Obstacles during training of pregnant doctors in Germany before and after COVID-19: is there a need for change?

Objectives: With the growing proportion of female practitioners in the medical field, management of pregnant medical doctors is an increasingly important concern. The 2018 amendments to the German Maternity Protection Act stipulate that pregnant doctors and students can and should be permitted to safely continue their work under strict protective measures. Despite these measures, the reality is that pregnancy still results in limits on professional advancement and attainment for many physicians. To improve this situation, we analyzed the current situation in Germany. Based on our analysis, we identified some areas in need of improvement and offered recommendations. Methods: We performed a nationwide online survey that was sent to medical doctors and students via the physicians' union Marburger Bund members' mailing list. The survey's main focus was on which kinds of clinical duties the pregnant doctors were assigned to, subdivided into four different time periods (under the previous and amended Maternity Protection Act, during COVID-19 pandemic and after), from 2016 to 2022. Results: Our survey included 4,748 female medical doctors and students, with a balanced distribution across the four different time periods. The most striking restriction reported by our participants was a ban on performing surgeries and invasive procedures, an experience reported by 57-65 % of pregnant doctors and medical students before the COVID-19 pandemic and nearly 80 % since the pandemic. In addition, since the COVID-19 pandemic, a complete employment ban has been enforced upon nearly 50 % of the pregnant doctors. More than 50 % of pregnant doctors considered their careers to have been obstructed or curtailed by their pregnancies prior to the pandemic, with that number growing to two-thirds since the pandemic. Conclusions: Pregnancy negatively impacts doctors' training and careers. Many women are not allowed to perform surgeries and invasive procedures, even while some of these practitioners report that they wish to and are capable of continuing their work. Change is needed to support enthusiastic young female doctors and students and enable them to maintain their skills and professional advancement during pregnancy.