Fairness in Residency

Training should work for future parents and future surgeons.

Share the childcare math. Under a published single-income model, most surgical programs left a single-parent resident underwater. A workforce that cannot afford a family is unfair to residents and a strain on the patients who need them to stay.

Open the family recommendation

Negative net income after childcare

98.3%

290 of 295 surgical programs in the model

Childcare vs one paycheck

Stated scope: single income, one child. Dual incomes, family help, and subsidies change the result. Parents of infants in the West averaged negative $21,278[45].

Median leave taken

4.5wks

ACGME paid-leave floor: 6 wks

Ophthalmology residents who took leave; floor at 100% salary.

Leave taken vs the floor

The ACGME floor since July 1, 2022 is 6 weeks of paid medical, parental, or caregiver leave at 100% of salary[39]. The 4.5-week median is ophthalmology residents who took leave[42].

Who leaves surgical training

Pooled general-surgery attrition [57] 18%

Across 20-plus studies and 19,821 residents: 25% for women versus 15% for men, with 48% of leavers exiting after the first year. A fifth moved to another surgery program. Uncontrollable lifestyle was the top reported cause.

Send the figures on

Share the childcare math with a program director. Send the attrition figures to a policymaker shaping surgical workforce policy.

Open Recommendation 5