Having children isn’t easy, but intense medical training, limited parental leave and a shrinking workforce make building a family even more difficult. With more residents working to build their families during training, a new study looks at the trends and calls on graduate medical education (GME) to improve policies to increase work-life balance for residents.

According to a 1983 survey, about 13 percent of female residents became pregnant during residency. More recently, that number has increased significantly, demonstrating that residents are spending their GME years building families.

About 40 percent of physician trainees plan to have a child during their graduate medical education training, according to a study in the July issue of Academic Medicine.

Researchers gathered information about pregnancy, institutional policies and parental leave from nearly 650 male and female trainees at Mayo School of Graduate Medical Education sites in Minnesota, Florida and Arizona. Among the physicians in training, 41 percent had children and 7 percent were currently pregnant themselves or had a partner who was pregnant.

Among the 41 percent who had children, researchers learned:

  • Most pregnancies occur during the GME years. Among the 398 pregnancies researchers had details on, about three quarters of pregnancies occurred during GME.
  • More men report having children than women. About 35 percent of female residents reported having children compared to 47 percent of male residents.
  • Both women and men plan to have more children during training. About one third of women and 35 percent of men said they planned to have their next child during their current training program. While another 18 percent of women and 17 percent of men planned to have their next child during their next training program.

Some residents and fellows were waiting to become parents until after GME training. A majority of women said that having a child would extend training, interfere with fellowship plans and they were also concerned about potential pregnancy complications. However, the study found that the number one concern about having children for men was financial hardship.

The research revealed that mothers took a median five to eight weeks for maternal leave, while fathers took less than one week of parental leave. Among women who took leave, researchers discovered that 40 percent still participated in career-related activities during that time, often for research. Women also wrote papers, studied for exams or pursued advanced degrees or other training.

Most institutions, including the Mayo Clinic, have formalized parental leave policies. While leave policies that include part-time options, flexible scheduling and specific policies for pregnancy improve the situation for trainees returning to work after childbirth, the authors of the study said those policies alone may be insufficient in addressing the burden trainees perceive when colleagues take parental leave—a reduced workforce within the programs.

The majority of trainees surveyed—59 percent—did not have a child. Two-thirds of those residents and fellows said they planned to have a child at some point in the future.

Approximately one-half of both male and female trainees who were childless, but planned to have children at the time of the study, told researchers they hoped to do so during their current or next training program.

“Program directors must address the challenges related to pregnancy and parental leave for this growing group of both male and female trainees,” study authors said.

The growth of training programs and flexible—nonteaching—attending staff physician services may alleviate workforce issues, researchers said. “But such options might not be available on demand and thus will require planning and resources to implement.”

Study authors said institutions should “pursue policies and practices to minimize the effects of parental leave on the workforce as trainees build their families.”

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