{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T07:10:19Z","timestamp":1793257819507,"version":"4.5.0"},"reference-count":17,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Physicians, especially surgeons, delay family building, and face age-related complications of pregnancy.<\/jats:p><\/jats:sec>Objective<\/jats:title>To explore factors that are associated with family building decisions among residents and fellows and to understand their thoughts on accessing family building supports, workplace culture, and attitudes toward family planning.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This qualitative study was conducted from May to August 2022 at postgraduate training sites across Ontario, Canada. Participants included 29 postgraduate learners. Purposive sampling from 80 eligible trainees was used to ensure diverse demographics, including sex, specialty, and institution. Semi-structured individual interviews lasting 30 to 90 minutes were conducted over a virtual platform. Participants were asked to share their thoughts and experiences on family planning in a medical career, family building goals, the role of mentorship, and knowledge of current family planning supports.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Themes associated with residents\u2019 perception of family planning within the context of a medical career.<\/jats:p><\/jats:sec>Results<\/jats:title>Twenty-nine trainees, ages 25 to 37 years old (22 [75.9%] were female, 26 [89.7%] were heterosexual; median [range] age, 30 [25-37] years) from various institutions took part in this study. The participants included both 24 residents (82.8%) and 5 fellows (17.2%) and 8 (27.6%) were from surgical specialties, 3 (10.3%) from pediatrics and subspecialties, 4 (13.8%) from internal medicine and subspecialties, 2 (6.9%) from obstetrics and gynecology, 3 (10.3%) family medicine, 2 (6.9%) from anesthesia, and 7 (24.1%) other medical specialties. Four themes were identified: (1) tension between role as a physician and role as a parent; (2) impact of role models and mentorship on family planning choices; (3) family building is discouraged during training, especially in surgical specialties; and (4) need for tangible family planning supports in training.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this qualitative study of residents\u2019 and fellows\u2019 perspectives on family building, trainees did not perceive residency and fellowship programs as supportive for individuals who want to family build during training leading to personal and professional dissonance. Trainees identified that more tangible supports, transparent information, and mentorship may improve a trainees\u2019 feeling of support.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.29345","type":"journal-article","created":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T15:33:53Z","timestamp":1724859233000},"page":"e2429345","source":"Crossref","is-referenced-by-count":17,"title":["Resident and Fellow Perspectives on Family Planning and Building During Training"],"prefix":"10.1001","volume":"7","author":[{"given":"E. Shirin","family":"Dason","sequence":"first","affiliation":[{"name":"University of Toronto Temerty Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Mount Sinai Hospital, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abby","family":"Kapsack","sequence":"additional","affiliation":[{"name":"University of Toronto Temerty Faculty of Medicine, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy N.","family":"Baxter","sequence":"additional","affiliation":[{"name":"University of Toronto Temerty Faculty of Medicine, Department of Surgery, Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital Unity Health Toronto, Toronto, Canada"},{"name":"Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dionne","family":"Gesink","sequence":"additional","affiliation":[{"name":"University of Toronto Dalla Lana School of Public Health, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Shapiro","sequence":"additional","affiliation":[{"name":"University of Toronto Temerty Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Mount Sinai Hospital, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea N.","family":"Simpson","sequence":"additional","affiliation":[{"name":"University of Toronto Temerty Faculty of Medicine, Department of Surgery, Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital Unity Health Toronto, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,8,28]]},"reference":[{"issue":"7","key":"zoi240888r1","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1001\/jamainternmed.2021.1635","article-title":"Delay of pregnancy among physicians vs nonphysicians.","volume":"181","author":"Cusimano","year":"2021","journal-title":"JAMA Intern Med"},{"issue":"5","key":"zoi240888r2","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.13521","article-title":"Evaluation of adverse pregnancy outcomes in physicians compared with nonphysicians.","volume":"5","author":"Cusimano","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"3","key":"zoi240888r3","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1097\/SLA.0000000000005724","article-title":"High infertility rates and pregnancy complications in female physicians indicate a need for culture change.","volume":"277","author":"Lai","year":"2023","journal-title":"Ann Surg"},{"issue":"1","key":"zoi240888r4","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1186\/s12909-018-1373-1","article-title":"Female trainees believe that having children will negatively impact their careers: results of a quantitative survey of trainees at an academic medical center.","volume":"18","author":"Kin","year":"2018","journal-title":"BMC Med Educ"},{"issue":"4","key":"zoi240888r5","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/j.jsurg.2023.01.004","article-title":"Parenting and childbearing in neurosurgical residency: perspectives from the United States and Canada.","volume":"80","author":"Samuel","year":"2023","journal-title":"J Surg Educ"},{"issue":"10","key":"zoi240888r6","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1503\/cmaj.131053","article-title":"Resident duty hours in Canada: past, present and 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