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Acad Med. 2019 Aug 13. doi: 10.1097/ACM.0000000000002948. [Epub ahead of print]

Parenthood During Graduate Medical Education: A Scoping Review.

Author information

1
S.W. Stack is assistant professor, Department of Medicine, associate director, Medicine Student Programs, and director, Medical Student Scholarship, University of Washington School of Medicine, Seattle, Washington; ORCID: https://orcid.org/0000-0001-6586-9266. K.E. Eurich is resident, Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington. E.A. Kaplan is assistant professor, Department of Medicine, University of Washington School of Medicine, Seattle, Washington; ORCID: https://orcid.org/0000-0001-6036-4402. A.L. Ball is care management and population health librarian, University of Washington School of Medicine, Seattle, Washington; ORCID: https://orcid.org/0000-0003-1880-9628. S. Mookherjee is associate professor, Department of Medicine, director, General Internal Medicine Faculty Development Program, and director, Academic Hospitalist Fellowship, University of Washington School of Medicine, Seattle, Washington. J.A. Best is associate professor of medicine, associate program director, Internal Medicine Residency Program, and associate dean, Graduate Medical Education, University of Washington School of Medicine, Seattle, Washington.

Abstract

PURPOSE:

To conduct a scoping review of the literature on parenthood during graduate medical education (GME) and to develop a conceptual framework to inform policy and guide research.

METHOD:

The authors searched PubMed and Embase for articles published from January 1993 through August 7, 2017, using a query framework that combined the concepts of "person" (e.g., "trainee") and "parenthood" (e.g., "breastfeeding"). They included studies describing parenthood or pregnancy of trainees in U.S. GME training programs. Two authors independently screened citations and abstracts and performed kappa coefficient tests to evaluate inter-reviewer reliability. Two authors performed a full-text review of and extracted data from each included article, and four authors coded data for all articles. The authors used descriptive statistics and qualitative synthesis to analyze data.

RESULTS:

Ninety articles met inclusion criteria, and nearly half (43/90; 48%) were published between 2010 and 2017. The authors developed six themes that surround resident parenthood: wellbeing, maternal health, others' perceptions, relationships, program preparation, and policy. They mapped these themes by relationship of stakeholders (infant and family, institutions) to the resident-parent to create a conceptual framework describing parenthood during GME.

CONCLUSIONS:

The findings from this scoping review have implications for policy and research. Those authoring parental leave policies could collaborate with national board leaders to develop consistent standards and include nontraditional families. Gaps in the literature include the effect of resident parenthood on patient care, postpartum health, and policy execution. Research in these areas would advance the literature on parenthood during residency.

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