Availability of Onsite Childcare Is Associated With Female Resident Representation: A Cross-Sectional Study

Physicians in training are of an age at which becoming or planning to become a parent is common. Female physician parents have greater childcare responsibilities and stress compared with their male colleagues. Therefore, we aimed to estimate the proportion of U.S. residencies with available onsite childcare and examine the association between onsite childcare and female resident representation at the program level.

We conducted a cross-sectional study of U.S. residencies from the 10 largest specialties, using 2022 program-level data reported within the Fellowship and Residency Electronic Interactive Database Access (FREIDA) catalog. We compared the percentage of female residents between programs that reported available versus unavailable onsite childcare, excluding programs with missing values for onsite childcare or percentage of female residents. To isolate the within-specialty association, we performed group mean centering by specialty for the primary outcome, the percentage of female residents. We used regression, adjusting for specialty, subsidized childcare, percentage of female faculty (specialty-centered), and clustering by program sponsor to examine the association between onsite childcare and female resident representation.

We included 3,118 of 3,364 programs with available data, and 2,417 (77.5%) did not have onsite childcare. The percentage of female residents (specialty-centered) was lower among programs without onsite childcare than those with onsite childcare (-.38 ± standard deviation 12.99 vs. 1.32 ± 12.36, adjusted coefficient 1.55, 95% confidence interval [.21, 2.90]).

Most training programs in the United States lack available onsite childcare for residents, and onsite childcare was associated with the percentage of female residents.