be discouraged from starting a family during training and practice. CONCLUSIONS Female physicians, particularly surgeons, have a significantly greater incidence of miscarriage, infertility, and pregnancy complications compared with the general population. The culture of medicine and surgery must continue to evolve to better support women with family planning during their training and careers.
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12
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Abstract
OBJECTIVE The objective of this study is to systematically synthesize the existing literature on the experiences of motherhood in female surgeons both during surgical training and as staff physicians, to identify knowledge gaps, and to provide recommendations for institutional changes to better support pregnant female surgeons. BACKGROUND There are disproportionately fewer medical students pursuing surgical specialties, as surgery is often seen as incompatible with childbearing and pregnancy. However, no review has summarized the published literature on the collective experiences of female surgeons in navigating motherhood. METHODS Four databases were searched and 1106 abstracts were identified. Forty-two studies were included and a thematic analysis was performed. RESULTS Four themes were identified: path toward motherhood (n=18), realities of motherhood (n=25), medical culture and its impact on career and family life (n=24), and institutional reproductive wellness policies (n=21). Female surgeons are more likely to delay motherhood until after training and have high rates of assisted reproductive technology use. Pregnancy during surgical training is associated with negative perception from peers, pregnancy complications, and scheduling challenges. Maternity leave policies and breastfeeding and childcare facilities are variable and often inadequate. Many female surgeons would agree that greater institutional support would help support women in both their roles as mothers and as surgeons. CONCLUSIONS Both female residents and staff surgeons experience significant and unique barriers before, during, and after motherhood that impact their personal and professional lives. Understanding the unique challenges that mothers face when pursuing surgical specialties is critical to achieving gender equity.
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13
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Slostad J, Jain S, McKinnon M, Chokkara S, Laiteerapong N. Evaluation of Faculty Parental Leave Policies at Medical Schools Ranked by US News & World Report in 2020. JAMA Netw Open 2023; 6:e2250954. [PMID: 36689228 PMCID: PMC9871796 DOI: 10.1001/jamanetworkopen.2022.50954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/15/2022] [Indexed: 01/24/2023] Open
Abstract
Importance Physician parents, particularly women, are more likely to experience burnout, poor family-career balance, adverse maternal and fetal outcomes, and stigmatization compared with nonparent colleagues. Because many physicians delay child-rearing due to the rigorous demands of medical training, favorable parental leave policies for faculty physicians are crucial to prevent physician workforce attrition. Objective To evaluate paid and unpaid parental leave policies at medical schools ranked by US News & World Report in 2020 and identify factors associated with leave policies. Design, Setting, and Participants This cross-sectional national study was performed at US medical schools reviewed from December 1, 2019, through May 31, 2020, and February 1 through March 31, 2021, due to the COVID-19 pandemic. All medical schools ranked by US News & World Report in 2020 were included. Main Outcomes and Measures The primary outcome was the number of weeks of paid and unpaid leave for birth, nonbirth, adoption, and foster care physician parents. Institutional policies for the number of weeks of leave and requirements to use vacation, sick, or disability leave were characterized. Institutional factors were evaluated for association with the duration of paid parental leave using χ2 tests. Results Among the 90 ranked medical schools, 87 had available data. Sixty-three medical schools (72.4%) had some paid leave for birth mothers, but only 13 (14.9%) offered 12 weeks of fully paid leave. While 11 medical schools (12.6%) offered 12 weeks of full paid leave for nonbirth parents, 38 (43.7%) had no paid leave for nonbirth parents. Adoptive and foster parents had no paid leave in 35 (40.2%) and 65 (74.7%) medical schools, respectively. Median paid parental leave was 4 (IQR, 0-8) weeks for birth parents, 4 (IQR, 0-6) weeks for adoptive parents, 3 (IQR, 0-6) weeks for nonbirth parents, and 0 (IQR, 0-1) weeks for foster parents. About one-third of medical schools required birth mothers to use vacation (29 [33.3%]), sick leave (31 [35.6%]), or short-term disability (9 [10.3%]). Among institutional characteristics, higher ranking (top vs bottom quartile: 30.4% vs 4.0%; P = .03) and private designation (private vs public, 23.5% vs 9.4%; P < .001) was associated with a higher rate of 12 weeks of paid leave for birth mothers. Conclusions and Relevance In this cross-sectional national study of medical schools ranked by US News & World Report in 2020, many physician faculty receive no or very limited paid parental leave. The lack of paid parental leave was associated with higher rates of physician burnout and work-life integration dissatisfaction and may further perpetuate sex, racial and ethnic, and socioeconomic disparities in academic medicine.
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Affiliation(s)
- Jessica Slostad
- Division of Hematology-Oncology, Rush University Medical Center, Chicago, Illinois
| | - Shikha Jain
- Division of Hematology-Oncology, University of Illinois, Chicago
| | - Marie McKinnon
- Department of Medicine, University of Chicago, Chicago, Illinois
- Department of Medicine, Emory University, Atlanta, Georgia
| | - Sukarn Chokkara
- Department of Medicine, University of Chicago, Chicago, Illinois
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14
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Delva F, Carcasset P, Mouton P, Auguste-Virginie R, Lairez F, Sentilhes L, Brochard P, Joseph JP. Greater Risk of Pregnancy Complications for Female Surgeons: A Cross-Sectional Electronic Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:125. [PMID: 36612447 PMCID: PMC9819732 DOI: 10.3390/ijerph20010125] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Female surgeons are exposed to physical and mental stressors that differ from those of other specialties. We aimed to assess whether female surgeons are more at risk of pregnancy complications than women in other medical specialties. METHODS We used a cross-sectional electronic survey of female physicians working in the French Region Nouvelle-Aquitaine who were pregnant between 2013 and 2018. A pregnancy complication was defined as the occurrence of miscarriage, ectopic pregnancy, fetal growth restriction, prematurity, fetal congenital malformation, stillbirth, or medical termination of the pregnancy. Multivariate logistic regression models were used to evaluate the risk of pregnancy complications for female surgeons relative to women practicing in other medical specialties. RESULTS Among the 270 women included, 52 (19.3%) experienced pregnancy complications and 28 (10.4%) were surgeons. In the multivariate analysis, female surgeons had a higher risk of pregnancy complications: adjusted odds ratio = 3.53, 95% confidence interval [1.27-9.84]. CONCLUSION Further research is necessary to identify the hazards specifically involved in the practice of surgery to be able to propose preventive actions targeted to female surgeons during their pregnancy.
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Affiliation(s)
- Fleur Delva
- Environmental Health Platform Dedicated to Reproduction, ARTEMIS Center, Bordeaux University Hospital, 33076 Bordeaux, France
- Bordeaux Population Health Research Center, Inserm UMR1219, University of Bordeaux, 33076 Bordeaux, France
- Centre d’Investigation Clinique 1401 Épidémiologie Clinique, Institut National de la Santé et de la Recherche, University of Bordeaux, 33076 Bordeaux, France
| | - Pierre Carcasset
- Environmental Health Platform Dedicated to Reproduction, ARTEMIS Center, Bordeaux University Hospital, 33076 Bordeaux, France
| | - Pauline Mouton
- Department of General Practice, University of Bordeaux, 33076 Bordeaux, France
| | | | - Fanny Lairez
- Department of General Practice, University of Bordeaux, 33076 Bordeaux, France
| | - Loïc Sentilhes
- Environmental Health Platform Dedicated to Reproduction, ARTEMIS Center, Bordeaux University Hospital, 33076 Bordeaux, France
- Department of Obstetrics and Gynecology, Bordeaux University Hospital, 33076 Bordeaux, France
| | - Patrick Brochard
- Environmental Health Platform Dedicated to Reproduction, ARTEMIS Center, Bordeaux University Hospital, 33076 Bordeaux, France
- Bordeaux Population Health Research Center, Inserm UMR1219, University of Bordeaux, 33076 Bordeaux, France
| | - Jean-Philippe Joseph
- Bordeaux Population Health Research Center, Inserm UMR1219, University of Bordeaux, 33076 Bordeaux, France
- Centre d’Investigation Clinique 1401 Épidémiologie Clinique, Institut National de la Santé et de la Recherche, University of Bordeaux, 33076 Bordeaux, France
- Department of General Practice, University of Bordeaux, 33076 Bordeaux, France
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15
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Govindasamy LS, Matthews A. Growing the
emergency department
family: Navigating pregnancy, parenting and
ACEM
training. Emerg Med Australas 2022; 34:1009-1011. [DOI: 10.1111/1742-6723.14116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 10/09/2022] [Indexed: 11/16/2022]
Affiliation(s)
| | - Alexander Matthews
- Emergency Department Flinders Medical Centre Adelaide South Australia Australia
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16
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Thomson N, McIlwaine K. Assisted reproductive… training. Emerg Med Australas 2022; 34:1012-1014. [DOI: 10.1111/1742-6723.14118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 10/09/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Natasha Thomson
- Paediatric Intensive Care Unit, Monash Medical Centre Melbourne Victoria Australia
| | - Kate McIlwaine
- Genea Fertility and Mercy Hospital for Women Melbourne Victoria Australia
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17
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Collie E, Lew R, Peate M. Merging motherhood and medicine: A qualitative study exploring barriers and enablers to motherhood among female doctors in Australia. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221114268. [PMID: 35866692 PMCID: PMC9310336 DOI: 10.1177/17455057221114268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To identify barriers and enablers to motherhood experienced by female doctors in Australia. METHODS Semi-structured telephone interviews were conducted with 18 female physician-mothers in Australia, during March and May 2020. Interview data were examined using thematic analysis to extract key themes. RESULTS Six key barriers and seven key enablers were identified. Barriers (B1-6) largely reflected structural and cultural issues operating within health services and the wider medical profession. Barriers were the experience of working in medicine (B1); demands of postgraduate specialty training (B2); attitudes towards mothers in medicine (B3); gender inequality (B4); insufficient entitlements and support (B5); and competing priorities, conflicting roles (B6). Enablers were supportive partnerships (E1); break from traditional gender roles (E2); capacity to delegate/outsource (E3); doctors supporting doctors (E4); flexible work arrangements (E5); increasing acceptance and support (E6); and capacity to combine career and family (E7). CONCLUSION This was the first qualitative study to explore motherhood experiences among female doctors in Australia. Participants reported structural and cultural barriers during all stages of motherhood. The mismatch between identified barriers and available supports reveals opportunities for improving the experience of physician-mothers.
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Affiliation(s)
- Erika Collie
- The University of Melbourne, Melbourne, VIC, Australia,Sunshine Coast University Hospital, Birtinya, QLD, Australia,Erika Collie, Sunshine Coast University Hospital, Birtinya, QLD 4575, Australia.
| | - Raelia Lew
- The University of Melbourne, Melbourne, VIC, Australia,Royal Women’s Hospital, Melbourne, VIC, Australia
| | - Michelle Peate
- The University of Melbourne, Melbourne, VIC, Australia,Royal Women’s Hospital, Melbourne, VIC, Australia
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18
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Lydon S, Madden C, Byrne D, O'Connor P. Advancing consideration of gender within health profession education: What is required? MEDICAL EDUCATION 2022; 56:250-252. [PMID: 34741335 DOI: 10.1111/medu.14685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 10/15/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Sinéad Lydon
- School of Medicine, National University of Ireland Galway, Galway, Ireland
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland Galway, Galway, Ireland
| | - Caoimhe Madden
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland Galway, Galway, Ireland
- Discipline of General Practice, National University of Ireland Galway, Galway, Ireland
| | - Dara Byrne
- School of Medicine, National University of Ireland Galway, Galway, Ireland
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland Galway, Galway, Ireland
| | - Paul O'Connor
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland Galway, Galway, Ireland
- Discipline of General Practice, National University of Ireland Galway, Galway, Ireland
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19
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Mangla M. Occupational risks to pregnant obstetrics and gynaecology trainees and physicians: Is it time to think about this? JOURNAL OF MOTHER AND CHILD 2022; 26:111-117. [PMID: 35853832 PMCID: PMC10032316 DOI: 10.34763/jmotherandchild.20222601.d-22-00006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/15/2022] [Indexed: 02/23/2023]
Abstract
The proportion of women in the workforce has been steadily increasing worldwide. Women now constitute approximately 75% of the global health workforce and almost 90% in nursing and midwifery professions. The present times have witnessed a dramatic gender shift in the speciality of obstetrics and gynaecology. Women now comprise a significant proportion of practicing obstetrics and gynaecology specialists all over the world. In 2018, more than 80% of resident doctors and nearly 60% of physicians in the speciality were female, far exceeding any other surgical speciality. Most resident doctors and a significant proportion of practising physicians in obstetrics and gynaecology are in the reproductive age group. They will become pregnant at some point in their training program or career. The present review focuses on all work-related exposure risks for pregnant obstetrics and gynaecology professionals. It discusses the risks of infectious diseases, radiation, stress, violence against doctors, and even peer support (or lack of it) that can have deleterious effects on the health of pregnant physicians and the health of their unborn foetuses.
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Affiliation(s)
- Mishu Mangla
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India
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