Fertility knowledge and family planning perspectives among female physicians: a cross-sectional study

PURPOSE: Female physicians spend a substantial proportion of their fertile years in academic and clinical training. The present study assessed fertility-related knowledge, concerns, and barriers to family planning among female physicians in Germany and their potential impact on career development. MATERIAL AND METHODS: In this cross-sectional study, cisgender female physicians from all disciplines and career stages practicing in Germany were recruited via online platforms, printed flyers, and women physicians' associations. An anonymous online survey was conducted between August 2024 and September 2025. It collected data on demographics, clinical, and academic career trajectories, fertility knowledge (using a modified FIT-KS and classified according to Bloom's cut-off values), as well as motherhood and career intentions. Associations were examined using Pearson and Spearman correlation coefficients and chi-square tests. p-values were interpreted descriptively, with a significant threshold set at p < 0.05. RESULTS: Of the 250 participating physicians, 214 completed the survey. The median age was 36.5 years (IQR 32-44). Respondents included residents (43.8%), specialists (22.3%), and senior physicians (19.5%). Overall fertility knowledge was moderate with a mean correct response rate of 70.2%. A total of 9.2% participants aspired to the highest academic rank, while 10.7% aimed for the highest clinical leadership position. Most respondents (90.2%) considered leadership positions compatible with part-time work. More than half reported postponing family planning, primarily due to limited career opportunities, long and inflexible working hours, and inadequate childcare support. Overall, 59% were mothers, with a mean of 1.99 children, and the mean age at first childbirth was 31.8 years. A higher age at first childbirth was significantly associated with retrospective regret about delaying parenthood. Physicians with children were more likely to work part-time. Among childless respondents, the main reasons were lack of suitable time due to studies or work (60.2%) and prioritization of career (45.5%). CONCLUSIONS: Fertility knowledge was moderate, suggesting that additional education may be needed to support informed family planning decisions. Greater acceptance and implementation of flexible working models, together with improved childcare infrastructure, may contribute to reducing barriers to balancing family and career.