Rangel EL, et al. - In this nationwide survey of childbearing general surgery residents, researchers investigated the cultural and structural factors of surgical training associated with residency and career dissatisfaction. Professional dissatisfaction was identified to be associated with three risk factors: altering fellowship training plans owing to difficulty balancing childbearing with the original choice of subspecialty, lack of formal maternity leave policies, and perception of stigma associated with pregnancy. To improve professional fulfillment for childbearing residents, mentorship in subspecialty selection and work-life integration, interventions to reduce workplace bias, and identification of obstacles to establishment of maternity leave policies are needed.

Methods

• Researchers electronically distributed a self-administered questionnaire through the Association of Program Directors in Surgery, the Association of Women Surgeons, and targeted Twitter and Facebook platforms.
• They performed the survey in January 2017 among surgeons who delivered at least one child during a US general surgery residency and was available online for 4 weeks.
• The respondents indicating agreement that they considered leaving residency owing to challenges surrounding childbearing (considered leaving), were reported to be dissatisfied with their residency.
• Respondents indicating agreement with statements (1) given an opportunity to revisit their job choice, they would choose a nonsurgical career more accommodating of motherhood (revisit career choice) or (2) they would advise a female medical student against a surgical career owing to difficulties balancing motherhood with the profession (advise against surgery) were reported to be unhappy with their career.
• Predictors of agreement with each of the 3 statements of professional dissatisfaction were identified using logistic regression.

Results

• The survey had 347 women respondents reporting 452 pregnancies.
• The mean (SD) age of the respondents was 30.5 (2.7) years.
• Agreement with at least one statement of residency or career dissatisfaction was reported for 179 respondents (51.6%).
• Findings revealed an association of lack of a formal maternity leave policy with “considered leaving” (odds ratio [OR], 1.83; 95% CI, 1.07-3.10).
• Association of perception of stigma during pregnancy with “revisit career choice” was noted (OR, 1.79; 95% CI, 1.01-3.19).
• All three markers of residency and career dissatisfaction (“considered leaving” OR, 2.68; 95% CI, 1.30-5.56; “revisit career choice” OR, 2.23; 95% CI, 1.13-4.43; and “advise against surgery” OR, 2.44; 95% CI, 1.23-4.84) were noted to be associated with changing fellowship plans owing to perceived difficulty balancing motherhood with the originally chosen subspecialty.