UPmémoires

English

Evaluation of Decree of June 2010 concerning the condition of the pregnant resident : investigation on internship with extra slots dedicated to pregnant women for general medicine residents

Introduction: In 2010, a new decree specified the hospital training shall add extra slots to be filled by pregnant women in proposed general medicine internships. Two years later, it seemed interesting to carry out an assessment of the situation in the field to measure the impact of a pregnancy on the training of residents in general medicine.

Equipment and methods: During the 2012-2013 winter semester, a first study was conducted among the student unions of medicine of all French universities, to assess the organization of internships for pregnant resident in general medicine. In October 2012, a second study was conducted among general medicine residents of two universities (Poitiers and Tours). Finally, in October 2013, 16 telephone interviews were conducted with residents that participated to the 2nd study and had been pregnant.

Results: Participation rate among the unions was 100 %. The harmonization of practices was consistent for the possibility to access an internship with extra slots. In eight faculties, access to this type of training was more complicated and could lead to an internship not chosen by the resident. For 14 faculties, some training sites were not proposed with an internship with extra slots for pregnant women. Finally, seven faculties had chosen to not downgrade the rank of women who invalidated a semester because of a pregnancy and were therefore not in compliance with the legislation. Among the 397 residents of Tours and Poitiers, 26 women were pregnant or had been pregnant during residency. Students were 88 % to disapprove downgrading as provisioned by the Law. One resident out of five has experienced a negative effect of her pregnancy on her training. During the course of interviews, downgrading has been described as unfair and discriminatory to the formation of some residents, because it cancels the efforts made prior to the pregnancy and closes the door to internship otherwise reachable by the resident previous level.

Conclusion: The amendment of 2010 has fully harmonized the status of internship in hospital proposing extra slots. However, improvements are still to be made. All internship shall propose extra slots to be attended by resident who are pregnant during their training and downgrading, which is discriminatory and detrimental to the formation of certain residents, shall not be allowed.

Keywords : general medicine, family medicine, resident, pregnancy, legislation, decommissioning, training, internship, additional, redundant.