Family planning trends in vascular surgery: Insights from a nation-wide survey to U.S. vascular surgery trainees and their training programs

<h2>ABSTRACT</h2><h3>Background</h3> Family planning for vascular surgery trainees can be difficult given the intensity of residency. This original study focuses on understanding and assessing information about family planning issues faced by vascular surgery residents and fellows to ultimately improve trainee wellbeing through advocacy of broader implementation of family planning resources. <h3>Methods</h3> Two separate anonymous surveys regarding family planning and fertility preservation, one targeting vascular surgery trainees, and another focusing on vascular surgery program directors (PDs) and associate program directors (APDs), were distributed amongst 73 integrated vascular surgery training programs and traditional fellowship programs across the United States in 2023. <h3>Results</h3> The survey targeting vascular surgery trainees was completed by 80 respondents. Of all respondents, 47.44 % were female, 51.28 % were male and 1.38 % identified as other. Most of the participants were between 28 - 31 years old or 31- 34 years old, constituting 38.75 % and 37.50 % of respondents, respectively. Of the respondents to the trainee survey, 81.01 % were enrolled in an integrated vascular surgery residency, while 18.99 % were enrolled in a vascular surgery fellowship. Most trainees, 44.44%, indicated that their preferred timing for having children would be after training, while 32.32% reported their preferred time would be during residency/fellowship, 10.10% during research year, and 13.13% were unsure. Thirty-two percent of female trainees reported having a fear of being discriminated against in their program if they became pregnant during training. Over a third of both male and female trainees, 37.97%, believe that having children negatively affects their work, and 35.44% assume that having children will negatively affect their coworkers. The survey focusing on PDs and APDs were completed by 29 respondents. Of the 29 respondents, 57.96% were PDs and 24.62% were APDs. Ninety-two percent of the programs reported having an established maternity/paternity leave policy. A majority of PDs and APDs reported that they do not believe that having children during vascular surgery training affects their trainees' clinical competency (p < 0.001). Both agreed to the benefit of having a formal discussion on family planning or parental leave policies and fertility preservation during medical school or residency with no significant difference between the two groups. <h3>Conclusion</h3> The rigorous demands of vascular surgery training can create challenges for the vascular trainee, in terms of family planning and its impact on their career path. The findings of this study form a foundation which can be used to discuss and implement policies for trainee support regarding family planning in vascular programs nationwide.