Parental Leave in Surgical Training: Webinar Highlights

Authors: Kylie Dickerson, MD, MS; Nensi Ruzgar, MD; Camila R. Guetter, MD, MPH; Alizeh Abbas, MD; Maria S. Altieri, MD, MS

     In March 2025, the Association of Women Surgeons Resident and Fellow Committee hosted a discussion on Parental Leave in Surgical Training. The session began with a presentation by Dr. Maria Altieri, Section Chief of GI Surgery and Director of Bariatric Surgery, Pennsylvania Hospital at the University of Pennsylvania, who has published multiple papers on parental leave policies during surgical training. The presentation was followed by a Q&A session with a panel of trainees who shared their experiences related to childbearing during clinical residency or dedicated research time, being a non-birthing parent, and exploring adoption. The goals of the webinar were to discuss different pathways to childbearing and parental leave policies during surgical training.

     Dr. Altieri discussed her personal experiences with childbearing during different phases of training, from medical school to residency, fellowship, and as a junior attending surgeon. She provided some staggering data showing that most medical schools in the US do not have official parental leave policies and that the US ranks poorly among other nations in regards to paid parental leave. Policies for parental leave vary between institutions and among state and national levels. State-specific policies include parental leave through the Family and Medical Leave Act (FMLA). On a national level, the American Board of Surgery has guidelines including a minimum number of clinical weeks per year (48) with an additional 4 weeks which can be taken for family or medical leave once during PGY1-3 and again during PGY 4-5. ACS released updated guidelines in 2024 highlighting the importance of supporting trainees. Institutional policies vary significantly among residency programs and can also differ in the amount of time off between maternal and paternal leave and the type of birth, including additional time for Cesarean sections.

     In addition to this discussion on parental leave policies, the webinar also included discussions on data regarding the fact that female surgeons have decreased fertility rates compared to the national average. Data published in 2021 showed that female surgeons are more likely to delay childbearing, require Assisted Reproductive Technology (ART), and have fewer children than their non-surgical counterparts. On average, women surgeons experience more than double the rate of miscarriages compared to the general population.

     Panelists for the Q&A session included residents with varied experiences with pregnancy during different phases of training, in addition to being a non-birthing parent and the process of adoption. The trainees discussed the level of support from their program leadership and co-trainees, adjustments they were able to request or make, and other considerations they had not expected. The panelists agreed that understanding policies is crucial, in addition to having buy-in from their program leadership, which is essential in order to have an easy transition to parenthood, while reducing the impact on surgical training.

     In conclusion, this session shed light on some of the gaps that still exist in parental leave policies both at the institutional and national levels. As women make up an increasingly higher percentage of the surgical workforce, it is critical that these issues are discussed as we strive towards solutions. Anyone interested in the topic can access the recording of the session on the AWS online webinar library or attend one of our upcoming webinars.

Kylie is a PGY4 general surgery resident at the University of Arizona in Phoenix who is pursuing a career in Surgical Oncology. She is from Monterey Bay, California and recently had her first child during clinical residency. She currently serves as a Regional Liaison for the AWS Resident and Fellow Committee.