Importance Previous work shows women who have children during surgical residency face difficulty balancing childbearing with training, which negatively affects residency and career satisfaction. Little is known about the factors that drive professional discontent. Objective To determine factors associated with professional dissatisfaction for childbearing residents. Design, Setting, and Participants Self-administered survey questionnaire electronically distributed through the Association of Program Directors in Surgery, the Association of Women Surgeons, and targeted Twitter and Facebook platforms. The survey was distributed in January 2017 to surgeons who delivered at least 1 child during a US general surgery residency and was available online for 4 weeks. Main Outcomes and Measures Respondents were reported to be dissatisfied with their residency if they indicated agreement that they considered leaving residency owing to challenges surrounding childbearing (considered leaving). Respondents were reported to be unhappy with their career if they indicated agreement with statements that (1) given an opportunity to revisit their job choice, they would choose a nonsurgical career more accommodating of motherhood (revisit career choice) or (2) they would advise a female medical student against a surgical career owing to difficulties balancing motherhood with the profession (advise against surgery). Logistic regression was used to determine predictors of agreement with each of the 3 statements of professional dissatisfaction. Results In total, 347 women responded to the survey and reported 452 pregnancies, and the mean (SD) age was 30.5 (2.7) years. One hundred seventy-nine respondents (51.6%) agreed with at least 1 statement of residency or career dissatisfaction. Lack of a formal maternity leave policy was associated with "considered leaving" (odds ratio [OR], 1.83; 95% CI, 1.07-3.10). Perception of stigma during pregnancy was associated with "revisit career choice" (OR, 1.79; 95% CI, 1.01-3.19). Changing fellowship plans owing to perceived difficulty balancing motherhood with the originally chosen subspecialty was associated with all 3 markers of residency and career dissatisfaction ("considered leaving" OR, 2.68; 95% CI, 1.30-5.56; "revisit career choice" OR, 2.23; 95% CI, 1.13-4.43; and "advise against surgery" OR, 2.44; 95% CI, 1.23-4.84). Conclusions and Relevance Surgery residents who perceived stigma during pregnancy, did not have a formal institutional maternity leave policy, or altered their fellowship training plans because of challenges of childbearing expressed greater professional dissatisfaction. Mentorship in subspecialty selection and work-life integration, interventions to reduce workplace bias, and identification of obstacles to establishment of maternity leave policies are needed to enhance professional fulfillment for childbearing residents.

中文翻译：

---

生育外科手术居民的居住和职业不满相关的因素。

重要性先前的工作表明，在外科住院期间生育孩子的妇女在平衡生育和培训之间面临困难，这对住院率和职业满意度产生了负面影响。导致职业不满的因素鲜为人知。目的确定与生育居民职业满意度有关的因素。设计，设置和参与者自我管理的调查问卷以电子方式通过外科程序主任协会，女性外科医生协会以及有针对性的Twitter和Facebook平台分发。该调查于2017年1月分发给在美国普通外科住院期间分娩了至少一个孩子的外科医生，在线访问时间为4周。主要成果和措施据报道，如果受访者表示同意因生育问题而考虑离开居住地（考虑离开），则他们对居住地不满意。据报道，如果受访者表示同意以下说法，则他们对自己的职业不满意：（1）有机会重新选择工作，他们会选择更适合母性的非手术职业（重新选择职业），或者（2）建议一名女医学生由于在兼顾母亲和职业方面遇到困难而反对外科手术（建议不要接受外科手术）。Logistic回归用于确定与三个专业不满陈述中的每个陈述相符的预测因素。结果总计 347位女性对此调查做出了回应，并报告了452例怀孕，平均（SD）年龄为30.5（2.7）岁。179名受访者（51.6％）同意至少1份关于居住权或职业不满的陈述。缺乏正式的产假政策与“考虑休假”有关（赔率[OR]为1.83； 95％CI为1.07-3.10）。怀孕期间对耻辱的感知与“重新选择职业”有关（OR为1.79； 95％CI为1.01-3.19）。由于在平衡母子关系和最初选择的专业方面存在困难而改变了奖学金计划，这与居住和职业不满的所有三个指标相关（“考虑离职” OR，2.68； 95％CI，1.30-5.56；“重新考虑职业选择” OR，2.23） ； 95％CI，1.13-4.43；和“建议不要手术” OR，2.44； 95％CI，1。23-4.84）。结论与相关性手术居民在怀孕期间受到耻辱，没有正式的机构产假政策，或者由于生育的挑战而改变了他们的进修培训计划，这表明他们对职业更加不满。需要进行亚专业选择和工作生活融合方面的指导，减少工作场所偏见的干预措施，并查明制定产假政策的障碍，以提高育龄居民的职业素养。