Childbearing and child care in surgery

Hypothesis: The responsibility for childbearing and child care has a major effect on general surgical residency and subsequent surgical practice. Methods: A survey of all graduates from a university general surgical train ing program between 1989 and 2000. Results: Twenty-seven women and 44 men completed general surgical training at our university during the period, and 42 (59%) responded to our survey. The age at completion of the residency was 34.0 +/- 2.2 years for men and 3 3.9 +/- 2.8 years for women. During residency, 64% (14/22) of the men and 1 5% (3/20) of the women had children. At the time of the survey, 21 (95%) of the men and 8 (40%) of the women had children. Most residents (24 [57%] of 42) relied on their spouse for child care. During surgical practice, 18 (4 3%) indicated that they rely on their spouse; 19 (45%) use day care, home c are, or both; and (8%) of 26 are unsatisfied with their current child care arrangement. During training, 38% (5/ 13) of men and 67% (2/3) of women too k time off for maternity leave, paternity leave, or child care. Two of 3 su rgeons would like to have had more time off during residency; most men (70% , or 7 of 10) recommended a leave of 1 to 3 months, and all women preferred a 3-month maternity or child care leave of absence. During surgical practi ce, only 12% (2/17) of men but 64% (7/11) of women have taken time off for either childbearing or child care. Half of the respondents (21/42) have a f ormal leave of absence policy at work, 52% (11/21) of which are paid. leave programs. Although the workweek of our practicing graduates is 69 +/- 16 h ours for men and 64+/-12 hours for women, 62% (26/42) spend more than 20 ho urs per week parenting. More than 80% (27/32) would consider a part-time su rgical practice for more parenting involvement; one third of the responders suggested that 30 hours a week constitutes a reasonable part-time practice , one third preferred fewer than 30 hours, and one third favored more than 30 hours per week. Data are presented as mean+/-SD. Conclusions: Childbearing and child care may have an enormous impact on one 's decision to pursue a career in surgery. To attract and retain the best c andidates for future surgeons, formal policies on the availability of child care services in the residency program and the workplace should be studied and implemented. Furthermore, national studies are needed to define approp riate, acceptable workweeks for part-time or flexible practices and the dur ation of leaves of absence for childbearing or child care.