S. K. Bakhshi1,2, N. Afzal2, N. Qadeer2, A. A. Merchant2, K. A. Rahim2, A. A. Noorali5, M. P. Lakhdir3, A. H. Haider2,4 1Aga Khan University Medical College, Surgery, Karachi, Sindh, Pakistan 2Aga Khan University Medical College, Deans Office, Karachi, Sindh, Pakistan 3Aga Khan University Medical College, Community Health Sciences, Karachi, Sindh, Pakistan 4Aga Khan University Medical College, Surgery & Community Health Sciences, Karachi, Sindh, Pakistan 5Aga Khan University Medical College, Medicine, Karachi, Sindh, Pakistan
Introduction:
Parenthood during surgical residency is documented to be taxing and arduous in the United States. Lack of supporting mechanisms for residents, who wish to have a child, warrants implementation of appropriate policies. To promote a conducive work environment, it is imperative to understand the status of existing guidelines. Our objective was to assess the accessibility of maternity and paternity leaves for surgical residents, and determine culturally-distinct barriers to parenthood during residency in a multi-center cohort from Asia.
Methods:
This was a cross-sectional study conducted using an electronic survey. It targeted surgical residents from 11 institutes, which offered nationally accredited residency programs for nine core specialties (general surgery, urology, orthopedic surgery, cardiothoracic surgery, pediatric surgery, neurosurgery, obstetrics/gynecology, ENT and plastic surgery). Sample size was calculated keeping 5% level of significance and design effect of 1. Univariate and multivariate regression analysis was done.
Results:
Among the 218 residents who responded, there were 110 (50.4%) males and 108 (49.5%) females. The mean age was 28.8 2.35 years. Ninety-three (42.7%) residents were married; 62 (28.4%) were a parent with 53 (24.3%) becoming one during residency. Parental leave was availed by 34 (15.6%) residents (14 male & 20 female), ranging from less than 4 weeks (11; 5.0%) to 12 weeks (14; 6.4%). There was a significant lack of awareness among residents (27; 12.4%) regarding the national parental leave policy for residents (p = 0.008). Majority residents (175; 80.3%) believed that surgical residency is not the best time for female residents to have children (p = 0.006), whereas 83 (38.1%) believed that it was best for male residents to become a parent during training (p = 0.001). There was a statistically significant agreement that the ideal duration of maternity leave should be 12 weeks (p = 0.028), but there was no consensus on the ideal paternity leave duration. The three most common modifiable factors that inhibit residents from having children during residency include inadequate parental leave policy, lack of time due to training and lack of support from faculty and colleagues. Insufficient support from faculty and peers was statistically significant on logistic regression (OR 2.192; 95% CI 1.067, 4.502).
Conclusion:
We report that inadequate support from faculty and colleagues is a major barrier in surgical residents’ decision to consider having a child during training. There is a significant need to raise awareness about existing policy on parental leaves among surgical residents. This can potentially change the perception about the ideal time for female surgical trainees to have a child.
