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Pregnancy doesn’t drive women doctors out of surgical training

By Ronnie Cohen

NEW YORK (Reuters Health) - A new study disputes a common stereotype that women who become pregnant during surgical training often drop out of those training programs.

Researchers led by Dr. Erin G. Brown of the University of California, Davis found that neither women nor men who had children born during their school’s surgical residency program were more likely to quit than residents who did not have children during training.

Brown told Reuters Health the idea for the study came to her when she was pregnant with her daughter, now one and a half years old, during her surgical residency.

“Things are changing. It’s not an overnight change. It’s a slow, steady culture change away from the old boys’ club mentality that women who have children during training aren’t going to cut it,” she said.

“This study shows that surgical residents who have children during training are just as good,” she added.

General surgical residency programs last five years and are known for being rigorous.

For the new study, Brown and her colleagues reviewed records on 85 residents enrolled in the University of California, Davis general surgery residency program from 1999 to 2009.

Forty-nine of the residents were men, and the average age of all residents entering the program was almost 28 years. Overall attrition was about 19 percent, with 16 residents leaving the program.

A similar proportion of male and female residents left the training program.

Of the 85 residents, 25 had children born during training.

Among female residents in particular, 25 percent had children during training and took an average maternity leave of 10 weeks. One of those women left the training program. One woman extended her residency training by two weeks, but the other women who had babies while in training completed the program on time.

Residents with children born during the program treated a similar number of patients and were equally likely to pass their boards as those who did not have children, according to findings published in JAMA Surgery.

In an accompanying commentary, Dr. Jeffrey Gauvin, director of the surgical training program at Santa Barbara Cottage Hospital in California, applauded the study but questioned its applicability to smaller programs like his own.

Davis has “a deep bullpen from which a program director can call in reserves when someone is on leave,” he writes. “This may be a very different scenario for small or midsized programs that have very limited - if any - reserves.”

Gauvin formerly directed the surgical residency program at the University of California, Davis.

Brown acknowledged that smaller programs could face greater challenges in accommodating surgical residents during maternity leave. She is currently compiling data from surgical residency programs of various sizes across the nation to see if the results of the Davis study hold.

“These are very motivated women who know what they want, and they’re able to manage the stress of parenting and training and don’t deviate from their career goals,” Brown said.

Women comprised just seven percent of U.S. medical school graduates in 1965, according to the Association of American Medical Colleges. Today that rate hovers near 50 percent.

But a majority of surgical residents continue to be male, Dr. Nina Shapiro told Reuters Health.

Shapiro, a professor of head and neck surgery at the University of California, Los Angeles, was not involved in the current study. She said she has watched life change for pregnant surgical residents since she began her training in 1991.

“Because there’s been an increase in the number of women, the climate has by default changed,” she said. “There’s a huge difference in 20 years.”

“The women going into surgery are very keenly watching those ahead of them. If women are showing they can have babies and be successful, I think other women are going to follow. It’s really inspiring for women going into these training programs.”

Shapiro is married to another physician, and they have two young children.

“Is it a perfect life?” she asked. “There are many days I can’t see my kids. For the most part, I make it work. I never miss a school event, a big event in my kids’ lives. I don’t miss too many small events. I do a lot of homework. I know a lot of fifth-grade math.”

SOURCE: http://bit.ly/1n1S0L8 and http://bit.ly/1nk9sMq JAMA Surgery, online July 16, 2014.

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