Tamara Thomas

Urban Health Today

Cultural, organizational, interpersonal, and individual factors create obstacles to family building for medical students and physicians, according to a study published in JAMA Network Open.
Physicians and medical students seeking to build families encounter significant challenges due to the structure and culture of the medical profession. For this study, Qiang Zhang, an MD student at UCLA, and colleagues evaluated the barriers and facilitators to family building for all people in medicine (including those who cannot become pregnant).
The study included 2,025 participants, predominantly women (92%). Of these, 8% identified as Black, 64% as White, and 15% as Asian. Most participants (85%) identified as heterosexual, and 59% were physicians who had completed their training.
The researchers explored 4 major themes in this study:
<ul>
<li>Cultural factors, including the conflict between medical training and family building</li>
<li>Organizational factors, such as the lack of institutional support for various family-building paths</li>
<li>Interpersonal factors: including the impact of social support on family building</li>
<li>Individual factors, such as socioeconomic status and other personal circumstances that facilitate or hinder family building</li>
</ul>
The respondent reported that the demanding nature of medicine, particularly the long hours and intense residency competition, posed significant challenges to family building.
“One in four women in medicine have infertility,” Qiang Zhang, BA, an MD student at UCLA, told Healio. “As medicine continues to grow more diverse, it’s important to raise awareness of this issue because one should not have to choose between having a career and having a family.”
Respondents also reported that building a family negatively impacted their careers, often leading to career delays and strained relationships with colleagues and supervisors.
Pregnant physicians and trainees also shared their experiences with discrimination, including being less likely to be promoted.
“Faculty have made it painfully clear they would look down on and resent any female colleague who got pregnant,” the physicians said.
Additionally, respondents reported challenges in building families post-residency and encouraged peers to resist pressures to delay family planning.
“We hope that through sharing personal stories of these participants, readers can better understand how the structure of medicine is not conducive for family building, and also hear proposed solutions to this problem,” Zhang said. “We hope readers will see how there are many forces at play in the medical system, including lack of institutional support for artificial reproductive technology, a culture of strenuous work and rigid schedules, discrimination, and lack of transparency, among others, that contribute.”
The researchers advocate for implementing family-building curricula in medical schools, providing adequate parental leave for all physicians and medical students, and providing comprehensive insurance coverage for various family-building options.
“We can all play a role in stepping up and speaking up on this issue,” Zhang said. Other proposed solutions we discussed in our paper include increasing protection for lactation and on-site child care. Other steps include fighting against the discriminatory culture toward pregnant trainees.”
Source:<a href="https://www.healio.com/news/hematology-oncology/20240104/physicians-trainees-report-multitude-of-barriers-to-family-building-in-medical-profession"> Healio</a>
Journal: <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2813409?utm_campaign=articlePDF&amp;utm_medium=articlePDFlink&amp;utm_source=articlePDF&amp;utm_content=jamanetworkopen.2023.49937">JAMA Network</a>

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Faculty have made it painfully clear they would look down on and resent any female colleague who got pregnant