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Lall MD, Jayaprakash N, Carrick A, Chang BP, Himelfarb NT, Thomas Y, Wong ML, Dobiesz V, Raukar NP. Consensus-Driven Recommendations to Support Physician Pregnancy, Adoption, Surrogacy, Parental Leave, and Lactation in Emergency Medicine. Ann Emerg Med 2024; 83:585-597. [PMID: 38639673 DOI: 10.1016/j.annemergmed.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 02/17/2024] [Accepted: 03/11/2024] [Indexed: 04/20/2024]
Abstract
The emergency department clinical environment is unique, and guidelines for promoting supportive and equitable workplace cultures ensure success and longevity for pregnant persons and parents in emergency medicine. There is paucity, variability, and dissatisfaction with current parental (historically referred to as maternity and paternity) leave policies. This paper describes the development of consensus-derived recommendations to serve as a framework for emergency departments across the country for incorporating family-friendly policies. Policies that foster a family-inclusive workplace by allowing for professional advancement without sacrificing personal values regardless of sex, gender, and gender identity are critical for emergency medicine recruitment and retention.
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Affiliation(s)
- Michelle D Lall
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA.
| | - Namita Jayaprakash
- Department of Emergency Medicine, Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI
| | - Angela Carrick
- Kansas College of Osteopathic Medicine, Wichita, KS; Department of Emergency Medicine, Hutchison Regional Medical Center, Hutchison, KS
| | - Bernard P Chang
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY
| | - Nadine T Himelfarb
- Department of Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Ynhi Thomas
- Henry J.N. Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX
| | - Matthew L Wong
- Department of Emergency Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Valerie Dobiesz
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Neha P Raukar
- Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN
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Kim JL, Forster CS, Allan JM, Schondelmeyer A, Ruch-Ross H, Barone L, Fromme HB. Gender and work-life balance: Results of a national survey of pediatric hospitalists. J Hosp Med 2024. [PMID: 38800852 DOI: 10.1002/jhm.13413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/22/2024] [Accepted: 04/25/2024] [Indexed: 05/29/2024]
Abstract
In medicine, difficulty integrating work and home can lead to decreased job satisfaction, diminished well-being, and increased turnover. Understanding the experience of pediatric hospitalists can provide insights into building a stable, long-term workforce. We aim to examine gender differences in work-life balance and parental leave for physicians practicing Pediatric Hospital Medicine. METHODS This was a cross-sectional survey study of 1096 pediatric hospitalists. Responses were collected via an online survey platform and summarized using descriptive statistics, including frequency distributions and measures of central tendency. A multivariable logistic regression was used to examine associated variables and work-life balance satisfaction. We analyzed free responses on parental leave to provide nuance to quantitative survey data. RESULTS Five hundred and sixty-five respondents (52% response rate) completed the survey with 71% women. 343 (62%) prioritize work-life balance in career decision-making. Women report taking on more household responsibilities than their partners (41.4% vs. 8.4%; p < .001) including a larger percentage of caregiving and domestic tasks. Female gender and performing <50% caregiving were associated with decreased work-life balance satisfaction; performing <50% domestic tasks increased satisfaction. Median parental leaves were 4 weeks, with men taking significantly shorter leaves (3.5 vs. 6 weeks; p < .001) and more "paid back" time off. CONCLUSION Work-life balance is an important factor in career decisions for men and women. Women perceive carrying a larger load at home. Qualitative results suggest that parental leave may be inadequate in length and salary support for men and women. This study adds insights into work-life integration in PHM.
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Affiliation(s)
- Juliann L Kim
- Department of Pediatrics, Pediatric Hospital Medicine, Palo Alto Medical Foundation, Palo Alto, California, USA
| | - Catherine S Forster
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jessica M Allan
- Department of Pediatrics, Pediatric Hospital Medicine, Palo Alto Medical Foundation, Palo Alto, California, USA
| | - Amanda Schondelmeyer
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Holly Ruch-Ross
- Department of Primary Care and Subspecialty Pediatrics, American Academy of Pediatrics, Itasca, Illinois, USA
| | - Lauren Barone
- Department of Primary Care and Subspecialty Pediatrics, American Academy of Pediatrics, Itasca, Illinois, USA
| | - H Barrett Fromme
- Department of Pediatrics, The University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
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Franzoi IG, Sauta MD, De Luca A, Granieri A. Returning to work after maternity leave: a systematic literature review. Arch Womens Ment Health 2024:10.1007/s00737-024-01464-y. [PMID: 38575816 DOI: 10.1007/s00737-024-01464-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/28/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE Working women often experience difficulties associated with balancing family and career, particularly if they choose to have children. This systematic literature review aimed at investigating women's experience in returning to work after maternity leave. METHODS The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The literature search led to the identification of 52 articles, which underwent data extraction and qualitative analysis. RESULTS Results were organized in 5 categories: (1) Work-life balance; (2) Women's mental and physical health; (3) Job-related wellbeing and working experience; (4) Breastfeeding. Women's both mental and physical health seem connected to a longer maternity leave and a greater coworkers' and supervisors' support. Returning to work seems to constitute one of the most important barriers for exclusive breastfeeding or breastfeeding continuation. A shorter duration of maternity leave, a higher workload and the lack of occupational policies supporting breastfeeding seem to be hindering factors. Partner and family support, and the opportunity for fathers to work under a flextime system after childbirth seem to increase both breastfeeding initiation and duration. Women who continue breastfeeding after returning to work seem to experience more family-to-work conflict and overload. CONCLUSIONS This paper show that there are still many understudied aspects in exploring women's experience of returning to work after maternity leave. This represents an important gap in the literature, since returning to work represents a particularly critical time in women's personal and occupational life, in which challenges and barriers may arise, potentially affecting their experience in the immediate future and years to come.
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Affiliation(s)
| | - Maria Domenica Sauta
- Department of Psychology, University of Turin, Via Verdi 10, Turin, 10124, Italy
| | - Alessandra De Luca
- Department of Psychology, University of Turin, Via Verdi 10, Turin, 10124, Italy
| | - Antonella Granieri
- Department of Psychology, University of Turin, Via Verdi 10, Turin, 10124, Italy
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Rapisarda S, De Carlo A, Pasqualetto E, Volling BL, Dal Corso L. Breaking the maternity mold: navigating the return to work and challenging rigid maternal beliefs through an online psychological intervention. Front Glob Womens Health 2024; 5:1266162. [PMID: 38638326 PMCID: PMC11024285 DOI: 10.3389/fgwh.2024.1266162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 03/20/2024] [Indexed: 04/20/2024] Open
Abstract
Working mothers must often balance work and family responsibilities which can be affected by rigid and irrational beliefs about motherhood. The present study had two aims: (a) to provide psychometric evidence for a shortened Italian version of the Rigid Maternal Beliefs Scale (RMBS) and (b) to facilitate mothers' return to work after maternity leave by reducing perceptions of anxiety and stress related to rigid maternal beliefs (i.e., perceptions and societal expectations of mothers, maternal confidence, maternal dichotomy) and by teaching specific recovery strategies (e.g., relaxation, mastery experiences) to manage anxiety and stress through an online psychological intervention. Results replicated the three-factor structure of the original RMBS and showed good psychometric properties. The online psychological intervention resulted in decrease in the rigidity of maternal beliefs, perceived anxiety and stress, and increase in recovery strategies. These initial results are promising and encourage further investigation into online psychological interventions for improving the well-being of working mothers.
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Affiliation(s)
- Sebastiano Rapisarda
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy
| | - Alessandro De Carlo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Elena Pasqualetto
- Department of Private Law and Critique of Law, University of Padova, Padova, Italy
| | - Brenda L. Volling
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States
| | - Laura Dal Corso
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy
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Hoang Roberts LN, Zwaans BMM, Vollstedt A, Sharrak A, Han E, Fischer M, Sirls L, Padmanabhan P. Maternity Leave Satisfaction Among Physicians Compared with Nonphysician Professionals. J Womens Health (Larchmt) 2024; 33:33-38. [PMID: 37639698 DOI: 10.1089/jwh.2023.0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
Objective: The objective of this study was to compare maternity leave satisfaction between physicians and nonphysicians. Currently, paid maternal leave is not guaranteed in the United States, resulting in palpable dissatisfaction among parents. Previous studies have shown associations between length of paid leave and career satisfaction and maternal happiness. Materials and Methods: A Qualtrics® electronic survey was distributed to female professionals through email and social media from April 2019 to March 2020. Inclusion criterion was ≥1 child by birth or adoption, or active pregnancy. Continuous and categorical data were analyzed using two-sample t-test and chi-square, respectively. Results: Of 808 respondents, 77% were physicians. Mean age at birth/adoption of first child was higher in physicians versus nonphysicians (32.1 years vs. 29.7 years; p < 0.001). Physicians took shorter maternity leave than nonphysicians (10.9 weeks vs. 12.0 weeks, p = 0.017) with half of that time paid by employers (5.4 weeks vs. 5.9 weeks, p = 0.2). Dissatisfaction was high among physicians (85.1%) and nonphysicians (92.4%) that correlates with maternity leave compensation dissatisfaction (49% vs. 71.3%, p < 0.001). Thirty-four percent of physicians versus 41% of nonphysicians stated that their health was negatively impacted by maternity leave length. Physicians and nonphysicians reported similar incidences of depression, and breastfeeding, delivery, and other postpartum complications. When queried, 38.8% of physicians and 57% of nonphysicians said they would desire >16 weeks of paid maternity leave (p < 0.001). Conclusions: In conclusion, dissatisfaction among professional women on maternity leave duration and compensation is high in the United States. Given health implications for both mother and child, this should invite further discussion and changes.
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Affiliation(s)
| | - Bernadette M M Zwaans
- Department of Urology, Beaumont Health, Royal Oak, Michigan, USA
- William Beaumont School of Medicine, Rochester, Michigan, USA
| | - Annah Vollstedt
- Department of Urology, University of Iowa, Iowa City, Iowa, USA
| | | | - Esther Han
- Orlando Health Medical Group, Orlando, Florida, USA
| | - Melissa Fischer
- Department of Urology, Beaumont Health, Royal Oak, Michigan, USA
- William Beaumont School of Medicine, Rochester, Michigan, USA
| | - Larry Sirls
- Department of Urology, Beaumont Health, Royal Oak, Michigan, USA
| | - Priya Padmanabhan
- Department of Urology, Beaumont Health, Royal Oak, Michigan, USA
- William Beaumont School of Medicine, Rochester, Michigan, USA
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Ausman SE, Mara KC, Brown CS, Epps KL, Kooda K, Mendez J, Rivera CG. CLinician and patient characteristics effect on Antimicrobial Stewardship Interventions (CLASI) study. Infect Control Hosp Epidemiol 2023; 44:2002-2008. [PMID: 37222155 DOI: 10.1017/ice.2023.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To determine whether the gender of clinicians making antimicrobial stewardship recommendations has an impact on intervention acceptance rate. DESIGN A retrospective, multivariable analysis of antimicrobial stewardship prospective audit and feedback outcomes. SETTING A multisite healthcare system including Mayo Clinic Rochester (MN), Mayo Clinic Arizona, Mayo Clinic Florida and 17 health-system hospital sites, where prospective audit and feedback is performed and documented within an electronic tool embedded in the medical record. PARTICIPANTS The study included 143 Mayo Clinic clinicians (84 cisfemales and 59 cismales). METHODS Outcomes were analyzed from July 1, 2017, to June 30, 2022, for intervention rates, communication methods, and intervention acceptance by clinician gender, profession, patient age, and intensive care unit (ICU) status of patient. RESULTS Of 81,927 rules, 71,729 rules met study inclusion. There were 18,175 (25%) rules associated with an intervention. Most of the rules were reviewed by pharmacists (86.2%) and stewardship staff (85.5%). Of 10,363 interventions with an outcome documented, 8,829 (85.2%) were accepted and 1,534 (14.8%) were rejected. Female clinicians had 6,782 (86.5%) of 7,843 interventions accepted, and male clinicians had 2,047 (81.2%) of 2,520 interventions accepted (P = .19). Female patients had more interventions than male patients (female vs male: 25.9% vs 24.9%; OR, 1.04; 95% CI, 1.02-1.08; P = .001). Patients in the ICU had a significantly lower intervention acceptance rate (ICU vs non-ICU: 78.2% vs 86.7%; OR, 0.56; 95% CI, 0.45-0.7; P < .001). CONCLUSIONS Female and male clinicians were equally effective at prospective audit and feedback in a multisite antimicrobial stewardship program. Patients in the ICU were less likely to have stewardship interventions accepted.
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Affiliation(s)
- Sara E Ausman
- Department of Pharmacy, Mayo Clinic Health System, Eau Claire, Wisconsin
| | - Kristin C Mara
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | | | - Kevin L Epps
- Department of Pharmacy, Mayo Clinic, Jacksonville, Florida
| | - Kirstin Kooda
- Department of Pharmacy, Mayo Clinic, Rochester, Minnesota
| | - Julio Mendez
- Division of Infectious Diseases, Mayo Clinic, Jacksonville, Florida
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Tsukahara Y, Novak M, Takei S, Asif IM, Yamasawa F, Torii S, Akama T, Matsumoto H, Day C. An international study on attitudes and opinions regarding female sports medicine physicians during pregnancy and the postpartum period. PHYSICIAN SPORTSMED 2023; 51:603-609. [PMID: 36460302 DOI: 10.1080/00913847.2022.2154624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/28/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVES Supporting female sports medicine physicians to simultaneously be mothers and pursue professional careers is crucial to maintain gender diversity in sports medicine physicians. The purpose of this study is to understand the attitudes toward female sports medicine physicians during pregnancy and postpartum. METHODS An anonymous online survey was distributed to sports medicine physicians practicing in 51 different countries. They were asked how comfortable they felt with female sports medicine physicians working on the sidelines of sporting events during pregnancy, if the female sports medicine physicians were as productive as their male counterparts after giving birth, and how satisfied they were with the percentage of female sports medicine physicians in their country. Data were analyzed using the chi-square test, and multivariate logistic regression analysis was performed to identify independent variables. RESULTS In total, 1193 physicians (380 [31.9%] female) were included for analysis. Physicians in Asia were the least comfortable with pregnant sports medicine physicians working on the sidelines and those in North America were the most comfortable (odds ratio = 0.28 and 2.51, 95% confidence interval 0.18-0.44 and 1.55-4.06, respectively). More experienced sports medicine physicians (odds ratio = 1.01, 95% confidence interval 1.00-1.03; p < 0.05) and divorced physicians (odds ratio = 0.33, 95% confidence interval 0.12-0.91; p < 0.05) were less comfortable with pregnant female sports medicine physicians working on sidelines, and those trained in orthopedics were less likely to agree that female sports medicine physicians were equally as productive as male counterparts postpartum (odds ratio = 0.29, 95% confidence interval 0.10-0.88; p < 0.05). Female physicians were less satisfied with the percentage of female sports medicine physicians in their country (odds ratio = 0.41, 95% confidence interval 0.27-0.60; p < 0.01) than their male counterparts. CONCLUSIONS Female sports medicine physicians may experience bias in their practice during pregnancy and postpartum.
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Affiliation(s)
- Yuka Tsukahara
- Waseda Institute for Sport Sciences, Waseda University, Tokorozawa, Japan
- Faculty of Physical Education, Tokyo Women's College of Physical Education, Tokyo, Japan
| | - Melissa Novak
- Department of Family Medicine, Oregon Health and Science University, Portland, ORE, USA
| | - Seira Takei
- Waseda Institute of Human Growth and Development, Waseda University, Tokorozawa, Japan
| | - Irfan M Asif
- Department of Family and Community Medicine, The University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | | | - Suguru Torii
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Takao Akama
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Hideo Matsumoto
- Public Interest Incorporated Foundation, Japan Sports Medicine Foundation, Tokyo, Japan
| | - Carly Day
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, USA
- Franciscan Physician Network, West Lafayette, IN, USA
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Ali S, Chowdhury R, Bittner K, Oxentenko AS, Kothari S. Assessing Family Leave Policies and Pregnancy Outcomes Among Gastroenterologists: A Survey of Physicians in the American College of Gastroenterology. Am J Gastroenterol 2023; 118:2294-2300. [PMID: 37463424 DOI: 10.14309/ajg.0000000000002408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/03/2023] [Indexed: 07/20/2023]
Abstract
INTRODUCTION Given variability in parental leave policies in gastroenterology (GI) with little data on outcomes, the American College of Gastroenterology conducted a survey to assess policies and outcomes. METHODS A survey was distributed to American College of Gastroenterology members with questions on demographics, fertility, pregnancy outcomes, and parental leave policies. RESULTS There were 796 responses, with 52.5% female individuals. Many (57%) delayed parenting. High rates of infertility (21%) and pregnancy complications (68%) were observed. Satisfaction with parental leave policies in GI was low (35%). DISCUSSION Our survey highlights the need for policies that support the well-being of our GI colleagues and families.
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Affiliation(s)
- Shazia Ali
- The Permanente Medical Group, San Jose, California, USA
| | | | - Krystle Bittner
- University of Rochester Medical Center, Rochester, New York, USA
| | | | - Shivangi Kothari
- University of Rochester Medical Center, Rochester, New York, USA
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Tsukahara Y, Day C, Novak M. Navigating the challenges: working as a sports medicine physician during pregnancy and postpartum. Br J Sports Med 2023; 57:1535-1536. [PMID: 37879859 DOI: 10.1136/bjsports-2023-107465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 10/27/2023]
Affiliation(s)
- Yuka Tsukahara
- Department of Sports Medicine, Tokyo Women's College of Physical Education, Kunitachi, Tokyo, Japan
| | - Carly Day
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana, USA
- Franciscan Physician Network, West Lafayette, Indiana, USA
| | - Melissa Novak
- Department of Family Medicine, Oregon Health & Science University Department of Family Medicine, Portland, Oregon, USA
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Li JH, Hanley LE, Powe CE, Seiglie JA, Haines MS, Wein MN, Bregar A, Miller KK, Dichtel LE. Supporting Our Physician Parents (SOPPort): A pilot program for parental wellness at the Massachusetts General Hospital. J Clin Transl Sci 2023; 7:e238. [PMID: 38028349 PMCID: PMC10663770 DOI: 10.1017/cts.2023.645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/08/2023] [Accepted: 09/27/2023] [Indexed: 12/01/2023] Open
Abstract
Physician parents encounter unique challenges in balancing new parenthood with work responsibilities, especially upon their return from parental leave. We designed a pilot program that incorporated 1:1 parental coaching to expectant and new physician parents and provided stipends for lactation support and help at home. Additional initiatives included launching a virtual new parent group during the COVID-19 pandemic and starting an emergency backup pump supplies program. There was positive feedback for our Parental Wellness Program (PWP), which was used to secure expanded funding. Pilot results showed that our program had a meaningful impact on parental wellness, morale, productivity, and lactation efforts.
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Affiliation(s)
- Josephine H. Li
- Endocrine Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Lauren E. Hanley
- Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Camille E. Powe
- Endocrine Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jacqueline A. Seiglie
- Endocrine Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Melanie S. Haines
- Endocrine Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Marc N. Wein
- Endocrine Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Amy Bregar
- Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Karen K. Miller
- Endocrine Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Laura E. Dichtel
- Endocrine Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Malapati SJ, Idossa D, Singh SRK, Wei Z, Kiel L, Chino F, Patel MA, Bruno XJ, Florez N. Parent Penalty: Parental Leave Experiences of Trainees and Early-Career Faculty in Oncology Subspecialties. JCO Oncol Pract 2023; 19:899-906. [PMID: 37708434 DOI: 10.1200/op.23.00242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/08/2023] [Accepted: 08/10/2023] [Indexed: 09/16/2023] Open
Abstract
PURPOSE Prime childbearing years occur during medical training and early career, leaving physicians with tough choices between family planning and career growth. Restrictive workplace parental leave (PL) policies may negatively affect physician well-being. We evaluate existing PL and lactation policies, as well as return-to-work experiences, among oncology trainees and early-career faculty. METHODS An anonymous 43-question cross-sectional survey was distributed via e-mail and social media channels between May and June 2021 to oncology trainees and physicians within 5 years of terminal training in the United States. The survey was administered through SurveyMonkey. Descriptive statistics were used to analyze data. Two hundred seventy-five participants were recruited via social media and outreach to program directors and coordinators in adult hematology/oncology and radiation oncology program directors. RESULTS The average duration of PL was <6 weeks for most participants. Among those who used PL, 50% felt pressured to work while on PL, 60% felt guilty asking coworkers for help, and 79% were overwhelmed with demands of work and home, whereas only 27% had resources available at workplace to assist with transition back to work. Among those who breastfed at return to work, 31% did not have access to a lactation room, 56% did not have adequate pumping breaks, and 66% did not have pumping breaks mandated in contract. CONCLUSION Our findings underline the immense magnitude of problems surrounding inadequate PL and support for lactating mothers among trainees and early-career physicians in oncology subspecialities. Policies and practices around PL and lactation should be restructured to meet the needs of the evolving oncology workforce.
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Affiliation(s)
| | | | - Sunny R K Singh
- University of Arkansas for Medical Sciences, Little Rock, AR
| | - Zihan Wei
- Dana-Farber Cancer Institute, Boston, MA
| | | | - Fumiko Chino
- Memorial Sloan Kettering Cancer Center, New York, NY
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12
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Xu X, Wang R, Zhang Y, Li J, Li H, Yu X, Zhang J, Li X, Huang Y. Occupational Factors Associated With Time to Breastfeeding Discontinuation After Return to Work Among Female Anesthesiologists in China: A Nationwide Survey. Anesth Analg 2023:00000539-990000000-00632. [PMID: 37756245 DOI: 10.1213/ane.0000000000006651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
BACKGROUND Breast milk is of great benefit to both infants and mothers. Due to occupational barriers, female physicians are at high risk of unintentionally discontinuing breastfeeding. However, evidence among anesthesiologists was limited. The purpose of this study was to investigate occupational factors associated with time to breastfeeding discontinuation among female anesthesiologists following maternity leave in China. METHODS We conducted a nationwide survey of female anesthesiologists who had given birth since January 1, 2015. A 60-item anonymous questionnaire was developed to collect information regarding breastfeeding practices and related factors. The questionnaire was revised based on the recommendations of 15 experts and feedback from the pilot survey. The survey was distributed by the Chinese Society of Anesthesiology. RESULTS The completion rate was 57.9%. In total, 1364 responders were analyzed from all 31 provinces of Mainland China. In total, 1311 (96.1%) responders reported a reduction in breast milk supply on returning to work. Among the 1161 responders who discontinued breastfeeding, 836 (72.0%) did not achieve desired goals due to occupational factors. The median [interquartile range] of maternity leave length and breastfeeding duration were 5 [4-6] months and 10 [7-12] months, respectively. The following occupational factors were associated with longer time to breastfeeding discontinuation after adjusting for confounding effects of personal factors: length of maternity leave (hazard ratio [HR] per month 0.44; 95% confidence interval [CI], 0.36-0.54; P < .001), pumping breast milk during work time (HR, 0.04; 95% CI, 0.02-0.08; P < .001), support from colleagues (HR, 0.92; 95% CI, 0.86-0.99; P = .032), and additional nonclinical activities (HR, 0.87; 95% CI, 0.77-0.98; P = .022). Trainees under supervision (HR, 1.20; 95% CI, 1.06-1.43; P = .005) and the need to remain in the operating room during cases (HR, 2.59; 95% CI, 1.09-6.12; P = .031) were associated with shorter time to breastfeeding discontinuation. Approximately 899 (65.9%) responders pumped breast milk during work time. Among them, reduction in pumping frequency (HR, 1.17; 95% CI, 1.00-1.36; P = .049) and difficulty in finding opportunities for pumping (HR, 2.34; 95% CI, 1.36-4.03; P = .002) were associated with shorter time to breastfeeding discontinuation. CONCLUSIONS We identified modifiable occupational factors associated with time to breastfeeding discontinuation. These findings underscored the necessity of facilitating breastfeeding in the workplace, including encouraging longer maternity leave and breastfeeding breaks, considering the feasibility of pumping in daily case assignments, establishing supportive culture, providing lactation rooms, and offering nonclinical activities.
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Affiliation(s)
- Xiaohan Xu
- From the Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ruiqi Wang
- School of Law, Tsinghua University, Beijing, China
| | - Yuelun Zhang
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Juan Li
- Narragansett Bay Anesthesia Group, Warwick, Rhode Island
| | - Hange Li
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Xuerong Yu
- From the Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jiao Zhang
- From the Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xu Li
- From the Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuguang Huang
- From the Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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13
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Feld LD, Sarkar M, Au JS, Flemming JA, Gripshover J, Kardashian A, Muir AJ, Nephew L, Orloff SL, Terrault N, Rabinowitz L, Volerman A, Arora V, Farnan J, Villa E. Parental leave, childcare policies, and workplace bias for hepatology professionals: A national survey. Hepatol Commun 2023; 7:e0214. [PMID: 37639705 PMCID: PMC10461944 DOI: 10.1097/hc9.0000000000000214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/22/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND The presence of workplace bias around child-rearing and inadequate parental leave may negatively impact childbearing decisions and sex equity in hepatology. This study aimed to understand the influence of parental leave and child-rearing on career advancement in hepatology. METHODS A cross-sectional survey of physician members of the American Association for the Study of Liver Diseases (AASLD) was distributed through email listserv in January 2021. The 33-item survey included demographic questions, questions about bias, altering training, career plans, family planning, parental leave, and work accommodations. RESULTS Among 199 US physician respondents, 65.3% were women, and 83.4% (n = 166) were attendings. Sex and racial differences were reported in several domains, including paid leave, perceptions of bias, and child-rearing. Most women (79.3%) took fewer than the recommended 12 paid weeks of parental leave for their first child (average paid leave 7.5 wk for women and 1.7 for men). A majority (75.2%) of women reported workplace discrimination, including 83.3% of Black and 62.5% of Hispanic women. Twenty percent of women were asked about their/their partners' pregnancy intentions or child-rearing plans during interviews for training. Women were more likely to alter career plans due to child-rearing (30.0% vs. 15.9%, p = 0.030). Women were also more likely to delay having children than men (69.5% vs.35.9%). CONCLUSIONS Women reported sex and maternity bias in the workplace and during training interviews, which was more frequently experienced by Black and Hispanic women. As two-thirds of women had children during training, it is a particularly influential time to reevaluate programmatic support to address long-term gender disparities in career advancement.
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Affiliation(s)
- Lauren D. Feld
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Massachusetts, Worcester, Massachusetts, USA
| | - Monika Sarkar
- Department of Medicine, Division of Gastroenterology & Hepatology, University of California San Francisco, San Francisco, California, USA
| | - Jennifer S. Au
- Department of Organ Transplant, Division of Gastroenterology and Hepatology, Scripps Clinic, La Jolla, California, USA
| | - Jennifer A. Flemming
- Department of Medicine and Public Health Sciences, Queen’s University, Ontario, Canada
| | - Janet Gripshover
- Department of Transplant Surgery, Ronald Regan UCLA Medical Center, Los Angeles, California, USA
| | - Ani Kardashian
- Department of Medicine, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Andrew J. Muir
- Department of Medicine, Division of Gastroenterology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Lauren Nephew
- Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Susan L. Orloff
- Department of Surgery, Division of Abdominal Organ Transplantation, Oregon Health & Science University School of Medicine, Portland, Oregon, USA
| | - Norah Terrault
- Department of Medicine, Division of Gastroenterology and Liver, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Loren Rabinowitz
- Department of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Anna Volerman
- Departments of Medicine and Pediatrics, University of Chicago, Chicago, Illinois, USA
| | - Vineet Arora
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Jeanne Farnan
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Erica Villa
- Dipartimento di Specialità Mediche, Struttura Complessa di Gastroenterologia, Universita Degli Studi Di Modena E Reggio Emilia, Modena, Italy
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Freudenberger DC, Herremans KM, Riner AN, Vudatha V, McGuire KP, Anand RJ, Trevino JG. General Surgery Faculty Knowledge and Perceptions of Breast Pumping Amongst Postpartum Surgical Residents. World J Surg 2023; 47:2092-2100. [PMID: 37103559 PMCID: PMC10387458 DOI: 10.1007/s00268-023-07005-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND There is a lack of data regarding the knowledge and perceptions teaching faculty possess about breast pumping among general surgery residents despite breast pumping becoming more common during training. This study aimed to examine faculty knowledge and perceptions of breast pumping amongst general surgery residents. METHODS A 29-question survey measuring knowledge and perceptions about breast pumping was administered online to United States teaching faculty from March-April 2022. Descriptive statistics were used to characterize responses, Fisher's exact test was used to report differences in responses by surgeon sex and age, and qualitative analysis identified recurrent themes. RESULTS 156 responses were analyzed; 58.6% were male and 41.4% were female, and the majority (63.5%) were less than 50 years old. Nearly all (97.7%) women with children breast pumped, while 75.3% of men with children had partners who pumped. Men more often than women indicated "I don't know" when asked about frequency (24.7 vs. 7.9%, p = 0.041) and duration (25.0 vs. 9.5%, p = 0.007) of pumping. Nearly all surgeons are comfortable (97.4%) discussing lactation needs and support (98.1%) breast pumping, yet only two-thirds feel their institutions are supportive. Almost half (41.0%) of surgeons agreed that breast pumping does not impact operating room workflow. Recurring themes included normalizing breast pumping, creating change to better support residents, and communicating needs between all parties. CONCLUSIONS Teaching faculty may have supportive perceptions about breast pumping, but knowledge gaps may hinder greater levels of support. Opportunities exist for increased faculty education, communication, and policies to better support breast pumping residents.
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Affiliation(s)
- Devon C Freudenberger
- Department of Surgery, Virginia Commonwealth University School of Medicine, 1200 E. Broad St., PO Box 980011, Richmond, VA, 23219, USA
| | - Kelly M Herremans
- Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Rd., Gainesville, FL, 32608, USA
| | - Andrea N Riner
- Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Rd., Gainesville, FL, 32608, USA
| | - Vignesh Vudatha
- Department of Surgery, Virginia Commonwealth University School of Medicine, 1200 E. Broad St., PO Box 980011, Richmond, VA, 23219, USA
| | - Kandace P McGuire
- Department of Surgery, Virginia Commonwealth University School of Medicine, 1200 E. Broad St., PO Box 980011, Richmond, VA, 23219, USA
| | - Rahul J Anand
- Department of Surgery, Virginia Commonwealth University School of Medicine, 1200 E. Broad St., PO Box 980011, Richmond, VA, 23219, USA
| | - Jose G Trevino
- Department of Surgery, Virginia Commonwealth University School of Medicine, 1200 E. Broad St., PO Box 980011, Richmond, VA, 23219, USA.
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15
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Day CS, Lattanza L, Van Heest A, Templeton K, Fore JA, Ode GE. AOA Critical Issues: Gender Justice in Academic Medicine: What It Might Look Like in Orthopaedic Surgery. J Bone Joint Surg Am 2023; 105:1214-1219. [PMID: 37027484 DOI: 10.2106/jbjs.22.01204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
Abstract
ABSTRACT As the number of women entering medicine has increased, so has the number of women entering orthopaedics; however, many orthopaedic programs struggle to create an equitable space for women, particularly in leadership. Struggles experienced by women include sexual harassment and gender bias, lack of visibility, lack of well-being, disproportionate family care responsibilities, and lack of flexibility in the criteria for promotions. Historically, sexual harassment and bias has been a problem faced by women physicians, and often the harassment continues even when the issue has been reported; many women find that reporting it results in negative consequences for their career and training. Additionally, throughout medical training, women are less exposed to orthopaedics and lack the mentorship that is given to their colleagues who are men. The late exposure and lack of support prevent women from entering and advancing in orthopaedic training. Typical surgery culture can also result in women orthopaedic surgeons avoiding help for mental wellness. Improving well-being culture requires systemic changes. Finally, women in academics perceive decreased equality in promotional considerations and face leadership that already lacks representation of women. This paper presents solutions to assist in developing equitable work environments for all academic clinicians.
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Affiliation(s)
| | | | | | | | - Jessi A Fore
- Henry Ford Health, Detroit, Michigan
- Oakland University William Beaumont School of Medicine, Rochester, Michigan
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16
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Rotenstein LS, Del Carmen MG, Dudley J. Enhancing Lactation Accommodations for Physicians-An Opportunity for Tangible Investments in Our Workforce. JAMA Netw Open 2023; 6:e2327736. [PMID: 37552483 DOI: 10.1001/jamanetworkopen.2023.27736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Affiliation(s)
- Lisa S Rotenstein
- Department of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Marcela G Del Carmen
- Department of Obstetrics and Gynecology, Harvard Medical School, Boston, Massachusetts
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts
| | - Jessica Dudley
- Department of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Now with Press Ganey Associates, Boston, Massachusetts
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17
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Mourad M, Prasad P, Wick C, Sliwka D. Physician Satisfaction With Lactation Resources Following an Intervention to Improve Lactation Accommodations. JAMA Netw Open 2023; 6:e2327757. [PMID: 37552478 PMCID: PMC10410473 DOI: 10.1001/jamanetworkopen.2023.27757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/11/2023] [Indexed: 08/09/2023] Open
Abstract
IMPORTANCE Physicians who attempt to continue breastfeeding after returning from childbearing leave identify numerous obstacles at work, which may affect job satisfaction, retention, and the diversity of the physician workforce. OBJECTIVE To study the association between improved lactation accommodation support and physician satisfaction. DESIGN, SETTING, AND PARTICIPANTS This cohort study compared the physician experience before and after a July 2020 intervention to improve physician lactation accommodation support at a large, urban, academic health system. The satisfaction of physicians returning from childbearing leave between July 1, 2018, and June 30, 2020 (preintervention), was compared with that of physicians returning from leave between July 1, 2020, and November 30, 2021 (postintervention). Initial data analysis was performed on February 22, 2022, with additional tests for interaction performed on May 18, 2023. INTERVENTION The intervention included creating functional lactation spaces, redesigning communication regarding lactation resources, establishing physician-specific lactation policies, and developing a program to reimburse faculty for time spent expressing breastmilk in the ambulatory setting. MAIN OUTCOMES AND MEASURES The main outcomes were (1) space improvements, use, and costs of the lactation accommodation program and (2) an ad hoc survey of physicians' reported experience with lactation accommodation support before and after the intervention. Survey data were collected using a 5-point Likert scale to assess physician perceptions of institutional support. Responses collected during the preintervention period were compared with those collected during the postintervention period using unpaired t tests. RESULTS In this study, 70 clinical faculty (mean [SD] age, 34.4 [2.9] years) took childbearing leave in the preintervention period compared with 52 (mean [SD] age, 34.8 [2.7] years) in the postintervention period. Fifty-eight physicians (83%) completed the preintervention survey and 48 completed the postintervention survey. When comparing the pre- and postintervention periods, faculty reported improvements in finding time in their clinical schedule to devote to pumping (mean [SD] response, 2.5 [1.3] vs 3.6 [1.5]; P < .001), initiatives to address the impact of lactation time on productivity (mean [SD] response, 2.0 [1.0] vs 3.0 [1.5]; P = .001), and a culture supportive of lactation (mean [SD] response, 2.8 [1.4] vs 3.4 [1.3]; P = .047). Forty childbearing faculty took advantage of lactation time reimbursement and were reimbursed a total of $242 744.37. Faculty whose return to work overlapped with the entire year of the study received financial support for lactation for a mean (SD) of 8.9 (0.2) months, with an average reimbursement of $9125.78. CONCLUSIONS AND RELEVANCE The findings of this cohort study suggest that a multifaceted intervention to combat common challenges in lactation support in academic medical centers yielded improvements in faculty perceptions of institutional support for pumping breastmilk, addressing the impact of lactation time on productivity, and providing a culture supportive of lactation. These findings support the adoption of interventions to improve physician lactation accommodations.
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Affiliation(s)
| | - Priya Prasad
- School of Medicine, University of California San Francisco
| | - Caroline Wick
- Lactation Accommodation Program, Campus Life Services, University of California San Francisco
| | - Diane Sliwka
- School of Medicine, University of California San Francisco
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18
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Hall AK, Rocca N, Stefan RA, Turner T, Chaplin T, Chan TM, McColl T, Wawrykow T, McEwen J, Lee S, Murray H. Navigating gaps in practice: consensus recommendations for educational and support structures for emergency physicians returning from gaps in practice. CAN J EMERG MED 2023; 25:568-579. [PMID: 37378871 DOI: 10.1007/s43678-023-00536-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 05/28/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVE The purpose of this study was to identify the learning needs of emergency physicians returning to Emergency Medicine (EM) practice after clinical leaves of less than 2 years, summarize existing return to practice programs, and propose recommendations regarding ideal educational and support structures for these physicians both during their practice gaps and upon return to EM. METHODS A multiple-phased study was conducted to establish recommendations regarding ideal educational and support structures for emergency physicians returning from practice gaps of less than 2 years. The overall design involved an initial environmental scan of existing and exemplar programs and regulatory body positions, followed by interviews with EM Department Heads from across Canada, and then subsequent content analysis and recommendation derivation by EM medical education expert group consensus. These summary recommendations were further revised by consensus at the 2022 CAEP conference academic symposium to derive a final set of consensus recommendations. CONCLUSIONS We have developed a set of recommendations regarding ideal educational and support structures for physicians experiencing gaps in practice of less than 2 years. This set of recommendations was informed by review of existing and exemplar programs, policies and experience of regulatory bodies, interviews with EM Department Heads across Canada, and a subsequent process of consensus at the 2022 CAEP conference academic symposium. It is hoped that this set of recommendations will inform discussions and potential strategies employed by departments to facilitate the smooth and effective return to EM practice for individuals experiencing gaps.
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Affiliation(s)
- Andrew K Hall
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.
| | - Nicole Rocca
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada
| | - Raluca Alexandra Stefan
- Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Tegan Turner
- Rady Faculty of Health Sciences, University of Manitoba, Max Rady College of Medicine, Winnipeg, MB, Canada
| | - Timothy Chaplin
- Department of Emergency Medicine, Queen's University, Kingston, ON, Canada
| | - Teresa M Chan
- Division of Emergency, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Tamara McColl
- Department of Emergency Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Teresa Wawrykow
- Department of Emergency Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Jill McEwen
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Shirley Lee
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Heather Murray
- Department of Emergency Medicine and Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
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19
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Patel H, Breeding T, Inouye M, Hoops H, Elkbuli A. Breaking barriers and advancing diversity, equity, and inclusion in trauma and acute care surgery: A current perspective. J Trauma Acute Care Surg 2023; 94:e42-e45. [PMID: 36941230 DOI: 10.1097/ta.0000000000003966] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
ABSTRACT The importance of diversity, equity, and inclusion (DEI) in trauma and acute care surgery (ACS) has become increasingly apparent in the field of medicine. Despite the growing diversity of the patient population, the surgical specialty has traditionally been dominated by White males. This involves increasing the representation of diverse individuals in leadership positions, professional societies, scholarships, graduate education, and practicing physicians. This opinion piece aims to address the gaps in the literature regarding DEI in trauma and acute care surgery and highlight the issues related to the workforce, gender gap, patient outcomes, and health services. To effectively guide DEI interventions, it is essential to capture patient-reported experience data and stratify outcomes by factors including race, ethnicity, ancestry, language, sexual orientation, and gender identity. Only then can generalizable findings effectively inform DEI strategies. Using validated measurement tools, it is essential to conduct these assessments with methodological rigor. Collaboration between health care institutions can also provide valuable insights into effective and ineffective intervention practices through information exchange and constructive feedback. These recommendations aim to address the multifactorial nature of health care inequities in trauma and ACS. However, successful DEI interventions require a deeper understanding of the underlying mechanisms driving observed disparities, necessitating further research. LEVEL OF EVIDENCE Level V.
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Affiliation(s)
- Heli Patel
- From the NOVA Southeastern University, Kiran Patel College of Allopathic Medicine (H.P., T.B.), Fort Lauderdale, Florida; John A. Burns School of Medicine (M.I.), Honolulu, Hawaii; Division of Trauma, Critical Care, Department of Surgery, (H.H.), and Acute Care Surgery, Oregon Health & Sciences University, Portland, Oregon; Division of Trauma and Surgical Critical Care, Department of Surgery, (A.E.), Orlando Regional Medical Center, Orlando, Florida; Department of Surgical Education (A.E.), Orlando Regional Medical Center, Orlando, Florida
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20
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Smith DG, Ross A, HogenEsch E, Okine R, Bonus ML, Feinberg EC, Bernardi LA. Anxiety, attitudes, and education about fertility among medical students in the United States. BMC MEDICAL EDUCATION 2023; 23:147. [PMID: 36869311 PMCID: PMC9984243 DOI: 10.1186/s12909-023-04075-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND As delayed family building is common among physicians, the goal of this study was to evaluate childbearing plans, anxiety related to future fertility, and interest in fertility education among medical students. METHODS Using convenience and snowball sampling methods, an electronic REDCap survey was distributed via social media and group messaging applications to medical students enrolled in medical schools across the United States. Answers were collected, and analysis of the descriptive statistics was performed. RESULTS The survey was completed by 175 participants, 72% of which were female (assigned at birth). The mean (± SD) age of participants was 24.9 ± 1.9 years. Of all participants, 78.3% desire to have children and 65.1% of these individuals plan to delay childbearing. On average, the planned age of first pregnancy is 31.0 ± 2.3 years. "Lack of time" was the greatest influence on decision regarding timing of childbearing. Of all respondents, 58.9% reported at least some anxiety related to future fertility. When females and males were compared, significantly more females (73.8%) versus males (20.4%) reported worrying about future fertility (p < 0.001). Participants reported that greater knowledge about infertility and potential treatments would help ease fertility related anxiety, and 66.9% of respondents showed interest in learning about how things such as age and lifestyle can impact fertility, preferably through medical curricula, videos, and podcasts. CONCLUSION A majority of the medical students in this cohort intend to have children and most plan to delay childbearing. A large percentage of female medical students reported anxiety related to future fertility, but many students showed interest in receiving fertility education. This study highlights an opportunity for medical school educators to incorporate targeted fertility education into their curriculum with the intention of decreasing anxiety and improving future reproductive success.
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Affiliation(s)
- D Grace Smith
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
| | - Abigail Ross
- Vanderbilt University, College of Arts and Science, Nashville, TN, USA
| | - Elena HogenEsch
- Northwestern University, McGaw Medical Center, Chicago, IL, USA
| | - Rachel Okine
- Northwestern University, Weinberg College of Arts and Sciences, Evanston, IL, USA
| | - Marissa L Bonus
- Northwestern University, McGaw Medical Center, Chicago, IL, USA
| | - Eve C Feinberg
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lia A Bernardi
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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21
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Uncovering the Experience: Return to Work of Nurses After Parental Leave. J Emerg Nurs 2023; 49:210-221. [PMID: 36411149 DOI: 10.1016/j.jen.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/04/2022] [Accepted: 10/11/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION To understand the experiences of emergency nurses who have returned to work after parental leave, specifically relating to the return to work transition, work-life balance, work engagement, and opportunities to continue human milk expression. METHODS Nurses (N = 19) were recruited from 5 emergency departments within 1 hospital system in the United States Midwest. Nurses (n = 11) were eligible to participate in a one-on-one interview if they had returned from parental leave within 6 months of the interview date. Nurses (n = 8) were eligible to participate in a focus group if they had returned from parental leave within 2 years of the interview date. Interviews were structured and data collection concluded when researchers believed data saturation was reached. Interviews were audio recorded and transcribed verbatim. Data were analyzed using Braun and Clarke's qualitative thematic analysis 6-phase framework. RESULTS Three major themes from the data were identified: (1) work engagement, (2) lactation, and (3) childcare. Work engagement was broken down into the subthemes: lack of communication, perceived engagement expectations, and actual engagement. Lactation was broken down into the subthemes: the act of pumping, lactation breaks, and lactation rooms. The coronavirus disease 2019 pandemic impact on return-to-work is described under each major theme. DISCUSSION Our findings provide insight into the unique challenges and experiences of nurses navigating parental leave and return-to-work in the emergency department. Strategies such as provision of managerial check-ins, return to work reorientation, lactation break coverage, enhanced supplementary lactation support, and leadership-provided accommodation may lighten the burden of these challenges and improve the returning nurse's job satisfaction.
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22
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Abstract
BACKGROUND Standardized parental leave policies for medical trainees are lacking, and barriers may differ among specialties. We aimed to characterize experiences of physicians who became parents during training and to identify particular issues for surgical trainees compared to their non-surgical peers. METHODS We distributed an electronic survey to physician parents via social media platforms from 10/2019 to 02/2020. Inclusion required becoming a parent during training. Responses were collected and standard descriptive and comparative analyses were performed. RESULTS Surveys were received from 64 physicians representing diverse specialties: 48 (74%) non-surgical respondents (NSR) and 16 (26%) surgical respondents (SR). Among all respondents, 25 (39%) reported a formal institutional policy for parental leave and 49 (76%) wished for more time off. Overall, respondents took a mean of 7.5 ± 5.2 (range 0-14) weeks of parental leave. However, NSR took 8.7 ± 5.8 weeks, while SR took 4.7 ± 2.7 (P = .006). Reported barriers to parental leave across specialties included graduation requirements (NSR 58% vs. SR 68% P = .46), peer pressure/perception (NSR 59% vs. SR 58% P = .97), and pressure from institutional leadership (NSR 31% vs. SR 35% P = .77). A substantial portion (28, 43%) of respondents had additional children during training, taking less time off for the second child (5.1 ± 7.4 weeks; 0-12). CONCLUSION A minority of respondents reported formal institutional parental leave policies, while an overwhelming majority felt that their time off was inadequate. Surgical trainees took shorter parental leaves than their non-surgical counterparts. Cultural and professional changes are crucial in promoting wellness and healthy transitions into parenthood.
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Affiliation(s)
- Ian C Bostock
- 461926The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Erin M Bayley
- 461926The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mara B Antonoff
- 461926The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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23
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Slostad J, Jain S, McKinnon M, Chokkara S, Laiteerapong N. Evaluation of Faculty Parental Leave Policies at Medical Schools Ranked by US News & World Report in 2020. JAMA Netw Open 2023; 6:e2250954. [PMID: 36689228 PMCID: PMC9871796 DOI: 10.1001/jamanetworkopen.2022.50954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/15/2022] [Indexed: 01/24/2023] Open
Abstract
Importance Physician parents, particularly women, are more likely to experience burnout, poor family-career balance, adverse maternal and fetal outcomes, and stigmatization compared with nonparent colleagues. Because many physicians delay child-rearing due to the rigorous demands of medical training, favorable parental leave policies for faculty physicians are crucial to prevent physician workforce attrition. Objective To evaluate paid and unpaid parental leave policies at medical schools ranked by US News & World Report in 2020 and identify factors associated with leave policies. Design, Setting, and Participants This cross-sectional national study was performed at US medical schools reviewed from December 1, 2019, through May 31, 2020, and February 1 through March 31, 2021, due to the COVID-19 pandemic. All medical schools ranked by US News & World Report in 2020 were included. Main Outcomes and Measures The primary outcome was the number of weeks of paid and unpaid leave for birth, nonbirth, adoption, and foster care physician parents. Institutional policies for the number of weeks of leave and requirements to use vacation, sick, or disability leave were characterized. Institutional factors were evaluated for association with the duration of paid parental leave using χ2 tests. Results Among the 90 ranked medical schools, 87 had available data. Sixty-three medical schools (72.4%) had some paid leave for birth mothers, but only 13 (14.9%) offered 12 weeks of fully paid leave. While 11 medical schools (12.6%) offered 12 weeks of full paid leave for nonbirth parents, 38 (43.7%) had no paid leave for nonbirth parents. Adoptive and foster parents had no paid leave in 35 (40.2%) and 65 (74.7%) medical schools, respectively. Median paid parental leave was 4 (IQR, 0-8) weeks for birth parents, 4 (IQR, 0-6) weeks for adoptive parents, 3 (IQR, 0-6) weeks for nonbirth parents, and 0 (IQR, 0-1) weeks for foster parents. About one-third of medical schools required birth mothers to use vacation (29 [33.3%]), sick leave (31 [35.6%]), or short-term disability (9 [10.3%]). Among institutional characteristics, higher ranking (top vs bottom quartile: 30.4% vs 4.0%; P = .03) and private designation (private vs public, 23.5% vs 9.4%; P < .001) was associated with a higher rate of 12 weeks of paid leave for birth mothers. Conclusions and Relevance In this cross-sectional national study of medical schools ranked by US News & World Report in 2020, many physician faculty receive no or very limited paid parental leave. The lack of paid parental leave was associated with higher rates of physician burnout and work-life integration dissatisfaction and may further perpetuate sex, racial and ethnic, and socioeconomic disparities in academic medicine.
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Affiliation(s)
- Jessica Slostad
- Division of Hematology-Oncology, Rush University Medical Center, Chicago, Illinois
| | - Shikha Jain
- Division of Hematology-Oncology, University of Illinois, Chicago
| | - Marie McKinnon
- Department of Medicine, University of Chicago, Chicago, Illinois
- Department of Medicine, Emory University, Atlanta, Georgia
| | - Sukarn Chokkara
- Department of Medicine, University of Chicago, Chicago, Illinois
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Allen KJ, Wright JC, Lee EM, Vickerman BJ, Barnett SG. Eight years of CRASH: A bi-national initiative helping critical care doctors return to work. Anaesth Intensive Care 2023; 51:6-13. [PMID: 35979666 DOI: 10.1177/0310057x221094048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Returning to work in critical care after a break in clinical practice can be a daunting process. This article describes development and evolution of the Critical Care, Resuscitation, Airway Skills: Helping you return to work (CRASH) course, including the supporting literature. CRASH is the first bi-national course assisting return to work (RTW) for critical care practitioners. It evolved as a collaborative effort across Australia and New Zealand, involving anaesthetists, emergency physicians and intensivists. The course is based around tailored sessions practising skills and clinical decision-making using simulation and case discussions, incorporating practical tips on returning to work. Participants receive resources to assist RTW including questionnaires and checklists developed by the faculty, which have been used to aid RTW in more than 30 hospitals in Australia and New Zealand. Attendance is open to all critical care practitioners who are registered with the relevant medical board and returning to work, who have taken leave from work for any reason. Since 2014, 197 participants have attended CRASH in-person or virtually, one of the largest RTW groups described in the literature. The aim of this article is to outline the literature around inactivity and RTW, and describe the development and adaptation of the CRASH course.
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Affiliation(s)
- Kara J Allen
- Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, Australia.,Department of Critical Care, University of Melbourne, Parkville, Australia.,Gandel Simulation Service, The Royal Women's Hospital, Parkville, Australia
| | - Janette C Wright
- Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, Australia
| | - Emelyn M Lee
- Anaesthesia Department, Sir Charles Gairdner Hospital, Nedlands, Australia.,Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital, Subiaco, Australia
| | - Brooke J Vickerman
- Department of Anaesthesia and Pain Management, Queensland Children's Hospital, South Brisbane, Australia.,Department of Anaesthesia, 72562Mater Hospital Brisbane, South Brisbane, Australia
| | - Sheila G Barnett
- Southern DHB Anaesthesia, Dunedin Public Hospital, Dunedin Central, Dunedin, New Zealand.,School of Medicine, University of Otago, Dunedin, New Zealand
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Hoyer A, Randolph A, Syed MF, Afkhamnejad E, Mirza RG. Enhancing Mentorship Networks through the Experiences of Women Professors of Ophthalmology. JOURNAL OF ACADEMIC OPHTHALMOLOGY (2017) 2023; 15:e1-e7. [PMID: 38737166 PMCID: PMC10804760 DOI: 10.1055/s-0042-1760206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 11/21/2022] [Indexed: 01/15/2023]
Abstract
Purpose The aim of this study is to identify and characterize women professors in ophthalmology to enhance professional development and equity of women in academic ophthalmology. Design Cross-sectional descriptive survey study. Participants Participants in the survey were women in ophthalmology departments who have obtained full professor rank at their respective institutions. Methods A cross-sectional study was conducted using data from an electronic survey of women ophthalmologists and researchers who had obtained full professorship rank in ophthalmology. The survey included questions about degree obtained, training path, fellowship, length and trajectory of academic career, family or medical leave participation, previous positions, and mentorship involvement. Statistical comparisons were made based on response. Main Outcome Measures Survey responses to questions pertaining to three domains: education and training, academic career, and mentorship. Results Women that obtained the professor title within ophthalmology largely held Doctor of Medicine/Doctor of Osteopathic Medicine degrees, were more likely to have completed fellowship training, and on average took 11 to 15 years to obtain the full professor title. The participants held a variety of other positions and titles throughout their academic careers. The vast majority of women reported having between 1 and 3 mentors during their careers with the majority also noting they currently participate in mentoring programs. Surveys were completed by 62 (30% response rate) women full professors of ophthalmology. Conclusion The experiences women have along the academic path to professorship are described in this survey and can help to inform junior faculty. Literature review highlights the importance of mentorship for work productivity, retention, and promotion within academic medicine which is an element seen in the vast majority of our participants' career paths. Guided by the identification of women professors within departments of ophthalmology and characterization of their experiences, a new initiative called Women Professors of Ophthalmology was formed under the Association of University Professors of Ophthalmology's organizational structure in 2021. This group that is tailored for women professors of ophthalmology to foster peer mentorship and guidance is poised to increase the retention and promotion of women in academic ophthalmology.
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Affiliation(s)
- Amanda Hoyer
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Amber Randolph
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Misha F. Syed
- Department of Ophthalmology and Visual Sciences, School of Medicine, The University of Texas Medical Branch, Galveston, Texas
| | - Elahhe Afkhamnejad
- Department of Ophthalmology and Visual Sciences, School of Medicine, The University of Texas Medical Branch, Galveston, Texas
| | - Rukhsana G. Mirza
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Worthington RO, Adams DR, Fritz CDL, Tusken M, Volerman A. Supporting Breastfeeding Physicians Across the Educational and Professional Continuum: A Call to Action. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:21-28. [PMID: 35921171 PMCID: PMC10423406 DOI: 10.1097/acm.0000000000004898] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The benefits of breastmilk and lactation are well established for both infants and women. National organizations recommend exclusively breastfeeding for the first 6 months of life and continued breastfeeding for the first 1-2 years of life. For physicians, childbearing years often coincide with key periods of training and their early career. Physician mothers have high rates of initiating breastfeeding but low success in maintaining breastfeeding. Breastfeeding discontinuation among physicians is a well-described, multifactorial issue that has persisted for decades. Reasons for discontinuation include inadequate access to pumping rooms, insufficient workplace and coworker support, and constrained schedules. Pumping is viewed as a burden to teammates and superiors, and physicians are often required to make up time spent pumping. Vague or absent policies to support breastfeeding by accreditation organizations and institutions create workplace conflict and impose additional stress on breastfeeding physicians, who devote significant time, energy, and mental reserves navigating clinical responsibilities, workplace relationships, and licensing requirements to pump. The authors propose several recommendations to improve the environment, support, and resources for breastfeeding physicians with a focus on what individuals, institutions, and professional organizations can do. Creating lactation policies that allow breastfeeding physicians equitable participation in the workplace is a matter of reproductive justice. Improving the collective awareness and support for breastfeeding trainees and physicians is a critical step in recruiting, retaining, and supporting women in medicine.
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Affiliation(s)
- Rebeca Ortiz Worthington
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh Medical Center / Veterans Affairs Pittsburgh Healthcare, Pittsburgh, PA
| | - Dara R. Adams
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Chicago, Chicago, IL
| | - Cassandra D. L. Fritz
- Division of Gastroenterology, Director of Diversity, Equity, and Inclusion for Internal Medicine Residency Program, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Megan Tusken
- Department of Psychiatry, University of Texas at Southwestern, Dallas, TX
| | - Anna Volerman
- Departments of Medicine and Pediatrics, University of Chicago, Chicago, IL
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Zimmermann CM, Kraus CL, Campbell AA, Kaleem MA, Shukla AG, McGlumphy EJ. Maternity and family leave experiences among female ophthalmologists in the United States. PLoS One 2023; 18:e0277376. [PMID: 37098000 PMCID: PMC10129012 DOI: 10.1371/journal.pone.0277376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/10/2023] [Indexed: 04/26/2023] Open
Abstract
OBJECTIVE To evaluate family and maternity leave policies and examine the social and professional impacts on female ophthalmologists. PARTICIPANTS Participants were recruited through the Women in Ophthalmology online list-serv to complete a survey evaluating maternity leave policies and their impacts. Survey questions were repeated for each birth event after medical school for up to five birth events. RESULTS The survey was accessed 198 times, and 169 responses were unique. Most participants were practicing ophthalmologists (92%), with a minority in residency (5%), in fellowship (1.2%), on disability/leave (0.6%), or retired (0.6%). Most participants (78%) were within their first ten years of practice. Experiences were recorded for each leave event, with 169 responses for the first leave, 120 for the second, 28 for the third, and 2 for the fourth. Nearly half of participants reported the information they received about maternity leave to be somewhat or extremely inadequate (first: 50%; second: 42%; third: 41%). Many reported a greater sense of burnout after returning to work (first: 61%, second: 58%, third: 46%). A minority of participants received full pay during the first through third maternity leave events, 39%, 27%, and 33%, respectively. About a third of participants reported being somewhat or very dissatisfied with their maternity leave experience (first: 42%, second: 35%; third: 27%). CONCLUSIONS Female ophthalmologists have varying experiences with maternity leave, but many encounter similar challenges. This study demonstrates that many women receive inadequate information about family leave, desire more weeks of leave, experience a wide variation in pay practices, and lack support for breastfeeding. Understanding the shared experiences of women in ophthalmology identifies areas where improvements are needed in maternity leave practices within the field to create a more supportive environment for physician mothers.
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Affiliation(s)
- Caroline M Zimmermann
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Courtney L Kraus
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Ashley A Campbell
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Mona A Kaleem
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Aakriti Garg Shukla
- Edward S. Harkness Eye Institute, Columbia University, New York, New York, United States of America
| | - Elyse J McGlumphy
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
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Lee LK, Miller KA, Chuersanga G, Melvin P, Zola J, Ward VL. Childbearing and Family Leave Policies for Physicians at US Children's Hospitals. J Pediatr 2022; 255:240-246. [PMID: 36528054 DOI: 10.1016/j.jpeds.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/13/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
The objective of this study was to examine the childbirth and parental leave policies for physicians at children's hospitals. We obtained institutional policies from 15 hospitals in 2021. The median duration of full salaried leave was 8 weeks (range, 2-12 weeks). Leave policies vary widely among US children's hospitals.
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Affiliation(s)
- Lois K Lee
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA; Office of Health Equity and Inclusion, Boston Children's Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA; Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston, MA.
| | - Kelsey A Miller
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Geeranan Chuersanga
- Office of Health Equity and Inclusion, Boston Children's Hospital, Boston, MA
| | - Patrice Melvin
- Office of Health Equity and Inclusion, Boston Children's Hospital, Boston, MA; Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston, MA
| | - Judith Zola
- Office of Human Resources, Boston Children's Hospital, Boston, MA
| | - Valerie L Ward
- Office of Health Equity and Inclusion, Boston Children's Hospital, Boston, MA; Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston, MA; Department of Radiology, Boston Children's Hospital, Boston, MA; Department of Radiology, Harvard Medical School, Boston, MA
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Ngai J, Capdeville M, Sumler M, Oakes D. A Call for Diversity: Women, Professional Development, and Work Experience in Cardiothoracic Anesthesiology. J Cardiothorac Vasc Anesth 2022; 37:870-880. [PMID: 36599777 DOI: 10.1053/j.jvca.2022.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/22/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Jennie Ngai
- Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU Langone Health, New York, NY.
| | - Michelle Capdeville
- Department of Cardiothoracic Anesthesia, Cleveland Clinic Lerner College of Medicine, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH
| | - Michele Sumler
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA
| | - Daryl Oakes
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA
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Baker A, Narayanan S, Tsai JP, Tjoumakaris SI, Haranhalli N, Fraser JF, Hetts SW. Society of NeuroInterventional Surgery: position statement on pregnancy and parental leave for physicians practicing neurointerventional surgery. J Neurointerv Surg 2022; 15:5-7. [DOI: 10.1136/jnis-2022-019613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/25/2022] [Indexed: 11/18/2022]
Abstract
BackgroundThe aim of this article is to outline a position statement on pregnancy and parental leave for physicians practicing neurointerventional surgery.MethodsWe performed a structured literature review regarding parental leave policies in neurointerventional surgery and related fields. The recommendations resulted from discussion among the authors, and additional input from the Women in NeuroIntervention Committee, the full Society of NeuroInterventional Surgery (SNIS) Standards and Guidelines Committee, and the SNIS Board of Directors.ResultsSome aspects of workplace safety during pregnancy are regulated by the US Nuclear Regulatory Commission. Other aspects of the workplace and reasonable job accommodations are legally governed by the Family and Medical Leave Act of 1993, the Affordable Care Act of 2010 and the Fair Labor Standards Act of 1938, Americans with Disabilities Act of 1990, Title IX of the Education Amendments of 1972, Title VII of the Civil Rights Act of 1964 as well as rights and protections put forth by the Occupational Safety and Health Administration as part of the United States Department of Labor. Family friendly policies have been associated not only with improved job satisfaction but also with improved parental and infant outcomes. Secondary effects of such accommodations are to increase the number of women within the specialty.ConclusionsSNIS supports a physician’s ambition to have a family as well as start, develop, and maintain a career in neurointerventional surgery. Legal and regulatory mandates and family friendly workplace policies should be considered when institutions and individual practitioners approach the issue of childbearing in the context of a career in neurointerventional surgery.
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Jean Dit Bailleul R, Loddé B, Dewitte JD, Pougnet L, Pougnet R. [Continued breastfeeding upon return to work: a qualitative study at the Brest University Hospital]. REVUE DE L'INFIRMIERE 2022; 71:35-37. [PMID: 36599530 DOI: 10.1016/j.revinf.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The objective of this qualitative study was to highlight the facilitating measures and difficulties encountered in continuing breastfeeding when returning to work at the Brest Regional University Hospital. The eleven mothers interviewed were able to take advantage of the solidarity in the care services to carry out their project, but simple institutional measures are still possible to facilitate this conciliation.
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Affiliation(s)
- Romain Jean Dit Bailleul
- Faculté de médecine de Brest, Université de Bretagne occidentale, 22 rue Camille-Desmoulins, 29238 Brest, France; CHRU Morvan, Service de santé au travail et maladies liées à l'environnement, 5 avenue Foch, BP 824, 29606 Brest cedex 2, France.
| | - Brice Loddé
- CHRU Morvan, Service de santé au travail et maladies liées à l'environnement, 5 avenue Foch, BP 824, 29606 Brest cedex 2, France; Centre de pathologies professionnelles et environnementales, CHRU Morvan, 2 avenue Foch, 29200 Brest, France; Optimisation des régulations physiologiques (Orphy), EA 4324, Université de Bretagne occidentale, UFR sciences et techniques, 6 avenue Le-Gorgeu-CS 93837, 29238 Brest cedex 3, France
| | - Jean-Dominique Dewitte
- CHRU Morvan, Service de santé au travail et maladies liées à l'environnement, 5 avenue Foch, BP 824, 29606 Brest cedex 2, France; Centre de pathologies professionnelles et environnementales, CHRU Morvan, 2 avenue Foch, 29200 Brest, France; Laboratoire d'études et de recherche en sociologie (LABERS), EA 3149, Université de Bretagne occidentale, 3 rue des Archives, 29238 Brest, France
| | - Laurence Pougnet
- Hôpital d'instruction des armées Clermont-Tonnerre, rue Colonel-Fonferrier, 29240 Brest, France
| | - Richard Pougnet
- CHRU Morvan, Service de santé au travail et maladies liées à l'environnement, 5 avenue Foch, BP 824, 29606 Brest cedex 2, France; Centre de pathologies professionnelles et environnementales, CHRU Morvan, 2 avenue Foch, 29200 Brest, France; Laboratoire d'études et de recherche en sociologie (LABERS), EA 3149, Université de Bretagne occidentale, 3 rue des Archives, 29238 Brest, France; Service universitaire de médecine préventive et de promotion de la santé, Université de Bretagne occidentale, CS 93837, 13 rue Lanrédec, 29200 Brest, France
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Lee A, Kuczmarska-Haas A, Dalwadi SM, Gillespie EF, Ludwig MS, Holliday EB, Chino F. Family Planning, Fertility, and Career Decisions Among Female Oncologists. JAMA Netw Open 2022; 5:e2237558. [PMID: 36315148 PMCID: PMC9623435 DOI: 10.1001/jamanetworkopen.2022.37558] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
IMPORTANCE Female oncologists often spend their childbearing years in training and establishing careers, with many later experiencing fertility issues when starting a family. Physician fertility and family planning are rarely discussed during training. Attitudes among female oncologists regarding family planning are unknown. OBJECTIVES To understand barriers to family planning as well as the association of fertility treatment with career decisions and to assess experiences of pregnancy-based discrimination among female oncologists. DESIGN, SETTING, AND PARTICIPANTS In this survey study, a novel 39-item questionnaire was distributed to US female oncologists from May 7 to June 30, 2020, via email and social media channels. Questions regarding factors associated with family planning, maternity leave, and discrimination were included. MAIN OUTCOMES AND MEASURES The distribution of survey responses was compared by oncology subspecialty. Multivariable logistic regression was performed to determine independent variables for discrimination experienced during maternity leave. RESULTS Responses were collected from 1004 female oncologists. Most respondents (847 [84.4%]) were married, and 713 (71.0%) were currently working full-time. A total of 351 oncologists (35.0%) worked in radiation oncology, 344 (34.3%) in medical oncology, 186 (18.4%) in surgical oncology, and 91 (9.1%) in pediatric oncology. A total of 768 respondents (76.5%) had children, and of these, 415 (41.3%) first gave birth during postgraduate training, and 275 (27.4%) gave birth in years 1 to 5 as an attending physician. Almost all respondents (951 [94.7%]) stated that their career plans were at least somewhat associated with the timing of when to start a family. Having a supportive partner was the most commonly cited positive association with family planning (802 [79.9%]), while long work hours and heavy workload (669 [66.6%]) were the most common negative factors. One-third (318 [31.7%]) had miscarried, and 315 (31.4%) reported difficulty with infertility that required fertility counseling and/or treatment; 660 (65.7%) thought fertility preservation should be discussed with women during medical school and/or residency. One-third (312 [31.1%]) reported experiencing discrimination during pregnancy, and 332 (33.1%) stated they experienced discrimination for taking maternity leave. On multivariable logistic regression, having more than 1 child was associated with increased likelihood of experiencing discrimination during maternity leave (2 children: odds ratio, 1.62 [95% CI, 1.10-2.39]; P = .02; ≥3 children: odds ratio, 1.84 [95% CI, 1.14-2.95; P = .01). CONCLUSIONS AND RELEVANCE In this survey study of female oncologists, 1 in 3 reported experiencing infertility and 1 in 3 stated they experienced discrimination during pregnancy and/or for taking maternity leave. Systemic changes are necessary to ensure women are supported and able to advance equitably in the field.
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Affiliation(s)
- Anna Lee
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston
| | | | - Shraddha M. Dalwadi
- Department of Radiation Oncology, University of Texas Health Science Center, MD Anderson Mays Cancer Center, San Antonio
| | - Erin F. Gillespie
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michelle S. Ludwig
- Department of Radiation Oncology, Baylor College of Medicine, Houston, Texas
| | - Emma B. Holliday
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - Fumiko Chino
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
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Singhal A, Aiken A. Call to Action: Women in Neuroradiology's Group (WINNERS)-Is There a Need? AJNR Am J Neuroradiol 2022; 43:1396-1399. [PMID: 36574333 PMCID: PMC9575528 DOI: 10.3174/ajnr.a7626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 07/06/2022] [Indexed: 01/14/2023]
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Jain S, Neaves S, Royston A, Huang I, Juengst SB. Breastmilk pumping experiences of physician mothers: quantitative and qualitative findings from a nationwide survey study. J Gen Intern Med 2022; 37:3411-3418. [PMID: 35060006 PMCID: PMC9550890 DOI: 10.1007/s11606-021-07388-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/29/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Nearly half of graduating medical students today are women, with many having children early in their careers, necessitating thoughtful consideration of practices and policies. The short duration of maternity leave for physician mothers often means that most who choose to breastfeed must return to work while still breastfeeding their infants. OBJECTIVE To characterize the experience of physician mothers and identify facilitators and barriers related to breastmilk pumping upon return to work. DESIGN Cross-sectional nationwide survey study administered to physician mothers electronically via REDCap™ to broadly characterize their personal experiences with family leave and return to work. PARTICIPANTS Physician mothers in the USA (n=724). APPROACH/MAIN MEASURE Demographic data and survey responses related to experiences during family leave and return to work, including free-text response options when participants indicated "other" experiences not captured by the survey response options and one open-ended question asking, "What do you think are the most important factors contributing to a positive maternity/family leave experience?" For this study, we searched free-text responses across the entire survey for keywords related to breastfeeding and pumping and thematically analyzed them to summarize key features of physician mothers' experiences. KEY RESULTS Lack of time, flexibility, dedicated and hygienic locations for pumping breast milk, disrespect and lack of support from others, and concerns about financial consequences of productivity changes were the most common barriers to pumping breastmilk reported by physician mothers. CONCLUSIONS Flexibility in scheduling, adjusted productivity targets, and clean, private, and well-equipped pumping rooms would likely provide the greatest support to help physician mothers thrive in their careers while simultaneously allowing them to provide the nourishment needed for their developing infants.
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Affiliation(s)
- Snigdha Jain
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Stephanie Neaves
- Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9055, USA
| | - Alexa Royston
- Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9055, USA
| | - Isabel Huang
- Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9055, USA
| | - Shannon B Juengst
- Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9055, USA.
- TIRR Memorial Hermann, Brain Injury Research Center, Houston, TX, USA.
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Bharadwaj AS, Sherwood MW, Cullen MW, Velagapudi P. The Busy Life of an Early Career Cardiologist: The Juggle Is Real! J Am Coll Cardiol 2022; 80:947-950. [PMID: 36007993 DOI: 10.1016/j.jacc.2022.02.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 10/15/2022]
Affiliation(s)
- Aditya S Bharadwaj
- Division of Cardiology, Loma Linda University Health, Loma Linda, California, USA.
| | | | - Michael W Cullen
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Poonam Velagapudi
- Division of Cardiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Barasinski C, Stankovic M, Debost-Legrand A, Delabaere A, Vendittelli F, Dutheil F. Workplace Lactation Support: A Cross-Sectional Study in a University Hospital and a Perinatal Network. Nutrients 2022; 14:nu14173463. [PMID: 36079721 PMCID: PMC9460242 DOI: 10.3390/nu14173463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 11/28/2022] Open
Abstract
Return to work negatively affects the initiation and duration of breastfeeding. Our study’s objective was to assess the percentage of departments in Auvergne with an appropriate space for pumping milk at work. Our cross-sectional survey investigated the arrangements for facilitating the continuation of breastfeeding on return to work at all departments at the Clermont-Ferrand University Hospital Center and perinatal (obstetric and pediatric) departments in this region. Our principal endpoint was the percentage of departments reporting that they had a lactation room—a room where nursing mothers can express milk—and whether it met the criteria defined by the French Labor Code. Among 98 respondents, 44 departments (44.9%) did not offer lactation rooms; of the remaining 54 departments, only 11 rooms met the legal requirements. All perinatal departments offered lactation rooms. The availability of a lactation room was associated with other breastfeeding support, such as a break period for expressing milk (p < 0.0001) and the availability of a refrigerator to store it (p = 0.01). Almost half the responding departments did not offer a lactation room where mothers could breastfeed or pump their milk. Measures must be envisioned to facilitate the pumping of breast milk by French women returning to work.
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Affiliation(s)
- Chloé Barasinski
- Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Centre National de la Recherche Scientifique (CNRS), Institut Pascal, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
- Correspondence: ; Tel.: +33-0-473755089
| | - Marina Stankovic
- School of Midwifery, University of Clermont-Auvergne, F-63000 Clermont-Ferrand, France
| | - Anne Debost-Legrand
- CHU Clermont-Ferrand, CNRS, Institut Pascal, Réseau de Santé en Périnatalité d’Auvergne, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
| | - Amélie Delabaere
- Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, Centre National de la Recherche Scientifique (CNRS), Institut Pascal, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
| | - Françoise Vendittelli
- CHU Clermont-Ferrand, CNRS, Institut Pascal, Réseau de Santé en Périnatalité d’Auvergne, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
| | - Frédéric Dutheil
- CNRS, Laboratoire de Psychologie Sociale et Cognitive (LaPSCo), Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Occupational and Environmental Medicine, Université Clermont Auvergne, WittyFit, F-63000 Clermont-Ferrand, France
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Chen, Davison, Perchik, Arleo, Magudia, Porter. How to implement paid family and medical leave: A toolkit for practices. Clin Imaging 2022; 91:52-55. [PMID: 35988474 DOI: 10.1016/j.clinimag.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/29/2022] [Accepted: 08/07/2022] [Indexed: 11/30/2022]
Abstract
Paid family and medical leave policies are increasingly popular in today's competitive labor market and provide well-documented advantages to all stakeholders. Implementing paid leave for radiologists can seem daunting due to overlapping legal and institutional policies, logistical challenges and call coverage, as well as industry-specific special considerations such as resident education and historical workplace attitudes. This toolkit can empower radiology leaders to implement written paid leave policies in their home institutions and demonstrate that equitable, compassionate institutional policies for paid leave are financially favorable, widely desirable, and increasingly achievable with the right tools in hand.
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Affiliation(s)
- Chen
- University of Alabama at Birmingham Department of Radiology, Birmingham, AL, USA
| | - Davison
- University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Perchik
- University of Alabama at Birmingham Department of Radiology, Birmingham, AL, USA
| | - Arleo
- New York-Presbyterian Hospital/Weill Cornell Medical Center, Department of Radiology, New York, NY, USA
| | - Magudia
- Duke University School of Medicine, Durham, NC, USA
| | - Porter
- University of Alabama at Birmingham Department of Radiology, Birmingham, AL, USA.
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Sharp EA, Nicholson KJ, Taft M, Glaser DH, Gibson B, Kazmerski TM. Parent-in-training: Resident and fellow experiences from pregnancy to parenthood. J Hosp Med 2022; 17:609-623. [PMID: 35855539 DOI: 10.1002/jhm.12914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Residents and fellows with children face distinct challenges; however, knowledge of factors associated with increased parental stress is limited. OBJECTIVE This study aimed to investigate experiences and concerns of physician trainees and identify factors associated with higher parental stress. METHODS An anonymous survey was distributed to all resident and fellow trainees in June 2021 to assess experiences regarding parental leave, breastfeeding, and childcare. We used the Parental Stress Scale (PSS) to identify the factors associated with stress and analyzed the results using descriptive statistics, linear regression, and thematic analysis. RESULTS Of 1719 trainees, 509 participated (62% women, 30% response rate); half were parents. One-third of the respondents (152/470) said that childcare costs affected the number of children they plan to have; One-third of respondents (152/470) said that childcare costs affected the number of children they plan to have; 45% (210/470) said childcare costs affected when they plan to have children. Among parents, the mean PSS score was 44.3 ± 12.3, with no significant gender differences. More women identified as primary or coprimary caregivers (97% [113/117] vs. 79% [60/76], p < .001) and anticipated training extensions due to parental leave (36% vs. 13% men, p = .009). Breastfeeding was associated with significantly higher PSS scores (p = .017). Twenty-four percent of breastfeeding parents (22/93) felt that their program/institution did not support their breastfeeding goals; lack of perceived support was associated with significantly higher PSS scores (63.6 ± 13.1 vs. 38.6 ± 8.7, p < .001). Trainees experiencing unreliable childcare had significantly higher PSS scores (p = .005). Forty percent (64/159) changed their career plans after becoming parents. CONCLUSIONS Physician trainee parents experience high stress, with women bearing disproportionate burdens in the domains of parental leave and breastfeeding. These results should inform policies promoting trainee wellness and gender equity.
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Affiliation(s)
- Eleanor A Sharp
- Department of Pediatrics, Division of Pediatric Hospital Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Maia Taft
- Department of Pediatrics, Division of Pediatric Hospital Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Daniel H Glaser
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Blake Gibson
- UPMC Western Psychiatric Hospital, Pittsburgh, Pennsylvania, USA
| | - Traci M Kazmerski
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Affiliation(s)
- Kelsey A Miller
- Division of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.,Departments of Pediatrics
| | - Lois K Lee
- Division of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.,Departments of Pediatrics.,Emergency Medicine, Harvard Medical School, Boston, Massachusetts
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Hendrickson M, Davey CS, Harvey BA, Schneider K. Breastfeeding Among Pediatric Emergency Physicians: Rates, Barriers, and Support. Pediatr Emerg Care 2022; 38:e1372-e1377. [PMID: 35616568 PMCID: PMC9246866 DOI: 10.1097/pec.0000000000002757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Physician mothers are at risk for early cessation of breastfeeding, in part because of challenges associated with returning to work. Given the inherent unpredictability of emergency medicine practice, we hypothesized that pediatric emergency medicine (PEM) physicians would face unique challenges in continuing breastfeeding while working in their field. The aims of this study were to determine the 6-month breastfeeding rates of PEM physicians, gain insight into their experiences expressing breast milk while working in pediatric emergency departments, and determine factors that support or discourage successful breastfeeding. METHODS This study was a cross-sectional survey of members of the American Academy of Pediatrics Section on Emergency Medicine via its quarterly membership survey program. Separate survey pathways were developed for respondents who had ever breastfed and those who had not. RESULTS One hundred ninety-three responded; 91 had breastfed, and 102 had not. Of those who breastfed, 90% did so for 6 months or longer. Mean (SD) duration was 12.5 (7.1) months (range, 2-48 months). Of those who expressed milk at work, only 7.6% felt they "always" had sufficient time to pump; 32% felt they "always" had what they considered to be an appropriate location to pump. Breastfeeding duration rate of at least 6 months was higher for those (66%) who "sometimes" to "always" had access to what they felt were appropriate locations to pump than for those (34%) who "never" or "occasionally" did (98 vs 85%, P = 0.048). Eighty-six percent of respondents who had never breastfed reported being "very supportive" of expressing milk at work. CONCLUSIONS Breastfeeding PEM physicians have high 6-month breastfeeding rates, and many express milk at work. Although colleagues report being supportive, barriers of perceived lack of sufficient time to pump and appropriate pumping locations remain.
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Affiliation(s)
| | - Cynthia S Davey
- University of Minnesota Clinical and Translational Science Institute, Minneapolis, Minnesota
| | - Brian A Harvey
- From the University of Minnesota Masonic Children's Hospital
| | - Kari Schneider
- From the University of Minnesota Masonic Children's Hospital
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Ziolkowski N, Rogowsky L, Innis J, Grant Buechner A, Springall E, Dengler J. Creation of a nationwide breastfeeding policy for surgical residents: a scoping review protocol. BMJ Open 2022; 12:e047466. [PMID: 35697452 PMCID: PMC9196187 DOI: 10.1136/bmjopen-2020-047466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Breast feeding is recommended for the first year of a baby's life due to numerous benefits for both the child and mother. After returning from maternity leave, surgical trainees face extensive barriers to breast feeding and tend to terminate breast feeding earlier than guideline recommendations. The aim of this scoping review is to assess existing breastfeeding policies for surgical trainees at the national level including postgraduate medical education offices, provincial resident unions and individual surgical programmes. METHODS AND ANALYSIS A modified Arksey and O'Malley (2005) framework will be used. Specifically, (1) identifying the research question/s and (2) relevant studies from electronic databases and grey literature, (3) identifying and (4) selecting studies with independent verification, and (5) collating, summarising, and reporting data while having ongoing consultation between experts throughout the process. Experts will include a lactation consultant (AGB), a human resource leader (JI), a health information specialist (ES), two independent coders (NZ, LR) and a board-certified surgeon (JD). This work will take place as of December 2020 and be carried out to completion in 2021. ETHICS AND DISSEMINATION Ethics approval will not be sought for this scoping review. Research findings will be disseminated through publications, presentations and meetings with relevant stakeholders.
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Affiliation(s)
- Natalia Ziolkowski
- Plastic, Reconstructive, and Aesthetic Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Larissa Rogowsky
- Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Julia Innis
- Human Resources Professionals Association, Toronto, Ontario, Canada
| | - Angela Grant Buechner
- Nutmeg Consulting, International Board Certified Lactation Consultant, Toronto, Ontario, Canada
| | - Elena Springall
- University of Toronto Libraries, University of Toronto, Toronto, Ontario, Canada
| | - Jana Dengler
- Plastic, Reconstructive, and Aesthetic Surgery, University of Toronto, Toronto, Ontario, Canada
- Division of Plastic and Reconstructive Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Smith KS, Bakkensen JB, Hutchinson AP, Cheung EO, Thomas J, Grote V, Moreno PI, Goldman KN, Jordan N, Feinberg EC. Knowledge of Fertility and Perspectives About Family Planning Among Female Physicians. JAMA Netw Open 2022; 5:e2213337. [PMID: 35583866 PMCID: PMC9118076 DOI: 10.1001/jamanetworkopen.2022.13337] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Pervasive gender disparities exist in medicine regarding promotion, achievement of academic rank, and appointment to leadership positions. Fertility and childbearing concerns may contribute to these disparities. OBJECTIVE To assess fertility knowledge and concerns and evaluate barriers to family building and impact on academic attrition reported by female physicians. DESIGN, SETTING, AND PARTICIPANTS This qualitative study used mixed methods; first, structured 1:1 interviews exploring fertility knowledge and family-building concerns were conducted among 16 female physicians between November 2019 and May 2020. Transcripts were coded in Dedoose and used to develop a survey instrument with subsequent pilot testing conducted among 24 female physicians between April 2020 and September 2020. Data analysis was performed from January 2021 to March 2021. MAIN OUTCOMES AND MEASURES Fertility knowledge, perceptions of peer and institutional support surrounding childbearing, factors contributing to delayed childbearing, and impact of family planning on career decisions. RESULTS Among 16 women who completed qualitative interviews, 4 (25%) were Asian, 1 (6%) was Black, 1 (6%) was multiracial, and 10 (63%) were White; mean (SD) age was 34.9 (4.0) years. Evaluation of fertility knowledge revealed 3 notable themes: (1) inadequate formal fertility education, (2) informal learning through infertility experiences of patients, peers, or personal struggles, and (3) desire to improve medical education through early introduction and transparent discussions about infertility. Exploration of childbearing concerns similarly revealed several salient themes: (1) high incidence of delayed childbearing, (2) perceived lack of peer and administrative support, and (3) impact of family building on career trajectory. These themes were borne out in pilot testing of the survey instrument: of 24 female physicians (7 Asian women [27%], 1 Black woman [4%], 1 Hispanic or Latinx woman [4%], 1 multiracial woman [4%], 15 White women [58%]; mean [SD] age, 36.1 [6.7] years), 17 (71%) had delayed childbearing and 16 (67%) had altered their career for family-building reasons. CONCLUSIONS AND RELEVANCE Qualitative interviews identified fertility and family building concerns among female physicians and were used to develop a tailored survey for women in medicine. These findings suggest that female physicians may delay childbearing and make substantial accommodations in their careers to support family building. A large-scale national survey is needed to better characterize the unique fertility, childbearing, and parenting needs of women in academic medicine to better understand how these concerns may contribute to academic attrition.
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Affiliation(s)
- Kathryn S. Smith
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jennifer B. Bakkensen
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Anne P. Hutchinson
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Shady Grove Fertility in Philadelphia, Philadelphia, Pennsylvania
| | | | - Jessica Thomas
- Preventive Medicine at Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Veronika Grote
- Osher Center for Integrative Medicine at Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Patricia I. Moreno
- Department of Public Health Sciences at the University of Miami Miller School of Medicine, Miami, Florida
| | - Kara N. Goldman
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Neil Jordan
- Institute for Public Health and Medicine-Center for Education in Health Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Center of Innovation for Complex Chronic Healthcare at the Edward J. Hines, Jr. VA Hospital, Hines, Illinois
| | - Eve C. Feinberg
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine, Chicago, Illinois
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DeBenedectis CM, Jay AK, Jordan SG, Raybon CP, Robbins JB, Deitte LA. Ensuring a Smooth Transition for Trainees Returning from Parental Leave - A Guide for Program Directors. Acad Radiol 2022; 29 Suppl 5:S38-S42. [PMID: 34108116 DOI: 10.1016/j.acra.2021.04.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/16/2021] [Accepted: 04/16/2021] [Indexed: 11/01/2022]
Abstract
Transitioning from parental leave during radiology residency training can be a time of stress and uncertainty. However, there are ways that program directors can help make the transition smoother and less overwhelming. Trainees report numerous stressors upon returning from leave involving childcare, lactation concerns and logistics, and discrimination. Program directors can help alleveate these stressors by counseling trainees returning from parental leave and providing reseources and a supportive enviroment. This article provides a structured frame work with tool for programs directors to ensure the transition from parental leave back to training is a smooth one.
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EDITORIAL COMMENT. Urology 2022; 162:103-104. [DOI: 10.1016/j.urology.2021.08.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Gulati M, Korn RM, Wood MJ, Sarma A, Douglas PS, Singh T, Merz NB, Lee J, Mehran R, Andrews OA, Williams JC. Childbearing Among Women Cardiologists: The Interface of Experience, Impact, and the Law. J Am Coll Cardiol 2022; 79:1076-1087. [PMID: 35300820 DOI: 10.1016/j.jacc.2021.12.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/30/2021] [Accepted: 12/14/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Maternity leave is highly variable in the United States given the lack of a federal workforce mandate. OBJECTIVES The purpose of this study was to describe the experiences and impact of childbearing on women cardiologists and their careers, within a legal framework. METHODS A survey was sent to women cardiologists, asking about their experiences while pregnant and on maternity leave. The incidence of complications and career impacts on the cardiologists was assessed. RESULTS Of 323 respondents who had been pregnant as a practicing cardiologist, extra service or call before maternity leave was required in 37.2%. Of those who performed extra service or call, 17.5% were placed on bedrest before delivery, compared with 7.4% who did not perform extra service or call (P = 0.005). During the year of pregnancy, 41.2% experienced a salary decrease; only 7.4% had their relative value units prorated for time on maternity leave; 23.2% had no paid maternity leave. Self-reported pregnancy complications occurred in 36.5%, those with complications had a 60% greater chance of reporting that pregnancy adversely affected their career, compared with those without complications. Nearly three-fourths (237 respondents) reported experiencing at least one of several troubling practices that are illegal in many circumstances. CONCLUSIONS Women cardiologists report wide variances in maternity leave in the United States, with many experiencing likely violations of the Family and Medical Leave Act or other statues. Childbearing issues in cardiologists should be addressed to improve the professional and personal lives of women cardiologists and the attractiveness of cardiology to potential trainees.
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Affiliation(s)
- Martha Gulati
- Division of Cardiology, University of Arizona, Phoenix, Arizona, USA. https://twitter.com/drmarthagulati
| | - Rachel M Korn
- Center for WorkLife Law, University of California, Hastings College of the Law, San Francisco, California, USA
| | - Malissa J Wood
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Amy Sarma
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Pamela S Douglas
- Division of Cardiology, Duke University, Durham, North Carolina, USA
| | - Toniya Singh
- Department of Cardiology, St Louis Heart and Vascular, St Louis, Missouri, USA
| | - Noel Bairey Merz
- Department of Cardiology, Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, California, USA.
| | - Jessica Lee
- Center for WorkLife Law, University of California, Hastings College of the Law, San Francisco, California, USA
| | - Roxana Mehran
- Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Olivia A Andrews
- Center for WorkLife Law, University of California, Hastings College of the Law, San Francisco, California, USA
| | - Joan C Williams
- Center for WorkLife Law, University of California, Hastings College of the Law, San Francisco, California, USA
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Creating work environments where people of all genders in gynecologic oncology can thrive: An SGO evidence-based review. Gynecol Oncol 2022; 164:473-480. [PMID: 35000796 PMCID: PMC9465952 DOI: 10.1016/j.ygyno.2021.12.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/14/2021] [Accepted: 12/27/2021] [Indexed: 01/10/2023]
Abstract
Equality, equity, and parity in the workplace are necessary to optimize patient care across all aspects of medicine. Gender-based inequities remain an obstacle to quality of care, including within the now majority women subspecialty of gynecologic oncology. The results of the 2020 SGO State of the Society Survey prompted this evidence-based review. Evidence related to relevant aspects of the clinical care model by which women with malignancies are cared for is summarized. Recommendations are made that include ways to create work environments where all members of a gynecologic oncology clinical care team, regardless of gender, can thrive. These recommendations aim to improve equality and equity within the specialty and, in doing so, elevate the care that our patients receive.
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French PT, Dickmeyer JJ, Winterer CM, Stone SE, Sherman AK, Simpson EA. Breastfeeding Advocacy: A Look into the Gap Between Breastfeeding Support Guidelines and Personal Breastfeeding Experiences of Faculty Physicians. Breastfeed Med 2022; 17:239-246. [PMID: 34910886 DOI: 10.1089/bfm.2021.0231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: Despite increased lactation support for mothers over the past few decades, physician mothers still face considerable challenges to achieving their breastfeeding goals. Disparities in breastfeeding exist between physician and nonphysician mothers in the United States. To formulate an effective advocacy agenda for this population, we surveyed faculty physician mothers about their breastfeeding experiences. We hypothesized that identifying frequent, modifiable barriers to breastfeeding could generate ideas for improved lactation support for female physicians. Study Design: A deidentified breastfeeding survey was sent to female faculty physicians at an academic children's hospital in 2020. Inclusion criteria included female faculty physicians who had given birth within the past 5 years. The responses of those who selected "yes" when asked if they had breastfed were analyzed. Results: Fifteen percent of respondents stated that they did not meet their breastfeeding goals. The most prevalent theme for both positive and negative factors in the qualitative analysis was pumping breast milk. Physician mothers provided key insight into (1) the impact of their role as physicians on their breastfeeding experience, (2) impact of their return to work on breastfeeding, and (3) ideas for improved lactation support. Conclusion: This study highlights the need to improve maternal and infant health by advocating for faculty physicians who are providing breast milk for their children. Advocacy efforts should focus on improving conditions for breast milk pumping and for effective policies around return to work after delivery. Further development and study of individualized breastfeeding support plans for physician mothers is needed.
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Affiliation(s)
- Pooja T French
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA.,University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Jodi J Dickmeyer
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA.,University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Courtney M Winterer
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA.,University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Sarah E Stone
- Department of Population Health, Inova L.J. Murphy Children's Hospital, Falls Church, Virginia, USA
| | - Ashley K Sherman
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA
| | - Elizabeth A Simpson
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA.,University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
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Casilla-Lennon M, Hanchuk S, Zheng S, Kim DD, Press B, Nguyen JV, Grimshaw A, Leapman MS, Cavallo JA. Pregnancy in physicians: A scoping review. Am J Surg 2022; 223:36-46. [PMID: 34315575 PMCID: PMC8688196 DOI: 10.1016/j.amjsurg.2021.07.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/11/2021] [Accepted: 07/13/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND The personal health and professional impact of physician pregnancy requires further study. We performed a comprehensive scoping review of physician pregnancy to synthesize and assess the evidence to aid decision-making for relevant stakeholders. METHODS A search of 7 databases resulted in 3733 citations. 407 manuscripts were included and scored for evidence level. Data were extracted into themes using template analysis. RESULTS Physician pregnancy impacted colleagues through perceived increased workload and resulted in persistent stigmatization and discrimination despite work productivity and academic metrics being independent of pregnancy events. Maternity leave policies were inconsistent and largely unsatisfactory. Women physicians incurred occupational hazard risk and had high rates of childbearing delay, abortion, and fertility treatment; obstetric and fetal complication rates compared to controls are conflicting. CONCLUSIONS Comprehensive literature review found that physician pregnancy impacts colleagues, elicits negative perceptions of productivity, and is inadequately addressed by current parental leave policies. Data are poor and insufficient to definitively determine the impact of physician pregnancy on maternal and fetal health. Prospective risk-matched observational studies of physician pregnancy should be pursued.
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Affiliation(s)
| | - Stephanie Hanchuk
- Department of Urology, Yale School of Medicine, Yale University, New Haven, CT, USA.
| | - Sijin Zheng
- Yale School of Medicine, Yale University, New Haven, CT, USA.
| | - David D Kim
- Yale School of Medicine, Yale University, New Haven, CT, USA.
| | - Benjamin Press
- Department of Urology, Yale School of Medicine, Yale University, New Haven, CT, USA.
| | - Justin V Nguyen
- Department of Urology, Yale School of Medicine, Yale University, New Haven, CT, USA.
| | - Alyssa Grimshaw
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT, USA.
| | - Michael S Leapman
- Department of Urology, Yale School of Medicine, Yale University, New Haven, CT, USA; Veterans Affairs Connecticut Healthcare System, West Haven and Newington, CT, USA.
| | - Jaime A Cavallo
- Department of Urology, Yale School of Medicine, Yale University, New Haven, CT, USA; Veterans Affairs Connecticut Healthcare System, West Haven and Newington, CT, USA.
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Juliebø-Jones P, Pietropaolo A, Spinoit AF, Bergesen AK, Guðbrandsdottir G, Beisland C, von Ostau N, Harke NN, Ribal MJ, Zerva M, Bres-Niewada E, Zondervan P, McLornan L, Ferretti S, Tonnhofer U, Necknig UH, Skolarikos A, Somani BK. Rules and regulations for a pregnant endourologist: the European perspective. World J Urol 2021; 40:857-864. [PMID: 34874462 PMCID: PMC8650738 DOI: 10.1007/s00345-021-03896-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Working in surgery while pregnant is challenging. Navigating this period safely is of paramount importance. Anecdotal observation suggests that there exists great variation among European nations in regard to maternity leave and radiation safety. The aim of this article was to gain insight into policy patterns and variations across Europe regarding these issues. Methods A series of core question items was distributed to representatives across 12 nations Austria, Belgium, Germany, Greece, Iceland, Italy, Netherlands, Norway, Poland, Republic of Ireland, Spain and the United Kingdom). Results The total number of weeks with full pay ranged from as little as 4 weeks in Belgium to 32 and Iceland. All countries included in this study give the option of additional weeks beyond the initial period, however at reduced pay. Some offer unpaid leave beyond this. Only 5/12 countries had a specific policy on when the pregnant surgeon should come off the on-call rota. Only Austria, Italy and Poland stipulate a requirement for the pregnant clinician to be replaced or be completely exempt in cases involving radiation. Only Germany, Iceland, Norway and Poland highlight the need to limit radiation dose in the first trimester. Beyond this, Germany alone provides written guidance for reduction in gown weight and along with Poland, display arguably the most forward-thinking approach to resting. Conclusion There is a marked range in maternal leave policies across Europe. There also exists a lack of universal guidance on radiation safety for the pregnant urologist. There is urgent need for this void to be addressed.
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Affiliation(s)
- Patrick Juliebø-Jones
- Department of Urology, Haukeland University Hospital, Bergen, Norway. .,Department of Clinical Medicine, University of Bergen, Bergen, Norway. .,Young Academic Urologists (YAU), Urolithiasis & Endourology Working Party, Arnhem, The Netherlands.
| | - Amelia Pietropaolo
- Department of Urology, Ghent University Hospital, Ghent, Belgium.,Young Academic Urologists (YAU), Urolithiasis & Endourology Working Party, Arnhem, The Netherlands
| | | | - Anne K Bergesen
- Department of Urology, Haukeland University Hospital, Bergen, Norway
| | - Gigja Guðbrandsdottir
- Department of Urology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Christian Beisland
- Department of Urology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Nicola von Ostau
- Department of Urology, Universitätsklinikum Essen, Essen, Germany
| | - Nina N Harke
- Department of Urology, Universitätsklinikum Essen, Essen, Germany
| | - Maria J Ribal
- Department of Urology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Maria Zerva
- Department of Urology, Red Cross Hospital, Athens, Greece
| | - Ewa Bres-Niewada
- Department of Urology, Roefler Memorial Hospital, Pruszkow, Poland
| | - Patricia Zondervan
- Department of Urology, Amsterdam Medical Centers, Amsterdam, The Netherlands
| | - Liza McLornan
- Department of Urology, Beaumont and Connolly Hospitals, Dublin, Republic of Ireland
| | | | - Ursula Tonnhofer
- Department of Paediatric Surgery, Medical University of Vienna, Vienna, Austria
| | | | - Andreas Skolarikos
- Department of Urology, National and Kapodistrian University of Athens, Athens, Greece
| | - Bhaskar K Somani
- Department of Urology, University Hospital Southampton, Southampton, UK
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The Need for Allyship in Achieving Gender Equity in Gastroenterology. Am J Gastroenterol 2021; 116:2321-2323. [PMID: 34665160 DOI: 10.14309/ajg.0000000000001508] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 08/16/2021] [Indexed: 12/11/2022]
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