Skip to main content
Top
Published in: Journal of General Internal Medicine 6/2017

01-06-2017 | Original Research

Impact of Pregnancy and Gender on Internal Medicine Resident Evaluations: A Retrospective Cohort Study

Authors: Megan L. Krause, MD, Muhamad Y. Elrashidi, MD, Andrew J. Halvorsen, MS, Furman S. McDonald, MD, MPH, Amy S. Oxentenko, MD

Published in: Journal of General Internal Medicine | Issue 6/2017

Login to get access

Abstract

Background

Pregnancy and its impact on graduate medical training are not well understood.

Objective

To examine the effect of gender and pregnancy for Internal Medicine (IM) residents on evaluations by peers and faculty.

Design

This was a retrospective cohort study.

Subjects

All IM residents in training from July 1, 2004–June 30, 2014, were included. Female residents who experienced pregnancy and male residents whose partners experienced pregnancy during training were identified using an existing administrative database.

Main Measures

Mean evaluation scores by faculty and peers were compared relative to pregnancy (before, during, and after), accounting for the gender of both the evaluator and resident in addition to other available demographic covariates. Potential associations were assessed using mixed linear models.

Key Results

Of 566 residents, 117 (20.7%) experienced pregnancy during IM residency training. Pregnancy was more common in partners of male residents (24.7%) than female residents (13.2%) (p = 0.002). In the post-partum period, female residents had lower peer evaluation scores on average than their male counterparts (p = 0.0099).

Conclusions

A large number of residents experience pregnancy during residency. Mean peer evaluation scores were lower after pregnancy for female residents. Further study is needed to fully understand the mechanisms behind these findings, develop ways to optimize training throughout pregnancy, and explore any unconscious biases that may exist.
Literature
1.
go back to reference Potee RA, Gerber AJ, Ickovics JR. Medicine and motherhood: shifting trends among female physicians from 1922 to 1999. Academic medicine: journal of the Association of American Medical Colleges. 1999;74:911–919.CrossRef Potee RA, Gerber AJ, Ickovics JR. Medicine and motherhood: shifting trends among female physicians from 1922 to 1999. Academic medicine: journal of the Association of American Medical Colleges. 1999;74:911–919.CrossRef
2.
go back to reference Hutchinson AM, Anderson NS 3rd, Gochnour GL, Stewart C. Pregnancy and childbirth during family medicine residency training. Family medicine. 2011;43:160–165.PubMed Hutchinson AM, Anderson NS 3rd, Gochnour GL, Stewart C. Pregnancy and childbirth during family medicine residency training. Family medicine. 2011;43:160–165.PubMed
3.
go back to reference Gabbe SG, Morgan MA, Power ML, Schulkin J, Williams SB. Duty hours and pregnancy outcome among residents in obstetrics and gynecology. Obstetrics and gynecology. 2003;102:948–951.PubMed Gabbe SG, Morgan MA, Power ML, Schulkin J, Williams SB. Duty hours and pregnancy outcome among residents in obstetrics and gynecology. Obstetrics and gynecology. 2003;102:948–951.PubMed
4.
go back to reference Turner PL, Lumpkins K, Gabre J, Lin MJ, Liu X, Terrin M. Pregnancy among women surgeons: trends over time. Archives of surgery. 2012;147:474–479.CrossRefPubMed Turner PL, Lumpkins K, Gabre J, Lin MJ, Liu X, Terrin M. Pregnancy among women surgeons: trends over time. Archives of surgery. 2012;147:474–479.CrossRefPubMed
5.
go back to reference Stewart DE, Robinson GE. Combining motherhood with psychiatric training and practice. Canadian journal of psychiatry. Revue canadienne de psychiatrie. 1985;30:28–34.CrossRefPubMed Stewart DE, Robinson GE. Combining motherhood with psychiatric training and practice. Canadian journal of psychiatry. Revue canadienne de psychiatrie. 1985;30:28–34.CrossRefPubMed
6.
go back to reference Finch SJ. Pregnancy during residency: a literature review. Academic medicine: journal of the Association of American Medical Colleges. 2003;78:418–428.CrossRef Finch SJ. Pregnancy during residency: a literature review. Academic medicine: journal of the Association of American Medical Colleges. 2003;78:418–428.CrossRef
7.
go back to reference Sayres M, Wyshak G, Denterlein G, Apfel R, Shore E, Federman D. Pregnancy during residency. The New England journal of medicine. 1986;314:418–423.CrossRefPubMed Sayres M, Wyshak G, Denterlein G, Apfel R, Shore E, Federman D. Pregnancy during residency. The New England journal of medicine. 1986;314:418–423.CrossRefPubMed
8.
go back to reference Tamburrino MB, Evans CL, Campbell NB, Franco KN, Jurs SG, Pentz JE. Physician pregnancy: male and female colleagues’ attitudes. Journal of the American Medical Women’s Association. 1992;47:82–84.PubMed Tamburrino MB, Evans CL, Campbell NB, Franco KN, Jurs SG, Pentz JE. Physician pregnancy: male and female colleagues’ attitudes. Journal of the American Medical Women’s Association. 1992;47:82–84.PubMed
9.
go back to reference Phelan ST. Sources of stress and support for the pregnant resident. Academic medicine: journal of the Association of American Medical Colleges. 1992;67:408–410.CrossRef Phelan ST. Sources of stress and support for the pregnant resident. Academic medicine: journal of the Association of American Medical Colleges. 1992;67:408–410.CrossRef
10.
go back to reference Gjerdingen DK, Chaloner KM, Vanderscoff JA. Family practice residents’ maternity leave experiences and benefits. Family medicine. 1995;27:512–518.PubMed Gjerdingen DK, Chaloner KM, Vanderscoff JA. Family practice residents’ maternity leave experiences and benefits. Family medicine. 1995;27:512–518.PubMed
11.
go back to reference Merchant SJ, Hameed SM, Melck AL. Pregnancy among residents enrolled in general surgery: a nationwide survey of attitudes and experiences. Am J Surg. 2012. Merchant SJ, Hameed SM, Melck AL. Pregnancy among residents enrolled in general surgery: a nationwide survey of attitudes and experiences. Am J Surg. 2012.
12.
go back to reference Klevan JL, Weiss JC, Dabrow SM. Pregnancy during pediatric residency. Attitudes and complications. American journal of diseases of children. 1990;144:767–769.CrossRefPubMed Klevan JL, Weiss JC, Dabrow SM. Pregnancy during pediatric residency. Attitudes and complications. American journal of diseases of children. 1990;144:767–769.CrossRefPubMed
13.
go back to reference Thackeray EW, Halvorsen AJ, Ficalora RD, Engstler GJ, McDonald FS, Oxentenko AS. The effects of gender and age on evaluation of trainees and faculty in gastroenterology. The American journal of gastroenterology. 2012;107:1610–1614.CrossRefPubMed Thackeray EW, Halvorsen AJ, Ficalora RD, Engstler GJ, McDonald FS, Oxentenko AS. The effects of gender and age on evaluation of trainees and faculty in gastroenterology. The American journal of gastroenterology. 2012;107:1610–1614.CrossRefPubMed
14.
go back to reference Beckman TJ, Mandrekar JN, Engstler GJ, Ficalora RD. Determining reliability of clinical assessment scores in real time. Teaching and learning in medicine. 2009;21:188–194.CrossRefPubMed Beckman TJ, Mandrekar JN, Engstler GJ, Ficalora RD. Determining reliability of clinical assessment scores in real time. Teaching and learning in medicine. 2009;21:188–194.CrossRefPubMed
15.
go back to reference Balk SJ, Christoffel KK, Bijur PE. Pediatricians’ attitudes concerning motherhood during residency. American journal of diseases of children. 1990;144:770–777.PubMed Balk SJ, Christoffel KK, Bijur PE. Pediatricians’ attitudes concerning motherhood during residency. American journal of diseases of children. 1990;144:770–777.PubMed
16.
go back to reference Franco K, Evans CL, Best AP, Zrull JP, Pizza GA. Conflicts associated with physicians’ pregnancies. The American journal of psychiatry. 1983;140:902–904.CrossRefPubMed Franco K, Evans CL, Best AP, Zrull JP, Pizza GA. Conflicts associated with physicians’ pregnancies. The American journal of psychiatry. 1983;140:902–904.CrossRefPubMed
17.
go back to reference Holmboe ES, Huot SJ, Brienza RS, Hawkins RE. The association of faculty and residents’ gender on faculty evaluations of internal medicine residents in 16 residencies. Academic medicine: journal of the Association of American Medical Colleges. 2009;84:381–384.CrossRef Holmboe ES, Huot SJ, Brienza RS, Hawkins RE. The association of faculty and residents’ gender on faculty evaluations of internal medicine residents in 16 residencies. Academic medicine: journal of the Association of American Medical Colleges. 2009;84:381–384.CrossRef
18.
go back to reference Brienza RS, Huot S, Holmboe ES. Influence of gender on the evaluation of internal medicine residents. Journal of women’s health. 2004;13:77–83.CrossRefPubMed Brienza RS, Huot S, Holmboe ES. Influence of gender on the evaluation of internal medicine residents. Journal of women’s health. 2004;13:77–83.CrossRefPubMed
19.
go back to reference Verheyden CN, McGrath MH, Simpson P, Havens L. Social problems in plastic surgery residents: a management perspective. Plastic and reconstructive surgery. 2015;135:772e–778e.CrossRefPubMed Verheyden CN, McGrath MH, Simpson P, Havens L. Social problems in plastic surgery residents: a management perspective. Plastic and reconstructive surgery. 2015;135:772e–778e.CrossRefPubMed
20.
go back to reference McDonald FS, Zeger SL, Kolars JC. Factors associated with medical knowledge acquisition during internal medicine residency. Journal of general internal medicine. 2007;22:962–968.CrossRefPubMedPubMedCentral McDonald FS, Zeger SL, Kolars JC. Factors associated with medical knowledge acquisition during internal medicine residency. Journal of general internal medicine. 2007;22:962–968.CrossRefPubMedPubMedCentral
21.
go back to reference Cole S, Arnold M, Sanderson A, Cupp C. Pregnancy during otolaryngology residency: experience and recommendations. The American surgeon. 2009;75:411–415.PubMed Cole S, Arnold M, Sanderson A, Cupp C. Pregnancy during otolaryngology residency: experience and recommendations. The American surgeon. 2009;75:411–415.PubMed
22.
go back to reference Nichols M. Curriculum change in an obstetrics-gynecology residency program and its impact on pregnancy in residency. American journal of obstetrics and gynecology. 1994;170:1658–1664. discussion 1664–1655.CrossRefPubMed Nichols M. Curriculum change in an obstetrics-gynecology residency program and its impact on pregnancy in residency. American journal of obstetrics and gynecology. 1994;170:1658–1664. discussion 1664–1655.CrossRefPubMed
23.
go back to reference Alliance for Academic Internal Medicine. 2014 APDIM Program Directors Survey-Summary File. 2014. Alliance for Academic Internal Medicine. 2014 APDIM Program Directors Survey-Summary File. 2014.
24.
go back to reference US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. Women’s Health USA 2011. Rockville: US Department of Health and Human Services; 2011. US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. Women’s Health USA 2011. Rockville: US Department of Health and Human Services; 2011.
Metadata
Title
Impact of Pregnancy and Gender on Internal Medicine Resident Evaluations: A Retrospective Cohort Study
Authors
Megan L. Krause, MD
Muhamad Y. Elrashidi, MD
Andrew J. Halvorsen, MS
Furman S. McDonald, MD, MPH
Amy S. Oxentenko, MD
Publication date
01-06-2017
Publisher
Springer US
Published in
Journal of General Internal Medicine / Issue 6/2017
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-017-4010-5

Other articles of this Issue 6/2017

Journal of General Internal Medicine 6/2017 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.