Impact of Procedural Training on Pregnancy Outcomes and Career Satisfaction in Female Postgraduate Medical Trainees in the United States

BACKGROUND: Compared with nonprocedural fields, procedural specialization requires longer training, less flexible schedules, and greater physical demands. The impact of these factors on pregnancy, maternity outcomes, and career satisfaction has not been well described. STUDY DESIGN: Data were gathered from 738 US postgraduate medical trainee mothers via an anonymous, IRB-approved online survey. Univariate analysis was performed using chi-square tests. A logistic regression model was used to investigate the impact of procedural training on odds of assisted reproduction use and pregnancy complications, adjusting for age at first pregnancy. RESULTS: Of the 738 respondents, 221 (30.0%) were in procedural fields. A greater percentage of procedural trainees were more than 30 years old at the time of first pregnancy (52.9% vs 43.1%; p = 0.01). Controlling for maternal age, procedural trainees were significantly more likely to require assisted reproduction (odds ratio [OR] 1.28; 95% CI 1.01 to 1.61; p = 0.04), and trended toward increased odds of prolonged time to conceive (OR 1.62; 95% CI 0.99 to 2.65; p = 0.06). After delivery, procedural trainees also had higher adjusted odds of shorter maternity leave (OR 1.52; 95% CI 1.06 to 2.18; p = 0.03) and were significantly more likely to report a desire to have chosen a less demanding specialty or job (OR 1.95; 95% CI 1.40 to 2.72; p < 0.001). CONCLUSIONS: Procedural trainees have higher rates of assisted reproduction, shorter maternity leave, and are ultimately more likely to express career dissatisfaction. These findings illustrate the need for adequate support for trainee mothers, particularly in procedural specialties. (C) 2017 by the American College of Surgeons. Published by Elsevier Inc. All rights reserved.