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AMA Supports Resident Doctors’ Access to Fertility Preservation

The average age at which a physician completes residency training is over 31. For surgical residents, the data indicates that the age could reach 36 years.

The commitment to physician training often coincides with the early reproductive years for residents. Recognizing this reality, Recently Adopted AMA Policy calls for support for the preservation of the fertility of doctors in training.

Danielle Rochlin, MD, has completed her plastic surgery residency and is currently a fellow in reconstructive microsurgery. A member of the AMA Residents and Fellows Section (AMA-RFS), she was one of the co-sponsors of the resolution passed by the AMA House of Delegates.

“Although residency and fellowship programs are increasingly accommodating pregnancy during training, many residents and fellows may still wish to delay pregnancy until after training for a variety of personal and professional reasons” , said Dr. Rochlin.

“Residents and fellows fear fertility issues if pregnancy is delayed until after training. These concerns may also deter medical students from choosing a career in a surgical or other field with longer and more demanding training. Fertility preservation offers another option,” she added.

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The need for fertility preservation measures – with a marked decline in female fertility after age 35 – is evident to resident physicians. The challenges are twofold: finding the time to undergo the treatments and offsetting the cost of these treatments.

Addressing the first of these concerns requires cultural change. To this end, AMA policy supports “the accommodation of residents and fellows who choose to undergo fertility preservation and infertility treatment, including, but not limited to, the need for attend medical visits to complete the gamete preservation process and administer drugs in a time-sensitive fashion.”

The cost barrier to treatment may be the most difficult to overcome. With a resident salary, the financial burden of continuing treatment can amount to a quarter of their annual income. In industries such as high technology, fertility preservation is becoming a frequently offered benefit through insurance coverage. AMA policy states that this should be the case for physicians in postgraduate medical training.

“Fertility preservation is not included in the vast majority of domestic health insurance programs and is extremely expensive,” Dr. Rochlin said. “Fertility preservation benefits are becoming more common among employer-sponsored benefits” outside of healthcare personnel.

The AMA believes “residents and fellows equally deserve access,” she noted. Specifically, the AMA’s new policy “encourages insurance coverage for fertility preservation and infertility treatment as part of the medical insurance benefits for residents and fellows offered under higher medical education. [GME] programs.”

Find out how the residency program’s leave policies provide new parents with some clarity.

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The AMA’s efforts on the issue are aimed at encouraging residency programs to offer fertility preservation. Dr. Rochlin sees this as a first step.

“We need buy-in from GME management during individual residencies and fellowships,” she said. “I am very grateful that the AMA is supporting this initiative, but the next step is for major residency and fellowship programs to implement these benefits into domestic staff health insurance programs.”

Turn to the AMA Thriving in Residency series for timely advice on how to get the most out of medical residency. Get resources and advice on handling rapid training requests, publishing scientific research, maintaining health and wellness, and managing medical student debt.

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