Tuesday, February 20, 2018

Are residents worse post-pregnancy?

This is an interesting article about how peer evaluations of female residents go down after pregnancy, while evaluations of men who have children during residency do not go down.

I was wondering why this might be the case. I thought of a few possibilities:

1) resentment towards pregnant residents who took a leave and everyone had to do extra work to cover. I wonder how evaluations might be affected in other residents who took leave for other reasons. Of course, people generally think of pregnancy as “a choice“ so leaves for other medical reasons might be looked at more sympathetically.

2) performance may actually decline after having a baby. I don’t know about you, but if I am awake breast-feeding two or three times per night, I’m probably not going to perform at the same level as I was when I was well rested. Also, once you have a baby, no matter how good your support system is, you’re still somewhat at the mercy of your child’s health. Even if you have someone to watch them when they are sick, you probably aren’t going to be able to work when you are actively vomiting from the G.I. bug that they gave you. (I tried.  I was sent home.) again, this is something where man should theoretically be affected as much as women, but there is probably more of a tendency for men who decide to have a baby during residency to have a spouse with a more flexible career. And also, they don’t have to breast-feed.

3) Other residents might not take you as seriously when you become a parent. They may feel your priorities are shifted, even if that’s not actually the case.

What do you think?  If you had a baby during residency, do you think it changed what the other residents thought of you? Did you change your opinion of female residents that you worked with after they had a baby?


  1. I think most people are a little rusty when they come back to work from any kind of leave, and the longer they are out the rustier they are. The further along you get in training the less it matters. Also, if you can expect to be a little behind your residency classmates if you’ve taken time off and they haven’t. In my program having a baby doesn’t seem to affect your reputation. Residents who were great before were still thought of that way after they had babies, and the opposite was true as well. It may be that people assumed they wanted to mommy track after they had kids, but I think in the cases I can think of, most of them wanted to anyway. The men? Since they are gone so little time I think it’s possible that a lot of people aren’t even aware their wives just had a kid.

  2. I read the article briefly. It’s hard to draw conclusions from a study done at one specific medical institution since findings might be limited to that institution. Maybe/maybe not. Also it’s interesting to note that the peer evals went down for the post pregnant female residents but not the faculty evaluations. I tend to think the faculty evals are likely more accurate and less subject to bias. I agree wholeheartedly with point 1, slightly agree with point 2 (sleep deprivation definitely affects work ability! But if it was that bad I think the faculty evals would be affected too), and agree again with point 3.

    I’ve definitely changed my style post baby. I can see how other residents would be resentful of covering shifts for me on leave, and I’ve tried to do my best to pay some back now I’m back. I try to be more efficient so I can spend more of the precious after-work-but-before-bedtime hours with Baby so I’m less likely to be chatty during clinic, more focused on getting my work done, and more likely to be seen bolting out the door at 5:01 if my schedule allows. I also am now a less regular fixture at our residency happy hours :( I actually feel like a stronger, more efficient resident now than I was before Baby, but maybe my co-residents see differently on the outside looking in?

    1. Thank you. Just like the article above, very encouraging!

  3. Two babies during residency lots of experience here. It irked me to no end that my male cohorts were congratulated and we were generally met with disdain and bias on peer and attending levels. I felt like I had to work twice as hard in order to salvage my reputation. I became much more efficient, like kicks above. Looking back on it all makes me realize how broken the entire system is. Women are made to feel guilty for procreation? And for taking too short leaves? I was at a dinner the other night and learned a cousin's husband got three months of paid paternity leave as a new hire at Microsoft!! We in medicine are in the stone ages of supporting families.

  4. I had an infant during residency so I started off as a parent. My residency was very supportive. I think programs can do a better job of paying locums or others to fill in for residents who need time off. I have seen folks (residents and students) come back after less than 4 weeks of maternity leave - that is just not healthy! I don’t think it’s fair to spread shifts around already stressed coresidents. Hire part time docs to do it or get creative in other ways so as not to cause tension between coresidents. I remember having to call in a few times when I or my kiddo was sick and I felt horribly. It shouldn’t be this way in order to care for yourself or a loved one.


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