Perception among medical oncology fellows of program support for pregnancy and parenthood: An ASCO State of Cancer Care in America analysis.

66 Background: ASCO’s strategic plan prioritizes professional well-being and promotion of healthy work environments across career stages, from training to practice. As fellowship often coincides with reproductive years, we examined fellows’ perceptions of program support for pregnancy and parenthood, career advancement opportunities, and overall occupational well-being. Methods: Fellows who took the 2025 ASCO Medical Oncology In-Training Exam were invited to complete an optional post-exam survey on parental status, institutional support for pregnancy and childcare, and perceptions regarding work-life balance and opportunities for career advancement. Perceptions were compared by respondent gender, parental status, and whether they delayed having children due to fellowship using chi-squared tests. Results: Of 2294 medical oncology fellows who took the exam, 1667 (73%; 52% male, 47% female) responded to 1+ survey items and were included in this analysis. Overall, 522 (31%) of fellows were parents (57% male, 42% female); 20% had a child prior to fellowship and 19% had a child during fellowship. Most fellows (93%) agreed that their program has comparable opportunities for advancement, regardless of parental status or gender. Nearly 1 in 4 (23%) of fellows disagreed that their work schedule leaves enough time for personal/family life, including more females than males (25% vs. 20%, p = 0.02) and more non-parents than parents (24% vs. 19%, p = 0.03). 29% of fellows reported that they delayed having children due to fellowship, with more females delaying than males (38% vs. 21%, p < 0.001). Compared to those who did not delay, fellows who delayed were: a) 2.7 times more likely to report not having enough time for personal/family life (38% vs. 14%, p < 0.001), and b) 2.6 times more likely to disagree that their program has comparable advancement opportunities regardless of parental status (13% vs. 5%, p < 0.001). Finally, most fellows (69%), including more non-parents than parents (76% vs. 66%, p < 0.001), did not know if their program provided at least one type of parental support (e.g., fertility coverage, lactation areas, childcare access). Conclusions: Nearly a third of medical oncology fellows report delaying having children due to fellowship. Findings suggest key opportunities for fellowship programs to raise awareness about their program’s available parental supports, and to explore structural support for work/life integration and career advancement. Given the overlap of fellowship training with typical family-building years, addressing these issues is critical to fostering a supportive oncology training environment.