Female representation in the surgical specialties remains poor. Reasons given include perceived difficulties in maintaining a work-life (and family) balance, limitations in flexible training and lack of suitable role models. Existing data suggests that female surgeons have fewer children and are more likely to delay parenthood and significantly have greater pregnancy-associated complications as well as having higher rates of infertility.
In a report this month from the British Journal of Surgery authors describe a cross-sectional survey of 416 surgical trainees/residents. Child bearing and non-child bearing trainee surgeons had a similar number of children. 56% of child bearing and 40% of non-child bearing trainees had delayed their families as a result of their training. The majority of trainee surgeons now regretted their decisions to delay starting a family. Both male and female trainees had undergone fertility testing at a higher rate than would be expected in the general population. Of the 222 child-bearing surgical trainees who had become pregnant 36% had experienced pregnancy loss (at a rate of 31%). The findings were similar to non-surgeon partners (and may reflect the fact that 60% of non-surgeon partners were doctors). In every age group the rate of pregnancy loss was higher than in comparable groups in the general population. The reported loss rates of 35% in those under 35 years of age are three times higher than would be expected in an age-matched cohort. A third of childbearing trainees did not take any time off work after their loss and fewer than half confided in a colleague as to their situation.
Childbearing surgical trainees experienced both minor (62%) and major (31%) pregnancy-associated complications with major complications exceeding that in the partners of non-childbearing surgical trainees. Although 70% of childbearing surgical trainees altered their work schedule during pregnancy, 77% felt guilty for burdening their colleagues by reducing their work commitment. 40% of those that did not alter their schedule made this decision to avoid being ‘considered weak’ and 35% around concerns of burdening colleagues.
On return to work after parental leave, 61% of childbearing surgical trainees reduced their working hours to less than 40 hours a week.
The authors of the paper call for changes to reduce rates of miscarriage and major pregnancy complications in surgical trainees. They suggest that altering working schedules and limiting physical exertion may mitigate against at least some of these risks. They call for cultural change such that surgical trainees can modify their working schedule and practice, as well as to enable non-childbearing surgical parents to take longer intervals of parental leave and alter work schedules after becoming a parent.
The Short Report was published this month in the British Journal of Surgery
https://doi.org/10.1093/bjs/znad204
