As for specialty choice, women are well represented in the primary care specialties of family medicine, internal medicine, and pediatrics, and underrepresented in the surgical subspecialties. In general, primary care residencies have a reputation for being more family-friendly than surgical residencies, probably in part because primary care specialties have the largest number of women. Besides primary care, obstetrics and gynecology (OB/GYN) and psychiatry are the other medical fields with the highest proportion of women residents.
Several primary care residency programs now offer “part-time” residencies or a “shared-schedule” option in which two trainees share one training slot and one salary. In 2007, 27% of pediatric residency programs in the US offered part-time residency options (McPhillips, 2007). The reduced hours can provide essential flexibility for a young family. Obviously, these training programs will take longer to complete than traditional ones.
Surgical specialties include general surgery, orthopedic surgery, ophthalmology, ear nose and throat (ENT), vascular surgery, neurosurgery, plastic surgery, pediatric surgery, and urology. In an 11-year study of one US general surgical training program, only 15% (3/20) of the female physicians had children during residency (Mayer, 2001). Due to lack of experience with pregnant residents, a precedent may not exist for maternity leave and breastfeeding policies at individual training programs in these traditionally male-dominated fields. As a female surgery resident planning to have a child during residency, you may be able to negotiate a fair arrangement with your program director, or you could encounter a total lack of support. Some surgical residency programs include a research year. With the understanding that scheduling a pregnancy doesn’t always work, a research year could be an ideal time to have a baby. Breastfeeding or expressing breast milk at predictable intervals may be more challenging in surgical rather than medical specialties due to long uninterrupted hours in the operating room.
Within any given specialty, support for physicians who have children during residency appears to vary widely among individual training programs. In general, larger programs will provide more scheduling flexibility than smaller ones. Additionally, larger programs may offer coverage options that won’t increase the workload of your colleagues. During the interview process, seek out any current residents with infants. Ask them how they are managing, what support they get from the residency program, and how their classmates have been affected.