{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T07:10:21Z","timestamp":1793257821423,"version":"4.5.0"},"reference-count":29,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Previously published literature found that 28.6% of surgical residents have or are expecting children, yet little information exists regarding the financial demands of childcare during residency.<\/jats:p><\/jats:sec>Objective<\/jats:title>To evaluate surgical residents\u2019 net financial balance after childcare costs at various postgraduate years and child ages.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cross-sectional study, conducted from June 14 to August 2, 2024, examined surgical residency programs across the US using publicly available data. Programs were categorized into US regions based on the Association of American Medical Colleges classifications: Northeast, Midwest, South, and West. Childcare costs were obtained from the National Database of Childcare Prices, and annual expenditure data came from the Bureau of Labor Statistics.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome was residents\u2019 net income by year of residency, calculated using salaries and expenditures. To compare costs by region and child age, net income was determined by subtracting mean expenditures and childcare costs from residency salaries. Calculations were validated using the Massachusetts Institute of Technology Living Wage Calculator.<\/jats:p><\/jats:sec>Results<\/jats:title>Of 351 US surgical residency programs, 295 with publicly available salaries for postgraduate years 1 through 5 met inclusion criteria. A total of 290 programs (98.3%) showed a negative net income when expenditures and childcare costs were deducted. This finding held true across all child age groups and US regions. The West had the most negative mean net income (\u2212$18\u202f852 [range, \u2013$35\u202f726 to $766]), followed by the Northeast (\u2013$15\u202f878 [range, \u2013$37\u202f310 to $3589]), Midwest (\u2013$12\u202f067 [range, \u2013$26\u202f111 to $1614]), and South (\u2013$8636 [range, \u2013$18\u202f740 to $4826]). Parents of school-aged children in the South had the lowest mean negative net income (\u2212$8453 [range, \u2212$16\u202f377 to $3417]), while parents of infants in the West had the highest mean negative net income (\u2212$21\u202f278 [range, \u2212$35\u202f726 to \u2212$5112]).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>This cross-sectional study of surgical residents\u2019 net income found that, after accounting for mean annual expenditures and childcare costs, a surgical resident\u2019s salary was insufficient to cover living expenses and childcare costs for single resident parents. This financial obstacle may deter individuals from pursuing surgical residency or from starting families as surgical residents.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.0708","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T15:01:17Z","timestamp":1741878077000},"page":"e250708","source":"Crossref","is-referenced-by-count":9,"title":["Affording Childcare on a Surgical Resident\u2019s Salary"],"prefix":"10.1001","volume":"8","author":[{"given":"Margaret G.","family":"Mercante","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Virginia, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily G.","family":"Tocco","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Virginia, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nidhi","family":"Kuchimanchi","sequence":"additional","affiliation":[{"name":"Department 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