Thinking of starting a family? Don’t become a doctor

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The medical profession doesn’t support, and in some ways actively discourages, physicians and medical students from starting and building families, a new study finds.

The study’s authors surveyed about 2,000 medical students, residents, fellows and practicing physicians during two months in 2021. Survey participants were recruited on social media and included individuals of all gender identities and sexual orientations. They were asked three open-ended questions:

• What would you do differently, if anything, with regard to family planning knowing what you know now?
• What advice do you have for current trainees who want to have a family?
• Is there anything else we should know about how your career has affected your family planning?

The results, the authors write, “depict a harsh reality in which the medical profession creates and sustains barriers to family building.” Respondents said that cultural and organizational factors were the primary roadblocks they encountered to family building. In particular, the enormous pressure imposed by medicine’s long and demanding training requirements and its highly competitive environment leads many physicians to delay family building until completing their training.

The authors note that the responses showed that pregnant individuals, those with children, and LGBGTQIA+ individuals face additional hurdles in the form of discrimination, a finding similar to that in a survey of more than one thousand women oncologists.

The effects of medicine’s high-stress environment are evidenced in some respondents’ decision to have smaller families and to start them later than they desired, or the inability to have children at all. Others changed their specialty or said they planned to leave medicine altogether.

At the organizational level, the responses revealed “a lack of transparency surrounding institutional polices and a lack of financial support for all family-building routes,” the authors write. And when students and practitioners do start families, they face “inconsistent, inadequate, and often unclear policies regarding parental leave, coverage for fertility treatment, children, and support for pregnancy loss.”

Many of the responses expressed support for the updated guidelines from the Accreditation Council for Graduate Medical Education and American Board of Medical Specialties mandating at least six weeks of parental leave. In addition, the authors recommend that medical schools include family building in their curricula, providing adequate parental leave for physicians and medical students, and providing insurance coverage for all family-building routes.

The study, Barriers to Family Building Among Physicians and Medical Students” appeared December 28 in JAMA Network Open.