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Item Breast Pumping in the Healthcare Workplace(2023-11-04) Yu, Corinna; Boyer, Tanna; Mitchell, SallyBackground: Reasons women do not breastfeed, or shorten their breastfeeding journey, include the lack of paid leave and the challenges of breast pumping in the healthcare workplace. Despite the health benefits of breastfeeding for mother and baby, health care workers returning to work often struggle to breast pump due to lack of access to lactation facilities and lack of time and support. The aim of this needs assessment was to determine the extent of these challenges. Methods: A survey was created and distributed through social media forums from 2020-2023 to determine the extent of these issues. IRB exemption was obtained (Protocol #2010273689). Responses were obtained from 222 health care workers across the United States. Data were analyzed and comments were sorted thematically. Results: Survey respondents were from the Midwest 30% (66), Southeast 25% (55), Northeast 18% (40), West 16% (35), and Southwest 10% (22) with 222 total responses. Physicians (n = 191) made up 86% of the responses across 11 specialties, with 15 of them being residents or fellows. There were 50% of respondents who did not have nearby access to a lactation room although 96% used a breast pump while at work. Pumping occurred every 2-3 hours for 48% and every 4-6 hours for 48% of respondents. Pumping duration was 11-20 minutes for 53% and 21-30 minutes for 32% of respondents, with transit time and other logistics taking an additional 1-5 minutes for 33%, 6-10 minutes for 47%, and 11-15 minutes for 12% of respondents. On a scale of 1-5, where 1 was “Pumping at work did not affect the duration of breastfeeding at all” and 5 was “I had to stop breastfeeding because I was not able to pump enough at work,” responses were 1 (19%), 2 (23%), 3 (20%), 4 (19%), 5 (19%). Respondents (n = 106; 48%) have used a wearable breast pump. On a scale from 1 to 10, where 1 is “No, I CAN NOT do my job equally well when wearing a breast pump” and 10 is “Yes, I CAN do my job equally well when wearing a breast pump,” 49% of those respondents chose 10. In the free text comments, multiple respondents discussed pumping while providing clinical care using wearable pumps. One person pumped while performing a vaginal delivery, another during an intraoperative code, and another while placing lines for a patient with a Type A aortic dissection. Discussion: Lack of access to lactation facilities, long transit times, frequent pumping, and long pumping sessions can be time prohibitive challenges for many health care workers. Lack of support from colleagues, administrators, and patients can influence breastfeeding duration. Wearable breast pumps have mixed reviews but have allowed many women to pump while doing normal work activities. Although only 107 respondents (48%) have used wearable breast pumps, 148 respondents (67%) answered “Does a wearable breast pump affect your ability to perform your job effectively?” suggesting opinions instead of personal experience. “Nearby access” of lactation facilities was not defined. The scope of work may differ from health care providers who do telemedicine, see patients in clinic, or perform codes in the operating room. Improvements on this survey include specifying the states for each US region and clarifying the year when respondents were breast pumping, as culture has evolved with a greater emphasis on wellness and increased numbers of women physicians. Expanding data on trainees would identify issues related to autonomy and educational practices. Conclusion: Accessible lactation rooms are lacking in the healthcare workplace. On average, respondents pumped every 2-6 hours with the majority taking 11-30 mins with 1-15 mins for logistics. Wearable breast pumps may be a viable option for some women to continue work activities while pumping. Workplace bias against breast pumping is still prevalent and more work needs to be done to support breast pumping women.Item Parental Leave During Anesthesiology Fellowship(2022-04-28) Rigueiro, Frank; Yu, CorinnaIntroduction: Parental leave is an important consideration for many residents and fellows as they choose programs balancing their career goals with their goals for family planning. Benefits of parental leave are decreased infant mortality and increased breastfeeding, which has health benefits for infants and mothers. In 2018, one study found only 7 of 15 residency training institutions in the local area had an institutional GME policy providing paid designated childbearing leave. A study at Mayo Clinic at 269 programs found that 40% of residents and fellows planned to have children during training. 89% of fathers rated parental leave as an important benefit, and pregnancy and childbirth plans altered choice of GME program in women more often than in men. The ACGME encourages allowances for parental leave but does not provide specific recommendations on how to manage the leave, giving programs institutional control over their own policy. Leave policies can be complicated by requirements from Centers for Medicare and Medicaid Services, Health Resources and Services Administration, the Veterans Health Administration, and the National Institutes of Health, depending on allocations for resident/fellow salary. Objective: As prospective anesthesiology fellows research programs with family planning in mind, how accessible are these local GME policies on parental leave? Methods: We compiled a list of all 140 ACGME-approved anesthesiology fellowship programs including 60 pediatric, 74 adult cardiothoracic, 63 critical care, 39 regional and acute pain medicine, 41 obstetric, 111 chronic pain medicine & 1 clinical informatic program. We performed online searches of each program’s website to look for institutional GME policies on parental leave. If we could not find the results within 10 minutes, it was considered not easily accessible. Results: Out of 140 anesthesiology ACGME-approved fellowship programs, 99 programs had parental leave policies easily accessible online (71%) whereas 41 programs did not have policies easily accessible online (29%). Of these 41 programs, 6 of them required a log-in for access to their parental leave policies. Discussion: Anesthesiology fellowship programs should consider having a generous parental leave policy and making this policy easily accessible online to demonstrate support for physician well-being and work-life balance. We found that many anesthesiology fellowship programs do not have parental leave policies easily accessible online for interested applicants. Reasons many trainees don’t use parental leave include the sense of being a burden to colleagues, anticipation of a heavier workload later, delayed program completion, not needing the time, or not being the primary caregiver. Additional research should pursue opportunities for competency-based training, flexible scheduling of work hours or start dates, part-time options, and childcare benefits to meet the rising demands of the current workforce. Conclusion: Parental leave is an important public health priority and an important aspect to physician well-being. Residency and fellowship programs should ensure they have established institutional GME policies and share them publicly in an easily accessible format online with interested applicants to remain competitive and guarantee a diverse applicant pool.