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Ann Surg. 2013 Mar;257(3):571-6. doi: 10.1097/SLA.0b013e318269d05c.

Striving for work-life balance: effect of marriage and children on the experience of 4402 US general surgery residents.

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Department of Surgery, Yale School of Medicine, New Haven, CT, USA.



To determine how marital status and having children impact US general surgical residents' attitudes toward training and personal life.


There is a paucity of research describing how family and children affect the experience of general surgery residents.


Cross-sectional survey involving all US categorical general surgery residents. Responses were evaluated by resident/program characteristics. Statistical analysis included the χ test and hierarchical logistic regression modeling.


A total of 4402 residents were included (82.4% response rate) and categorized as married, single, or other (separated/divorced/widowed). Men were more likely to be married (57.8% vs 37.9%, P < 0.001) and have children (31.5% vs 12.0%, P < 0.001). Married residents were most likely to look forward to work (P < 0.001), and report happiness at work (P < 0.001) and a good program fit (P < 0.001). "Other" residents most frequently felt that work hours caused strain on family life (P < 0.001). Residents with children more frequently looked forward to work (P = 0.001), were happy at work (P = 0.001), and reported a good program fit (P = 0.034), but had strain on family life (P < 0.001), and worried about future finances (P = 0.005). On hierarchical logistic regression modeling, having children was predictive of a resident looking forward to work [odds ratio (OR): 1.22, P = 0.035], yet feeling that work caused family strain (OR: 1.66, P < 0.001); being single was associated with less strain (OR: 0.72, P < 0.001). The female gender was negatively associated with looking forward to work (OR: 0.81, P = 0.007).


Residents who were married or parents reported greater satisfaction and work-life conflict. The complex effects of family on surgical residents should inform programs to target support mechanisms for their trainees.

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