Parenting challenges of international medical graduate hematologists-oncologists in the United States.

Abstract

9016 Background: Almost two-thirds of physicians report delaying childbearing due to medical training. Amongst hematologists-oncologists (HOs), up to 75% report burnout related to parenting. International Medical Graduates (IMGs) account for a third of all practicing HOs; yet little is known about the unique challenges they face in navigating parenthood. This cohort study aimed to explore parenting challenges of IMG HOs in the U.S. Methods: An anonymous survey was distributed electronically via social media and the ASCO community of practice between December 2024 and January 2025. Descriptive statistics were employed to compute frequencies and percentages of survey responses. Chi-square tests for independence were performed to evaluate associations between key survey variables. Results: Among 73 respondents, majority were aged 30–39 (50%) and were women (75%). At the start of their first U.S. post-graduate training, 51% of respondents were on J1/ H1B visa. The majority (77%) delayed parenthood due to medical careers with higher rates of delay in non-citizen/non-permanent resident (NCNPR) IMGs compared to those with permanent residence/citizenship (81% versus 71%). A Chi-square test indicated an association between immigration status and the likelihood of delayed parenthood (p=0.03). Parenthood delay correlated with work hours, financial strain, and lack of social support (Table 1). Key factors affecting career trajectory included decreased academic productivity (66%), reduced conference participation (64%), and declined advancement opportunities (53%). After having children, the most common challenges were achieving work-life balance (95%), lack of social support (93%), and increased burnout (92%). Visa status contributed to parenthood challenges for 38% of NCNPR IMGs. Respondents cited the need for childcare resources, enhanced leave policies, workplace accommodations, visa assistance, stronger support and mentorship. Conclusions: IMG HOs face significant challenges balancing parenthood and career, including higher burnout rates than previously reported amongst physicians. Within the cohort of IMG HOs, there is a significant association of immigration status with likelihood of delaying parenthood. Findings highlight the need for systemic support through improved childcare resources, workplace accommodations, mentorship, and visa assistance. Correlation between parenthood delay and determinants of parenthood timing. Factor Chi-Square p-value Duty hours 44.41 <0.0001 Financial strain 22.91 0.0285 Unsupportive work environment 34.5 0.0006 Lack of accommodations during pregnancy 29.79 0.003 Lack of/unclear parental leave policy 30.1 0.0027 Lack of accommodations post parental leave 26.28 0.0098 Lack of social support 39.96 0.0001 Impact on career trajectory 31.99 0.0014 Delay in training completion 30.06 0.0027