Research recently published in JAMA® shows that pregnant and postpartum residents and fellows who were given a package of support that included mentorship from more senior physician mothers reported lower rates of burnout than did colleagues who got the standard accommodations offered by their training program.
In the study, “Pragmatic Parental Support to Mitigate Burnout Among Pregnant and Postpartum Trainees,” published in JAMA in May, a randomized clinical trial followed 143 childbearing physicians in seven U.S. training institutions from at least 12 weeks’ gestation in their pregnancies through 24 weeks postpartum, starting in May 2023 and concluding two years later.
Some of the residents and fellows were given a four-part prenatal and postpartum support package. Then, all the participants were asked questions about burnout, professional fulfillment, organizational and personal values alignment, relationship strain, career satisfaction and sleep-related impairment.
The mothers who were given a smart bassinet, a wearable breast pump, virtual perinatal support and formal faculty mentorship reported significantly lower burnout scores than did those who were not given the support package.
Pregnancy and postpartum are challenging for residents
The study’s authors noted that “although no national multispecialty study has established the prevalence of childbearing during training, estimates suggest that 10% to 41% of physicians become pregnant during graduate medical education, varying by specialty, institution and survey methodology.”
Pregnant residents and fellows can experience challenges in addition to those inherent in early parenthood, the study says. These include cultural barriers to rest and recovery time, discrimination and inadequate lactation support.
“Engagement in family life, including parenting opportunities, is increasingly appreciated as part of a healthy human experience,” JAMA Deputy Editor Linda Brubaker, MD, wrote in an accompanying editorial on the topic. She noted that delaying childbearing can have negative consequences for women physicians, including “subfertility, infertility and higher risks during pregnancy, including miscarriage, preterm delivery, hypertensive disorders of pregnancy and intrauterine growth restriction.”
AMA members can explore a range of peer-reviewed research and clinical information published by the JAMA Network™, which brings JAMA® together with JAMA Network Open and 11 specialty journals. Published continuously since 1883, JAMA is one of the most widely circulated, peer-reviewed, general medical journals in the world. If you are an AMA member or interested in becoming one, learn how to access these educational materials and innovative tools.
Creating a framework for tackling burnout
The study’s design could not conclusively demonstrate which of the support mechanisms contributed the most to the positive benefits. In her editorial, Dr. Brubaker noted that the bassinet, breast pump and perinatal support—the latter of which came from a dedicated app—were elements that could have been separately purchased. But the formal mentorship, which came from an unpaid faculty mentor with motherhood experience, was not available otherwise.
Additionally, she wrote, there may have been protective effects from the perception that direct action was being taken to help these residents and fellows during the prenatal and postpartum period.
“The knowledge that individuals in the intervention group were receiving tangible multicomponent support, not just supportive words, may have had impact” in mitigating burnout, Dr. Brubaker wrote.
As the leader in physician well-being, the AMA provides organizational solutions that help physicians and health systems optimize practice efficiency, reduce burnout, and rediscover the Joy in Medicine®.
That includes an AMA STEPS Forward® toolkit that helps address resident and fellow burnout by creating a holistic, supportive culture that optimizes well-being for physician learners.
“If residents are feeling a sense of burnout, when they get into practice—depending on their specialty—this is not something that’s going to go away or be reduced,” said Nancy Nankivil, the AMA’s director of organizational well-being. “It is critical that healthcare organizations continue to focus on improving key system drivers related to well-being.”
