Survey Reveals Challenges of Balancing Motherhood and Surgical Training

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Nearly 350 mothers with 452 pregnancies during the study period were included in the survey.
Nearly 350 mothers with 452 pregnancies during the study period were included in the survey.

The long, unpredictable hours, exhaustive work demands, and extremely high expectations of medical training can be difficult on any resident. But they can be particularly challenging for mothers due to gender discrimination, lack of mentorship, and insufficient infrastructure.

Researchers at the Center for Surgery and Public Health at Brigham and Women's Hospital in Boston, Massachusetts, took a closer look at some of these challenges by conducting a survey to better characterize the experiences of pregnant surgical residents.1 The study included 347 female general surgeons, mean age 30.5 years, who had 1 or more pregnancy during their residencies (total pregnancies during study period: 452).

“It's important to understand what the challenges are so that we can talk about possible solutions openly,” lead study author Erika Rangel, MD, MS, FACS, director of Surgical Critical Care and Inpatient Programs and Brigham and Women's Hospital, said in a press release.2

Study results reveal that women were dissatisfied with their maternity leave options, have inadequate lactation and childcare support, and still experience negative stigma associated with pregnancy during training. Seventy-five percent of respondents reported witnessing faculty members or other residents making negative comments about pregnant trainees or childbearing during training.

Additionally, 66.8% of survey respondents reported a lack of mentorship advice for balancing their medical career and motherhood, and desired such mentorship. Overall, 29.5% of women surveyed would discourage other women from pursuing a surgical career because of these challenges;  39% percent strongly considered quitting.

“My kids are my universe, but being a surgeon is very much at the core of who I am,” Dr Rangel said. “It saddens me to think that anyone would think being a great mother and an accomplished surgeon are mutually exclusive things. They are not.”

Waiting until the end of training to start a family is not an attractive option to some women, as many will be in their mid-to-late 30s once they're licensed medical professionals.

“There really is never an ideal time to have a baby. The right time is whenever it happens for you and you will find your own unique balance,” Dr Rangel concluded. “I tell women to try to outsource as much as you can. Invest in great childcare and make sure to schedule time in your calendar for your family and for yourself. And the most important thing is to learn to forgive yourself — it's ok to ask for help from your partner, your village, your community. No one is perfect.”

While this study focused specifically on surgical residents, many other pregnant medical students are likely facing the same challenges. The survey results help to shine a light on what being a mother in medical training can be like and may provide insight on how medical programs can implement solutions that create a more supportive environment.

Some solutions include flexible scheduling, greater mentorship for mothers in medical training, improved infrastructure for breastfeeding, and better child care options.

References

  1. Rangel EL, Smink DS, Castillo-Angeles M, et al. Pregnancy and motherhood during surgical training [published online March 21, 2018]. JAMA Surg. doi:10.1001/jamasurg.2018.0153
  2. Survey results identify challenges of balancing motherhood with surgical training [news release]. Boston, MA: Brigham and Women's Hospital. https://www.brighamandwomensfaulkner.org/about-bwfh/news/survey-results-identify-challenges-of-balancing-motherhood-with-surgical-training. Accessed April 5, 2018.

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