Plastic Surgery Residents Report Barriers to Affordable Childcare

Plastic surgery residents face persistent barriers accessing affordable childcare, with high costs and a major impact on surgical training—with most of the burden falling on women residents, finds a study in the June issue of Plastic and Reconstructive Surgery.

The researchers sent an anonymous survey to current plastic surgery residents. The survey focused on current childcare accommodations and availability, along with attitudes and issues surrounding childrearing during residency.

Of 32 residents responding to the survey, 21 were women. Thirty-eight percent of respondents had at least one child. Of these, 75 percent of men reported that their spouse was the primary source of childcare, compared to 12 percent of women.

“One hundred percent of respondents with children reported childcare creates a financial burden,” write study authors who were led by Chelsea Cernosek Wallace, MD, and colleagues of University of Kentucky, Lexington. Median costs of childcare per child were $2,150 per month, or $25,800 per year. For married residents, median gross household income was $109,000 per year—thus these couples were paying nearly one-fourth of their income for childcare. Because of their inflexible work hours and the limited hours of daycare facilities, many residents had to use a nanny or other in-home childcare.

None of the residents with children said their institution provided access to on-site childcare—but 75 percent said they would use this service if it were available. Most residents said that their institution didn’t provide flexibility to accommodate childcare needs. Women residents were twice as likely to miss work due to problems with childcare arrangements, compared to men.

Two-thirds of women residents said that if they were choosing a plastic surgery training program, the availability of on-site childcare would influence their decision. One fourth of women residents with children said they had seriously considered leaving their residency program due to difficulties with childcare accommodations.

The challenges of raising children during plastic surgery residency have long been recognized. A 1994 editorial in Plastic and Reconstructive Surgery highlighted the need for adequate childcare facilities to promote a productive return to work. “Unfortunately, [more than] 25 years later, the lack of accessible and affordable childcare remains a dilemma faced by many plastic surgery trainees,” the researchers write.

Noting the disproportionately high burden on women residents, Wallace and colleagues conclude: “[F]ailing to provide adequate access to affordable, reliable childcare truly creates a gender disparity, resulting in a negative impact on plastic surgery training…. All institutions with plastic surgery residency programs should provide affordable, accessible childcare that accommodates the 24-hour natures of both patient care and parenthood.”