Medical students often struggle with the goals of family planning and the potential impact on their careers and workplace dynamics. A new study suggests that this struggle could ultimately influence students‘ choice of medical specialties and lead to delayed childbirth. Surgical specialties, in particular, seem to offer little support for family-building, and resident physicians with children are perceived as burdensome to their colleagues.
Dr. Shirin Dason, a researcher in gynecologic reproductive endocrinology and infertility at Mount Sinai Hospital at the University of Toronto, led the study. „This study was an important first step in understanding how medical students navigate family planning within the context of their careers,“ she said. „We hope to share our findings in the hopes that institutions – and the profession as a whole – will consider how to improve support for learners and educators in achieving their family planning goals.“
The study, published online on December 13, 2023 in JAMA Surgery, explored the perspectives, goals, and challenges of fourth-year medical students on family planning, timing of parenthood, and specialty selection. Through semi-structured interviews conducted via Zoom in 2021, the research team engaged with 34 students qualified for residency programs at the Temerty Faculty of Medicine at the University of Toronto, with participants pursuing various specialties such as family medicine, obstetrics and gynecology, surgery, internal medicine, and other medical fields.
The study identified several key themes. Firstly, students felt that family planning during a medical career, especially during residency training, was not adequately supported. Two-thirds of the participants indicated that they had considered their family planning goals when selecting their specialty. Additionally, they noted challenges related to parental leave, work-life balance, financial stability, medical training schedules, physical demands of pregnancy, and availability of childcare.
Moreover, the study revealed that family planning is a taboo subject in medicine, with a lack of open discussions on the topic. The students felt that mentors‘ attitudes, whether encouraging or discouraging, influenced their personal views. They also perceived surgical specialties as offering less support for family building and encountered continued stereotypes, leading them to favor specialties and programs perceived as more supportive.
The students also observed that residents with children are seen as burdensome to their colleagues and contribute to burnout among peers. This reinforced their fears about parental leave, professional reputation, and workplace dynamics. Ultimately, these views influenced students to seek larger programs that could better distribute work demands and possibly accommodate parental leave.
Based on these findings, Dason and her colleagues developed a resource website called „Family Planning for Physicians“ to support medical students, resident physicians, and fellows in their information seeking and planning. They also integrated a workshop into postgraduate and undergraduate curricula to address and improve support systems within the medical training environment.
Addressing the study results, Dr. Liane Feldman, a surgery professor at McGill University, emphasized the need for a cultural change in medicine, recognizing and celebrating success beyond productivity. She also highlighted the importance of changing attitudes and perspectives to support the team dynamic and share the workload when a trainee takes parental leave.
The study was funded by various sources, and the researchers reported no relevant financial relationships.