Pregnancy and accommodations during residency training- insights from a multi-institutional survey of U.S. trainees

This study examined the intersections between childbearing and graduate medical education (GME) to identify barriers and develop recommendations that promote a supportive training environment. With support from the Gender Equity in Academic Medicine and Science Alliance, the authors conducted a cross-sectional survey in 2024 of residents in ACGME-accredited programs across specialties. The survey assessed experiences related to pregnancy, family building, and accommodations during residency. A total of 1,332 residents in ACGME postgraduate years 1–4 completed the survey between September and December 2024. After excluding those who did not identify gender or completed less than 50% of the survey, there were 1280 respondents representing 165 institutions. A traditional response rate could not be calculated. Most identified as women ( n = 932, 72.81%). About one quarter ( n = 241, 25.86%) were pregnant during training and 97 (40.25%) reported pregnancy related conditions. Pregnancy loss occurred in 39 (16.18%). A small number of women ( n = 87, 9.33%) and men ( n = 23, 6.61%) sought out a reproductive specialist. The most frequently reported barriers to pregnancy accommodations were staffing needs ( n = 137, 56.85%), individual program requirements ( n = 116, 48.13%) or institutional requirements ( n = 108, 44.81%). The study identified persistent barriers related to pregnancy and childbearing during graduate medical education, including unclear policies, inconsistent accommodations, and limited communication of available resources. Clearer policy frameworks and strengthened institutional communication may improve trainee well-being and advance a more equitable and sustainable medical workforce.