Scheduling practices for pregnant emergency medicine residents

Authors

Casey Z. MacVane, Department of Emergency Medicine, Maine Medical Center Tufts University School of Medicine Portland Maine USA.Follow
Madeleine Puissant, Department of Emergency Medicine Maine Medical Center Portland Maine USA.Follow
Megan Fix, Department of Emergency Medicine University of Utah School of Medicine Salt Lake City Utah USA.
Tania D. Strout, Department of Emergency Medicine, Maine Medical Center Tufts University School of Medicine Portland Maine USA.Follow
Caitlin Bonney, Department of Emergency Medicine University of New Mexico Health Sciences Center Albuquerque New Mexico USA.
Laura Welsh, Department of Emergency Medicine, Boston Medical Center Boston University School of Medicine Boston Massachusetts USA.
Andrew Mittelman, Department of Emergency Medicine, Boston Medical Center Boston University School of Medicine Boston Massachusetts USA.
Jana Ricker, Department of Emergency Medicine Maine Medical Center Portland Maine USA.Follow
Isha Agarwal, Department of Emergency Medicine, Maine Medical Center Tufts University School of Medicine Portland Maine USA.Follow

Document Type

Article

Publication Date

11-21-2022

Institution/Department

Emergency Medicine, Medical Education

Journal Title

AEM Education and Training

Abstract

BACKGROUND: Night shift work is associated with adverse pathophysiologic effects on maternal and fetal well-being. Although emergency medicine (EM) residents work frequent night shifts, there is no existing guidance for residency program directors (PDs) regarding scheduling pregnant residents. Our study assessed scheduling practices for pregnant EM residents, differences based on program and PD characteristics, barriers and attitudes toward implementing a formal scheduling policy, and PDs' awareness of literature describing adverse effects of night shifts on maternal-fetal outcomes. METHODS: We conducted an anonymous, web-based survey of U.S. EM residencies ( = 276). Quantitative data were summarized; chi-square analysis and logistic regression were used to assess relationships between program and PD characteristics and schedule accommodations. Qualitative description was used to analyze an open-ended question, organizing findings into major and minor themes. RESULTS: Of the 167 completed surveys (response rate 61%), 67% of programs reported no formal policy for scheduling pregnant residents but made adjustments on an individual basis including block changes (85%), decreased (46%) or no night shifts (34%), and working shifts earlier in pregnancy to cover later shifts (20%). Barriers to adjustments included staffing constraints (60%), equity concerns (45%), or impact on wellness (41%) among all residents and privacy (28%). PDs endorsed scheduling adjustments as important (mean 8.1, 0-10 scale) and reported guidance from graduate medical education governance would be useful (60%). Larger program size, but not PD gender or proportion of female residents, was associated with an increased likelihood of scheduling modifications. Twenty-five percent of PDs reported little knowledge of literature regarding night shift work and pregnancy. Qualitative themes supported quantitative findings. CONCLUSIONS: Most EM residency programs do not have formal scheduling policies for pregnant residents, but most PDs support making adjustments and do so informally. More education and guidance for PDs are needed to promote the development of formal policies.

Comments

Madeleine Puissant- Resident

First Page

e10813

Recommended Citation

MacVane CZ, Puissant M, Fix M, et al. Scheduling practices for pregnant emergency medicine residents. AEM Educ Train. 2022;6(6):e10813. Published 2022 Nov 21. doi:10.1002/aet2.10813