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Parenthood and physician training: high stress and career change

NEW DATA SHOW that having children is not only a big source of stress for residents and fellows, but it might also have important effects on the physician workforce.

A study in the Journal of Hospital Medicine found that among 500 trainees at the University of Pittsburgh Medical Center who responded to a June 2021 survey, half were already parents. Just over three-quarters of those trainees (77%) became parents during their training.

Family planning
Participants in the study said that training had significant effects on their family plans. One-third of respondents, for example, said that child care costs affected the number of children they planned to have. Forty-five percent said that child care costs affected the timing of having children.

Of the residents and fellows who weren’t parents, 64% said they couldn’t imagine having kids during training. Not surprisingly, 66% of those respondents said they were waiting to start a family until their training was finished.

Child care duties
Among trainees who were already parents, there were pronounced gender differences in parental duties. When it came to functioning as the primary caregiver, that was a role taken by 97% of women and 79% of men.

Female trainees took longer parental leaves than men (7.4 weeks vs. 1.8 weeks). More women said they would have to extend their training than men (36% vs. 13%).

And after becoming parents, 40% of respondents changed career plans. There were no differences by gender in those data.

Support from training programs
For female trainees who had a child while in training, the support they receive from their training program can be crucial to their success. The study found that mothers who were breastfeeding had higher scores on a parental stress scale (46.7%) compared to trainees who weren’t breastfeeding (38.3%).

Among breastfeeding respondents, 24% felt their programs didn’t support their goals. That lack of support was associated with higher parental stress scale scores: 63.6% vs. 38.6%

Researchers found that trainees in procedural specialties were more likely to say they didn’t have enough time and space for breastfeeding compared to their colleagues in nonprocedural specialties (74% vs. 52%).

Role of stress
The study said that stress scores are important because research has shown that high parental stress levels can interfere with caregiving, breastfeeding, and parent-child bonding and attachment.

The study says high parental stress levels may also affect the health care workforce, given that more than one-third of respondents changed career plans after having a child. Many move away from academic medicine and procedural specialties.

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