Critical analysis needed to spark culture shift around family building in medicine
Key takeaways:
- Researchers identified four common themes around family building among trainees.
- Results showed that trainees’ experience of medical culture is not supportive of family building.
Medical trainees perceived residency and fellowship programs as unsupportive for individuals wanting to family build during medical training, according to results of a qualitative study.
Trainees recommended institutions provide more tangible support, transparent information and mentorship to improve feelings of support, researchers concluded.
Influencing factors
“We undertook this study to explore factors that residents and fellows consider in whether or when to family build in their careers,” Shirin Dason, MD, FRCSC, reproductive endocrinology and infertility specialist at Trio Fertility, Toronto, Canada, told Healio. “This was a follow-up to previous studies by our team that demonstrated physicians delay childbearing overall. Despite adequate parental leave support in Ontario, Canada, medical learners still choose to delay their family plans to complete their training; we wanted to understand why.”
Researchers sought to examine the factors associated with family building decisions to better understand thoughts on accessing family building supports, workplace culture and attitude toward family building among a cohort of 24 residents and five fellows across postgraduate training sites in Ontario, Canada.
Between May and August 2022, researchers conducted individual, semi-structured, 30- to 90-minute virtual interviews. They asked participants about their thoughts and experiences on:
- family planning in a medical career;
- family-building goals;
- role of mentorship; and
- knowledge of current family planning support.
Common themes
Overall, 29 trainees, aged 25 to 37 years (75.9% women; median age, 30 years) across various institutions participated in the study. Medical specialties included surgical (27.6%), internal medicine and subspecialties (13.7%), pediatrics and subspecialties (10.3%), family medicine (10.3%), obstetrics and gynecology (6.9%), anesthesia (6.9%) and other medical specialties (24.1%).
Researchers identified four common themes:
- tension between role as a physician and as a parent;
- impact of role models and mentorship on family planning choices;
- family building being discouraged during training, especially in surgical specialties; and
- need for tangible family planning support in training.
“We overall found that medical culture is not felt to be supportive of family building, which led to a felt tension between one’s role as a physician and one’s current or potential role as a parent,” Dason said. “There is minimal explicit information provided to learners on how one could balance family building and their training or future career. There is also fear of reputational harm, even amongst peers.”
‘Much-needed change’
Dason said the study findings did not surprise the research team.
“These voiced experiences are now having the opportunity to come to light as an important avenue to explore. Our research serves as a much-needed needs assessment in this area,” she said.
She said explicit discussions around family building in training and in future careers is important for medical learners to begin to frame their life trajectory.
“Calling everyone into this discussion and providing appropriate mentorship can role model balancing a family and a career in medicine,” she said. “This should include men who are often excluded from conversations around family building. Additionally, critical analysis of support systems is necessary, and parental leave may be the first step for some areas. Other important areas include duty hours conducive to parenting and adequate human resources.”
Future goals for Dason and colleagues include using the findings to support continued advocacy in physician family planning and family building within their institution and province.
“We are keen that our findings will encourage other physician groups to critically analyze their own systems and implement a much-needed change in the overall culture around family planning and building,” she said.
For more information:
Shirin Dason, MD, FRCSC, can be reached at shirin.dason@medportal.ca.
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