Despite training and working at the cutting edge of medicine, new research reveals that 67% of surgical trainees have considered delaying or did delay starting a family due to their studies, with 58% reporting negative stigma around taking parental leave.
The survey, conducted by Dr Wendy Liu, Dr Joyce Yu, and RACS Fellows Dr Upeksha DeSilva and Dr Christine Lai, also showed that 40% of trainees believed that surgery had negatively impacted their family relationships.
Despite the fact that 94% of surgical trainees valued work-life balance, with 73% willing to consider flexible or part-time training to balance work and family commitments, the survey found that nearly a third of female trainees (32%) have considered leaving surgery because of their experiences.
Dr Liu, a Royal Australasian College of Surgeons (RACS) Trainee and general surgery registrar at Royal North Shore Hospital, said medical colleges, including RACS, should consider implementing an accessible parental leave policy – a move supported by 93% of respondents.
“RACS, along with other medical colleges, need to be proactive in implementing a parental leave policy that is reflective of a changing culture in medicine,” Dr Liu said.
“Many trainee surgeons are not eligible for parental leave because they are required to move from state-to-state to complete their surgical training and advance their career.
“New South Wales is the only state which recognises parental leave entitlements for returning trainees. The other states are playing catch-up and trainee surgeons are the ones suffering.”
The doctors’ research also focussed specifically on the experience of female surgical trainees, fellows, and consultants, and found that out of 140 respondents – of whom 36% were pregnant during surgical training – 83% worked more than 40 hours a week during their third trimester.
Despite 81% indicating that they were worried their work schedule would compromise either their or their baby’s health, 35% per cent of responders continued working beyond 38 weeks gestation.
Half of them experienced pregnancy or neonatal-related complications, most commonly attributed to a physically taxing job, long hours and interrupted sleep.
Breastfeeding was important to 89%, but 40% stopped early due to challenges expressing between clinical duties and a lack of suitable lactation facilities.
Nearly 90% were concerned requests for accommodations would be perceived negatively by colleagues and supervisors, and overall, 79% of females took six or more weeks of paid parental leave.
The situation was not much better for male trainees: no one took more than six weeks of paid parental leave, and 31% took no paid parental leave at all – nearly half of the male parents surveyed did not qualify for or were declined paid parental leave.
Dr Yu, a pre-vocational doctor at Hornsby Ku-Ring-Gai Hospital said it should be easier for surgical trainees to start a family, without it impacting their career progression.
“To attract and retain talented and dedicated surgeons, our culture must change to support pregnancy and ensure mentorship is widely available,” Dr Yu said.
“A clear parental leave policy would help eliminate ambiguity and help deliver greater work-life balance. There needs to be someone looking after the surgeons too.”
Their findings are supported by another recent survey of Australian and New Zealand (ANZ) doctors by North Health VIC in November 2021, which found that 39% of female surgeons had experienced infertility issues, more than double the rate of the Australian population.
Compared to female physicians and GPs, women surgeons were more likely to delay having a family due to work (surgeons: 68.7%, physicians: 67.5%, GPs: 53.3%, P = 0.002), increasing the prevalence of age-related infertility issues.
The authors state that increasing awareness and addressing work related barriers to family planning is required to support the female surgical workforce.