A National Survey of Pregnancy and Parenthood Among Nephrology Trainees: A Focus on Nephrology Fellowship

Key Points Parental leave policies for physician trainees are inconsistent. Nephrology fellows are largely unaware of parental leave policies and pregnancy accommodations in their programs. Individual nephrology programs should improve awareness about national and local program policies among trainees. Background National and international policies on parental leave for physician trainees are inconsistent. Physician trainees, including nephrology fellows, may be at higher risk of pregnancy complications. Physician trainees face barriers in meeting their breastfeeding goals and in finding childcare because of nontraditional work hours with extended or unpredictable shifts. We examine awareness of current policies in US nephrology fellowship programs regarding parental leave, pregnancy/breastfeeding accommodations, and fellows' perspectives on family planning. Methods An anonymous, online survey of US nephrology fellows was undertaken from June 9 to August 24, 2023. Results One hundred twenty nephrology fellows submitted the survey. Most of the fellow respondents were unaware of parental leave policies of their training programs (63%), the Accreditation Council for Graduate Medical Education (75%), and/or the American Board of Medical Specialties (75%). Forty-two percent were unaware of the duration of parental leave at their program. Nearly 45% of all respondents were unsure if their program limited night shifts or shifts >24 hours for pregnant trainees. Forty-three percent reported they were unsure of lactation accommodations, and 40% were unsure of access to subsidized childcare. When fellows received work accommodations for pregnancy or parenthood, their work obligations were largely covered by co-fellows (60%) or attendings (38%). Over 60% of fellows agreed or strongly agreed that they would avoid a pregnancy in fellowship because of concern that they would have to extend their training. Of the 40 fellows who chose to pursue pregnancy or parenthood during medical training, 75% did not change their career plans as a result. Conclusions Most nephrology fellows were unaware of parental leave policies and pregnancy/lactation accommodations. While the topic itself has a broad effect to all physician trainees, there is a need for improved awareness about national and local program policies among trainees across individual nephrology programs. Podcast This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2024_08_16_CJASNAugust00000000.mp3