Assessing the Importance and Availability of Family Planning Policies for Surgical Residency Programs: A Review.

OBJECTIVE To assess the availability and quality of family-planning resources available to surgical trainees. SUMMARY BACKGROUND DATA The overlap of residency with reproductive years creates significant challenges for those who wish to build a family. Trainees in the three longest residencies - neurosurgery, plastic surgery, and cardiothoracic surgery - report increased rates of infertility, complications, and challenges with childrearing. Despite recent recommendations surrounding parental leave, there remains a paucity of widely accepted guidelines related to fertility and family planning, leaving critical gaps for trainees. METHODS A cross-sectional study was conducted to query the GME offices of all institutions with a categorical neurosurgery, integrated cardiothoracic, or plastic surgery residency for policies related to family-planning, fertility, or child-bearing. Analyses were performed to assess the relative availability and quality of these resources in general, and among institutions. RESULTS Of 115 institutions, Western programs consistently outperformed the rest of the US, offering the most comprehensive resources, including robust insurance plans (P=0.025), lactation and adoption policies (P<0.001), and radiation exposure policies for pregnant residents (P=0.041). High-performing institutions showed superior availability of information on insurance benefits; guidelines for paid parental leave; guides for childrearing; and generous childcare programs. CONCLUSIONS Despite recent guidelines, there remains marked variability in the availability and quality of policies and resources related to family planning for physician trainees. It is imperative that governing bodies and institutions take steps toward creating more consistent training environments through improvement through such initiatives as the development of publicly accessible institutional resources, advocacy for fair access to fertility preservation, and expansion of institutional services and programming.