E. Askew1, S.J. Halix1, A. Rubio Chavez1, E. Koelliker1, T.M. Lwin2, T.D. Shanafelt3, C.P. Landrigan4, A.S. Winn4, H. Farid5, K.D. Lillemoe1, E.L. Rangel1 1Massachusetts General Hospital, Department Of Surgery, Boston, MA, USA 2City Of Hope National Medical Center, Department Of Surgery, Duarte, CA, USA 3Stanford University, Department Of Medicine, Palo Alto, CA, USA 4Boston Children’s Hospital, Division Of General Pediatrics, Boston, MA, USA 5Beth Israel Deaconess Medical Center, Department Of Obstetrics And Gynecology, Boston, MA, USA
Introduction: Domestic partnerships of physician trainees are strained by prolonged training, limited free time, and work-related stress. Most studies of these relationships highlight the physician experience; the few that examine domestic partners’ perspectives primarily focus on male physicians’ wives, overlooking female physicians and the modern emphasis on shared domestic responsibilities. The stressful transition to parenthood, exacerbated by medical training, can negatively affect relationships. To our knowledge, no studies explore the impact of new parenthood on the domestic partnerships of medical trainees. This study aims to illuminate these experiences, highlighting stressors that contribute to trainee distress and impact workforce participation.
Methods: This multisite, cross-sectional qualitative study recruited domestic partners (DPs) of residents and fellows who had given birth in the past 12 months. The trainees were participants in the “The 4th Trimester Initiative,” a randomized clinical trial assessing support for childbearing trainees. DPs underwent semi-structured interviews exploring four domains: impact of medical training on marriage, distribution of domestic work including childcare, changes in their own career perspectives, and the interplay of work and family stress. Data were analyzed using mixed inductive-deductive thematic analysis and thematic network analysis.
Results: 33 domestic partners of female childbearing trainees across 15 specialties participated. 100% identified as men (n=33), with 30% (n=10) from historically minoritized racial or ethnic groups. Four key themes emerged (Table), highlighting the challenges faced, responses to challenges, and supports to cope with challenges: (1) DPs were frustrated with the trainee’s inflexible schedule and resented the trainee’s program and the medical profession at large; (2) DPs reevaluated their own career plans based on the trainee’s job demands; (3) DPs took on the majority of domestic work to accommodate the rigidity of the trainee’s schedule; and (4) family and peer support, along with a collaborative approach to parenting, mitigated the difficulties of new parenthood.
Conclusion: The demanding nature and inflexibility of medical training place significant burdens on physician trainees’ domestic partners during early parenthood. Supportive social networks, particularly among peers and family, and a more flexible work environment that can allow for shared responsibilities, can help mitigate these challenges. Training programs should actively foster these support systems and increase schedule flexibility to enhance the well-being of childbearing trainees and their domestic partners.