How residency leave policies affect retention and diversity in surgical specialties

In this interview, Avani Desai, an MD candidate at the University of North Carolina at Chapel Hill, discusses findings from the Urology study “Variability in accessibility of residency parental leave policies across surgical specialties” and their broader implications for surgical trainees and the health care workforce. She emphasizes that inadequate or unclear parental leave policies carry significant consequences, particularly during residency, a period already characterized by long hours, intense demands, and high stress. Research shows that insufficient leave is associated with higher rates of burnout, depression, and attrition among physicians, effects that are magnified in trainees who are navigating both professional and personal milestones.

Desai explains that when policies are difficult to access or poorly defined, residents often delay or forego family planning, or face heightened anxiety while trying to navigate leave in environments they may perceive as unsupportive. These challenges disproportionately affect women, as family planning frequently influences their career decisions. The lack of clarity and support, she notes, can discourage talented individuals from pursuing or remaining in surgical specialties, perpetuating gender disparities in training, the surgical workforce, and ultimately leadership roles.

The impact extends beyond individuals to health systems as well. Ambiguity and inadequacy in leave policies contribute to higher turnover, decreased retention, and a narrower pipeline of future surgeons. This erosion of diversity within the field weakens innovation, inclusivity, and sustainability in surgical practice.

Desai argues that investing in robust, transparent, and equitable parental leave policies is essential not only for supporting individual residents but also for strengthening the profession as a whole. Clearer policies can reduce trainee anxiety, improve well-being, and foster greater gender equity. Ultimately, she frames such reforms as critical to building a more sustainable, diverse, and resilient surgical workforce for the future.

REFERENCE

1. Desai A, Stivali T, Muir, C, Bethel E, Michel K, Smith, A. Variability in accessibility of residency parental leave policies across surgical specialties. Urology. 2025 Jul 15:S0090-4295(25)00695-8. doi:10.1016/j.urology.2025.07.015