Journal of General Internal Medicine

, Volume 32, Issue 6, pp 648–653 | Cite as

Impact of Pregnancy and Gender on Internal Medicine Resident Evaluations: A Retrospective Cohort Study

  • Megan L. Krause
  • Muhamad Y. Elrashidi
  • Andrew J. Halvorsen
  • Furman S. McDonald
  • Amy S. Oxentenko
Original Research

Abstract

Background

Pregnancy and its impact on graduate medical training are not well understood.

Objective

To examine the effect of gender and pregnancy for Internal Medicine (IM) residents on evaluations by peers and faculty.

Design

This was a retrospective cohort study.

Subjects

All IM residents in training from July 1, 2004–June 30, 2014, were included. Female residents who experienced pregnancy and male residents whose partners experienced pregnancy during training were identified using an existing administrative database.

Main Measures

Mean evaluation scores by faculty and peers were compared relative to pregnancy (before, during, and after), accounting for the gender of both the evaluator and resident in addition to other available demographic covariates. Potential associations were assessed using mixed linear models.

Key Results

Of 566 residents, 117 (20.7%) experienced pregnancy during IM residency training. Pregnancy was more common in partners of male residents (24.7%) than female residents (13.2%) (p = 0.002). In the post-partum period, female residents had lower peer evaluation scores on average than their male counterparts (p = 0.0099).

Conclusions

A large number of residents experience pregnancy during residency. Mean peer evaluation scores were lower after pregnancy for female residents. Further study is needed to fully understand the mechanisms behind these findings, develop ways to optimize training throughout pregnancy, and explore any unconscious biases that may exist.

KEY WORDS

graduate medical education pregnancy evaluation 

Notes

Acknowledgments

Contributors: None.

This study was supported in part by the Mayo Clinic Internal Medicine Residency Office of Educational Innovations as part of the Educational Innovations Project of the Accreditation Council for Graduate Medical Education (ACGME).

Prior presentations: None.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.

REFERENCES

  1. 1.
    Potee RA, Gerber AJ, Ickovics JR. Medicine and motherhood: shifting trends among female physicians from 1922 to 1999. Academic medicine: journal of the Association of American Medical Colleges. 1999;74:911–919.CrossRefGoogle Scholar
  2. 2.
    Hutchinson AM, Anderson NS 3rd, Gochnour GL, Stewart C. Pregnancy and childbirth during family medicine residency training. Family medicine. 2011;43:160–165.PubMedGoogle Scholar
  3. 3.
    Gabbe SG, Morgan MA, Power ML, Schulkin J, Williams SB. Duty hours and pregnancy outcome among residents in obstetrics and gynecology. Obstetrics and gynecology. 2003;102:948–951.PubMedGoogle Scholar
  4. 4.
    Turner PL, Lumpkins K, Gabre J, Lin MJ, Liu X, Terrin M. Pregnancy among women surgeons: trends over time. Archives of surgery. 2012;147:474–479.CrossRefPubMedGoogle Scholar
  5. 5.
    Stewart DE, Robinson GE. Combining motherhood with psychiatric training and practice. Canadian journal of psychiatry. Revue canadienne de psychiatrie. 1985;30:28–34.CrossRefPubMedGoogle Scholar
  6. 6.
    Finch SJ. Pregnancy during residency: a literature review. Academic medicine: journal of the Association of American Medical Colleges. 2003;78:418–428.CrossRefGoogle Scholar
  7. 7.
    Sayres M, Wyshak G, Denterlein G, Apfel R, Shore E, Federman D. Pregnancy during residency. The New England journal of medicine. 1986;314:418–423.CrossRefPubMedGoogle Scholar
  8. 8.
    Tamburrino MB, Evans CL, Campbell NB, Franco KN, Jurs SG, Pentz JE. Physician pregnancy: male and female colleagues’ attitudes. Journal of the American Medical Women’s Association. 1992;47:82–84.PubMedGoogle Scholar
  9. 9.
    Phelan ST. Sources of stress and support for the pregnant resident. Academic medicine: journal of the Association of American Medical Colleges. 1992;67:408–410.CrossRefGoogle Scholar
  10. 10.
    Gjerdingen DK, Chaloner KM, Vanderscoff JA. Family practice residents’ maternity leave experiences and benefits. Family medicine. 1995;27:512–518.PubMedGoogle Scholar
  11. 11.
    Merchant SJ, Hameed SM, Melck AL. Pregnancy among residents enrolled in general surgery: a nationwide survey of attitudes and experiences. Am J Surg. 2012.Google Scholar
  12. 12.
    Klevan JL, Weiss JC, Dabrow SM. Pregnancy during pediatric residency. Attitudes and complications. American journal of diseases of children. 1990;144:767–769.CrossRefPubMedGoogle Scholar
  13. 13.
    Thackeray EW, Halvorsen AJ, Ficalora RD, Engstler GJ, McDonald FS, Oxentenko AS. The effects of gender and age on evaluation of trainees and faculty in gastroenterology. The American journal of gastroenterology. 2012;107:1610–1614.CrossRefPubMedGoogle Scholar
  14. 14.
    Beckman TJ, Mandrekar JN, Engstler GJ, Ficalora RD. Determining reliability of clinical assessment scores in real time. Teaching and learning in medicine. 2009;21:188–194.CrossRefPubMedGoogle Scholar
  15. 15.
    Balk SJ, Christoffel KK, Bijur PE. Pediatricians’ attitudes concerning motherhood during residency. American journal of diseases of children. 1990;144:770–777.PubMedGoogle Scholar
  16. 16.
    Franco K, Evans CL, Best AP, Zrull JP, Pizza GA. Conflicts associated with physicians’ pregnancies. The American journal of psychiatry. 1983;140:902–904.CrossRefPubMedGoogle Scholar
  17. 17.
    Holmboe ES, Huot SJ, Brienza RS, Hawkins RE. The association of faculty and residents’ gender on faculty evaluations of internal medicine residents in 16 residencies. Academic medicine: journal of the Association of American Medical Colleges. 2009;84:381–384.CrossRefGoogle Scholar
  18. 18.
    Brienza RS, Huot S, Holmboe ES. Influence of gender on the evaluation of internal medicine residents. Journal of women’s health. 2004;13:77–83.CrossRefPubMedGoogle Scholar
  19. 19.
    Verheyden CN, McGrath MH, Simpson P, Havens L. Social problems in plastic surgery residents: a management perspective. Plastic and reconstructive surgery. 2015;135:772e–778e.CrossRefPubMedGoogle Scholar
  20. 20.
    McDonald FS, Zeger SL, Kolars JC. Factors associated with medical knowledge acquisition during internal medicine residency. Journal of general internal medicine. 2007;22:962–968.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Cole S, Arnold M, Sanderson A, Cupp C. Pregnancy during otolaryngology residency: experience and recommendations. The American surgeon. 2009;75:411–415.PubMedGoogle Scholar
  22. 22.
    Nichols M. Curriculum change in an obstetrics-gynecology residency program and its impact on pregnancy in residency. American journal of obstetrics and gynecology. 1994;170:1658–1664. discussion 1664–1655.CrossRefPubMedGoogle Scholar
  23. 23.
    Alliance for Academic Internal Medicine. 2014 APDIM Program Directors Survey-Summary File. 2014.Google Scholar
  24. 24.
    US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. Women’s Health USA 2011. Rockville: US Department of Health and Human Services; 2011.Google Scholar

Copyright information

© Society of General Internal Medicine 2017

Authors and Affiliations

  • Megan L. Krause
    • 1
  • Muhamad Y. Elrashidi
    • 1
  • Andrew J. Halvorsen
    • 2
  • Furman S. McDonald
    • 3
  • Amy S. Oxentenko
    • 1
  1. 1.Department of Internal Medicine Mayo ClinicRochesterUSA
  2. 2.Internal Medicine Residency Office of Educational InnovationsMayo ClinicRochesterUSA
  3. 3.Departmentof Academic AffairsAmerican Board of Internal MedicinePhiladelphiaUSA

Personalised recommendations