Editorial: A Proposed Mentorship Program for Expectant Surgical Residents
Key findings
- Surgical residency program leaders need to create a culture of support for pregnant, postpartum, and lactating trainees
- Massachusetts General Hospital researchers propose establishing a formal mentorship program for pregnant residents
- They describe a framework for designing and implementing a mentorship program with goals that include providing practical advice, advocating for residents, and role-modeling positive behaviors
As surgical residency programs reach gender parity, department leaders need to create a culture of support for pregnant, postpartum, and lactating trainees. That requires a multifaceted approach, but establishing a mentorship program can be an essential component.
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Erika L. Rangel, MD, MS, formerly in the Division of General and Gastrointestinal Surgery at Brigham and Women's Hospital and now in the Department of Surgery, Division of Trauma, Emergency Surgery and Surgical Critical Care and associate program director of the General Surgery Residency Program at Massachusetts General Hospital, Alessandra L. Moore, MD, formerly at the Brigham, and colleagues describe a framework for designing and implementing a formal mentorship program for pregnant residents in JAMA Surgery.
Getting Started
The goals of the mentorship program should include providing practical advice, role-modeling positive behaviors, reporting mistreatment, and advocating for pregnant residents to faculty and program leaders as needed.
Residency program leaders may wish to invite female surgical faculty who are also parents to mentor pregnant residents. If few such faculty are available, leaders could partner with other training programs or professional societies to find virtual mentors.
Workbook
To encourage open discussion early in training, programs will optimally present first-year residents with a "welcome workbook" that lists the following:
- Leave options
- Examples of how surgical residents have structured parental leave in compliance with policies of the American Board of Surgery and Accreditation Council for Graduate Medical Education
- Local lactation and childcare resources
Surgical residents who have recently had a child during training are an important resource to help create the workbook. Providing the workbook during medical school rotations will help establish the department's culture of family support.
Initial Meetings
When a resident first meets with program leaders after announcing a pregnancy:
- The conversation should begin with "Congratulations!" to assuage resident apprehension about potential stigma and emphasize this is a celebratory time
- The resident should receive the welcome workbook and a list of faculty (or external) mentors
- A second meeting should be scheduled before adjourning the first
- After the resident has had time to consider leave options and select a mentor, a second meeting should be held for the program director to introduce the faculty mentor and resident
Mentor–Mentee Dyads
Mentor-mentee dyads should schedule at least three in-person meetings to build rapport, including after the resident returns to clinical duties when postpartum depression and other difficulties may manifest.
Topics of suggested focus are the challenges of operating during long cases while pregnant, childcare complexities, perceptions of stigma, difficult rotations, and how to accomplish breast milk expression on busy operative days. Mentors should be encouraged to share their experiences transitioning into dual roles as surgeon and parent.
Parting Thoughts
The proposed mentorship program is scalable and requires no financial investment. This straightforward, practical intervention is low-hanging fruit for programs that want to create meaningful cultural change that helps female surgeons sustain long careers. Departments can build on initial efforts by:
- Actively seeking feedback from participating residents about satisfaction and suggestions for modifications
- Benchmarking improvements in resident well-being
- Considering the creation of similar mentorship programs for nonbirthing resident parents, who may face gender stereotypes that undervalue their need to bond with a new child and other stressors related to work–family balance
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