Parenthood in US Medical Training Across Specialty Groups: Scoping Review.

Abstract

Background: Residency and fellowship are demanding phases characterized by intense schedules, limited autonomy, sleep deprivation, and hierarchical environments. Training years often coincide with peak reproductive age, presenting trainees with the dilemma of delaying parenthood or managing training and parenthood concurrently.

Objective: This scoping review examines recent literature on factors influencing the experiences of male and female physician trainee parents across various specialties.

Methods: Four databases were searched for studies published from January 2014 through January 2025 examining pregnancy, parenthood, or lactation outcomes among physician trainees and distinguishing between specialties. Eligible studies were screened, data extracted using predefined criteria, and findings thematically coded. Chi-square and Fisher exact tests assessed specialty-related differences for each theme.

Results: The authors identified 15,861 records, removed 6440 duplicates, and excluded 8989 records. Further, 432 full-text papers were reviewed, with 105 papers included in the final analysis: surgical (n=59), medical subspecialty (n=30), primary care (n=11), and multiple specialties (n=5). Surgical and medical subspecialty studies more often identified interpersonal and policy challenges than primary care. Surgical studies highlighted issues such as pregnancy-related bias, lack of support, rigid schedules, and training-parenthood conflict. Primary care studies more often identified conflicts between parenthood and patient care responsibilities (primary care: 3/11, 27% vs surgical: 3/59, 5% and medical subspecialty studies 0/30, 0%, P=.01). Negative well-being impacts from training and parenthood were reported more often in primary care (3/11, 27%) and surgical studies (13/59, 22%) than in medical subspecialties (1/30, 3%, P=.03).

Conclusions: Trainees face physician parenthood challenges across social ecological levels, with surgical and subspecialty trainees experiencing more systemic barriers and primary care trainees more patient care-related concerns.