Assessing the Importance and Availability of Family Planning Policies for Surgical Residency Programs

Introduction: The overlap of physician training with prime reproductive years creates significant challenges for those who wish to build a family. Trainees in the three longest residencies – neurosurgery, plastic surgery, and cardiothoracic surgery – often experience increased rates of infertility, complications, and challenges with childrearing. Aside from recent American Board of Medical Specialties (ABMS) and Accreditation Council for Graduate Medical Education (ACGME) policies providing trainees with 6-weeks of parental leave, there remains a paucity of national or widely accepted guidelines related to fertility and family planning, leaving critical gaps for which individual institutional GME offices are responsible for policies, procedures, and resources.

Methods: Institutions offering ACGME accredited US-based neurosurgery, plastic surgery, and cardiothoracic surgery residency programs were meticulously reviewed through April 2024 for policies and resources for family planning, fertility, and parental leave. A grading system was developed to objectively analyze the availability of identified resources, with comparative analysis performed with ANOVA, Chi-square, and independent sample t-tests.

Results: Of 115 analyzed institutions, the University of California/San Francisco, University of California/San Diego, and Vanderbilt University emerged as the top performers by overall score across categories. Their high-ranking scores reflect the availability of superior information on insurance benefits; guidelines for paid parental leave; guides for childrearing; generous childcare programs; and policies related to radiation exposure. Geographically, Western programs consistently outperformed the rest of the US, offering the most comprehensive resources including robust insurance plans (p=0.025), lactation and adoption policies (p < 0.001), and radiation exposure policies for pregnant residents (p=0.041).

Conclusion : There remains marked variability in the availability and quality of policies and resources related to family planning for physician trainees. Thus, it is imperative for the overall wellbeing of residents that governing bodies and institutions take steps toward improvement through such initiatives as development of publicly accessible institutional resources, advocacy for fair access to fertility preservation, and expansion of institutional services and programming.