Infertility affects nearly one out of every four female physicians – a rate that is significantly higher than that of the general population. Female residents often put off having children due to work-related concerns, such as the rigorous demands of medical training, managing strenuous work schedules, and worries about the impact of their choices on colleagues. Meanwhile, their fertility declines with age.
The stark reality of health care structures is that they have historically been designed with a lack of female presence in mind. The long and rigorous nature of medical training, which entails a four-year undergraduate degree, a four-year medical education, and a three- to seven-year residency, leaves little to no room for accommodating the unique challenges faced by women health care workers who want to have a family. This, among many other adversities faced by women physicians, were discussed at last month’s Women in Medicine Summit in Chicago, IL.
It is crucial that we first recognize that the current structures of our health care system are outdated. We need to better accommodate women who have been and will continue to be present in this profession. This includes dismantling the idea that a medical career and motherhood are mutually exclusive and creating more inclusive frameworks that support people who desire to have children.
Even in the 20th century, when 50% of medical school matriculants are female, the field of medicine has yet to take women’s peak productive years into account in conversations on resident well-being. Unfortunately, the lack of support for female physicians and their reproductive rights in the traditional structure of health care education and practice disproportionately places the burden on female physicians. In addition to juggling the psychological consequences of infertility such as loneliness, guilt, and regret, female physicians are put in a position where they are forced to make a harsh choice between a fulfilling career and the joys of motherhood.
As Women in Medicine Summit speakers Dr. Ariela L. Marshall and Dr. Arghavan Salles suggest, we need to advocate for a transformed system, where women are better supported in various aspects of building a family. These include raising awareness of different infertility and management options, alternative methods of childbearing, and plans to support physician parents. We also must educate women in medicine on their options for family planning. Medical schools and residency programs play a pivotal role in shaping the future of medicine, and it is imperative that they take a proactive stance in addressing the challenging issues of infertility and fertility preservation.
Prioritizing well-being and women’s right to choose can come in different forms. One of the fertility preservation techniques that is becoming increasingly popular is oocyte cryopreservation – more commonly known as “freezing eggs.” This expensive procedure, often costing up to $15,000 per attempt, involves self-administering hormone medications over 10–12 days to stimulate simultaneous egg development, monitored by pelvic ultrasounds and frequent bloodwork. After maturation, a brief outpatient surgical procedure under anesthesia retrieves the mature eggs, which an embryologist verifies for fertilization potential.
In addition to incorporating education on family planning, programs could also offer more tangible support and provide financial resources for those who would like to take the cryopreservation route. Medical schools and residency programs could give those who would like to proceed with egg freezing more flexibility to accommodate medical procedures such as regular ultrasounds. By doing so, we can ensure that aspiring physicians have the necessary resources and support to pursue both their dreams of becoming doctors and their desires to start a family. This would help break down the barriers that currently exist and empower women to make informed choices about their reproductive health while pursuing their medical careers.
The conclusion is that it is time for change. As a fourth-year medical student, getting ready to start residency, I've already witnessed the considerable sacrifices that come with pursuing a career in medicine. Many of us willingly make these sacrifices with the ultimate aim of serving our patients and improving the health of our communities. However, it's crucial to acknowledge that the sacrifices extend beyond just the demanding hours and rigorous training. Female physicians should not have to sacrifice their inherent right to motherhood after taking the Hippocratic oath in the pursuit of their medical careers.
Cagla Unal is a fourth-year Turkish American student at Southern Illinois University School of Medicine. She is pursuing a career in pediatrics as she is committed to supporting the well-being of this vulnerable population. Her dedication to advancing healthcare equity extends beyond patient care to advocate for the well-being of health care providers. She can be found on Twitter.
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