Family planning, pregnancy, and parenthood during surgical training: Experiences and perspectives from trainees and early career surgeons in Australia and New Zealand.

Objective: To identify and address areas for improvement within the current surgical training model in Australia and New Zealand relating to family planning and inflexible training as top barriers to gender equity in surgery.

Methods: A cross-sectional study of accredited surgical trainees and early career surgeons in Australia and New Zealand was conducted between September and October 2023. Participants were recruited by the RACS Fax Mentis, the Urological Society of Australia and New Zealand (USANZ) e-newsletter, and medical social media networks. Qualitative and quantitative data were collated by the electronic survey and thematically analyzed.

Results: There was a total of 146 participants. Approximately two-thirds of respondents identified as mothers and one-third as fathers, with representation from all surgical specialties. We identified four key themes including the disruptive impact of poor work-life balance on family planning, an absence of workplace systemic supports, a need for structured support program upon return-to-work from parental leave, and challenges in balancing professional and parental identities and responsibilities.

Conclusion: To promote a culture of equity, inclusivity, and acceptance, restructuring of surgical training programs are necessary to support trainees as they navigate family planning and parenthood. Promotion of flexible training options and recruitment of additional clinical supports around parental leave period may reduce negative biases toward trainees simultaneously balancing family and work. Systemic change is required to lower barriers to entry and achieve gender equality in surgery.