Samuel Nardin, McQueen Sydney A, Barnett Randaline R, Everson Megan C, Fiala Clare, Lau Ruth, Zadeh Gelareh
Department of Neurosurgery, University of Toronto, Toronto, Ontario, Canada.
UNC Department of Neurosurgery, Chapel Hill, North Carolina.
J Surg Educ. 2023 Apr;80(4):572-580. doi: 10.1016/j.jsurg.2023.01.004. Epub 2023 Feb 1.
Despite growing interest in family planning alongside surgical training, significant barriers exist including time constraints, stigma, and lack of paid leave and formal policies. We currently lack a deep understanding of the challenges residents face and how practice cultures may prohibit successful policy enactment.
To investigate residents' perspectives surrounding parenting and childbearing during neurosurgical residency in the United States and Canada.
A cross-sectional, qualitative study methodology was used, including focus groups with neurosurgical residents. Purposive sampling was employed to capture a broad range of perspectives including stage of training, geographical location, and gender. Data collection and analysis occurred in parallel, using a thematic analysis approach. Data collection continued until no new themes relating to the research questions were identified.
Notable challenges included lack of formal family leave policies, time constraints, insufficient clinical human resources, physical health concerns, lack of lactation accommodations, and lack of mentorship. A subset of barriers were uncovered that stem specifically from workplace cultures, including gender norms, difficulty in asking for help, concerns for inconveniencing others, and pressures to time parental leave during research blocks. Several positive changes were identified including growing awareness and female representation, and benefits of the dual surgeon-parent identity.
While parenting during neurosurgery residency is becoming increasingly common, significant practical and cultural barriers persist including a marked absence of formal policies. Culture shifts are essential in ensuring opportunities for life outside of medicine for all residents, irrespective of family status.
尽管在外科培训期间对计划生育的兴趣日益浓厚，但仍存在重大障碍，包括时间限制、耻辱感、缺乏带薪休假和正式政策。目前，我们对住院医师面临的挑战以及实践文化如何阻碍政策的成功实施缺乏深入了解。
调查美国和加拿大神经外科住院医师培训期间住院医师对育儿和生育的看法。
采用横断面定性研究方法，包括与神经外科住院医师进行焦点小组讨论。采用目的抽样法，以获取包括培训阶段、地理位置和性别在内的广泛观点。数据收集和分析同时进行，采用主题分析方法。数据收集持续进行，直到没有发现与研究问题相关的新主题。
显著的挑战包括缺乏正式的家庭休假政策、时间限制、临床人力资源不足、身体健康问题、缺乏哺乳设施以及缺乏指导。发现了一些具体源于工作场所文化的障碍，包括性别规范、求助困难、担心给他人带来不便以及在研究阶段安排育儿假的压力。确定了一些积极变化，包括意识的提高和女性代表性的增加，以及双重外科医生-父母身份的好处。
虽然神经外科住院医师培训期间育儿越来越普遍，但重大的实际和文化障碍仍然存在，包括明显缺乏正式政策。文化转变对于确保所有住院医师，无论家庭状况如何，都有机会从事医学以外的生活至关重要。
