Family Planning during Surgical Training Policy

Trimester

Anticipated Challenges

Trainee’s Responsibility

Program Responsibility

Pre-conception

• Time required to attend medical appointments
• Physical and emotional changes associated with hormone administration for fertility

• Communicate with PD* about time needed for appointments and/or to administer medications

• Keep resident endeavors around fertility confidential
• Accommodate resident’s needs for fertility and family planning
• Provide residents with the option to reduce or eliminate 24-hour call/night float that can adversely affect cycles

First Trimester

• Nausea and fatigue
• Limit fluoroscopy exposure (throughout pregnancy) and toxic exposure (HIPEC, sevoflurane)
• Higher risk of miscarriage than other trimesters

• Notify PD* (either in 1st or 2nd trimester)
• If desired, meet with PD to discuss reducing 24-hour shifts and night float
• Consider picking up dosimeter badge(s) to monitor radiation exposure (Dr. Warren Gasper)
• Notify rotation director and/or PD/APD for contingency planning regarding toxic exposure (e.g., HIPEC and sevoflurane)

• Designated APD@ to have initial meeting with trainee (provide Parenthood support packet)
• Make accommodation within the schedule to allow for desired parental leave.
• Postpone rotations that have prolonged radiation exposure (i.e., vascular)
• If requested, work with residents to reduce or eliminate 24-hour shifts and night float

Second Trimester

• OB appointments
• Prenatal workup (anatomy prenatal US, amniocentesis, CVS, etc)

• Communicate with team members (co-residents, APP#, and faculty) time that is needed for appointments and testing.
• Select “Surgeon New Parent” mentor

• Prepare paperwork for parental leave 2-3 months before (Winnie Green)
• Check-in with mentor (at least three times during pregnancy/postpartum period)
• Check-in with designated member of education leadership (during each phase of pregnancy and monthly if needed)

Third Trimester

• Antenatal Testing
• Physical limitations of mobility and risk of preterm labor

• Work with faculty to allow for breaks during long cases (for patient and trainee safety)

• Recommended rotations: ICU, endocrine, GI, Breast, and rotations with proximity to MB (if frequent antenatal testing is needed)

Parental leave

• Refer to Guidelines on Family Leave for Surgical Trainees

• Program arranges for call coverage during leave and requires no “make up” call from resident on leave

Post-partum period (“4th trimester”)

• Refer to Lactation Wellness Policy
• Physical changes associated with postpartum period
• Emotional challenges with returning to work and being away from child

• Be familiar with lactation policy
• Connect with lactation champion at each site
• Close communication with team members including attendings if any intra-operative accommodations are anticipated

• Consider transition rotation
• Continue check-ins with “Surgeon New Parent” mentor
• Continue check-in with designated member of education leadership: check on trainee’s emotional transition back to work
• The designated program point person will contact rotation directors and faculty to make them aware of the need for protected time for pumping, as outlined in the UCSF Department of Surgery Lactation Wellness Policy”