Women surgeons are more likely to use assisted reproductive technology, have fewer children

Dr. Phillips and colleagues have identified yet another issue that may add to the complexity of surgical training, i.e., pregnancy. Both surgical training and having children are time-sensitive priorities that may conflict with one another and add extra stress to the decision matrix. There is no perfect answer here. So, even after the decision is made to have a child, there will still be many other conflicts coming down the pike.

Dr. Rozycki

The key to managing such issues is to realize the following: Be flexible. You can "do it all" but not all at once. You have a whole lifetime to accomplish goals and from time to time, adjustments in plans have to be made: You lead life, it does not lead you. There is no "yellow brick road." This is where surgeons excel. They exhibit strength and courage when facing such conflicts and recognize that they have the skills and stamina to move their lives forward even in the face of complex challenges.

Grace Rozycki, M.D., FACS, is the Willis D. Gatch Professor of Surgery and executive vice chair of the department of surgery, Indiana University Schoolof Medicine, Indianapolis.

Being pregnant at 40 is miserable but being pregnant at 40 is also incredibly lucky. I just returned from maternity leave after my third child and promise you this is true. As this study demonstrates, despite what we may tell ourselves, we are biologically engineered to procreate in our 20s, not in our 40s. The problem is that in our 20s and early 30s, we are so focused on our career that we all too often neglect our personal life.

We talk about the "choice" of many women surgeons to not have children as an active one, which simplifies a very complex issue. There are many reasons why women surgeons have fewer children than the general population and often it does not represent an active choice.

Dr. Greenberg

Infertility is an intensely personal and emotional issue that is rarely discussed. As such, we often don't realize how many of our colleagues are facing this challenge and can feel isolated when discussions of work/life balance are overly focused on the challenges of raising children.Our discipline is changing in many positive ways that may improve these statistics so that more women surgeons can have a fulfilling career and enjoy motherhood if they so choose. Research such as this will hopefully help the younger generation to start thinking about these issues earlier and motivate the older generation to provide an environment that is conducive to having children at any stage of a surgical career.

Caprice Greenberg, M.D., FACS, is associate professor of surgery, University of Wisconsin, Madison, and director of the Wisconsin Surgical Outcomes Research Program.

As a medical student applying into a surgical subspecialty, I am sobered but certainly not surprised by these findings. I approach my career and desire for a family with wary readiness to face a lifetime of setting tough priorities that at times may feel isolating. Is a career as a surgeon incompatible with pregnancy, lasting marriage, and well -behavedcared for children? I would say no, though it depends on who your partner is, where you work, and careful timing. With increasing numbers of women entering surgery who refuse to compromise mothering their own children, the work environment will have to change.

Ms. Gamble

Part of this changing landscape may mean that female surgeons will undergo assisted reproductive technologies at higher rates than their nonsurgeon counterparts. It may mean that shift work becomes more acceptable. The changes we create as a medical community should affect both men and women; we should be wary of designing special tracks or programs that can lend to further isolation and hand-waving of leadership. To ensure gender equity in surgery, we are asking for institutional change - something for which there is never a perfect or easy time. Surgeons simply have to make it a priority.

Charlotte R. Gamble is a fourth-year medical student at the University of Michigan, Ann Arbor.