Provincial agreements for pregnant and parenting orthopedic surgery residents: a call for a national residency guideline.

In Canada, orthopedic surgery residents who identify as women face unique challenges regarding family planning during training. We investigated provincial policies on pregnancy, parental leave, and return to work in 8 provinces across Canada. We also explored the British Orthopaedic Association (BOA) guideline as a potential model for improving support for Canadian orthopedic surgical residents during pregnancy, parental leave, and professional development. Our analysis reveals disparities in duty hours, parental leave benefits, and pregnancy-related restrictions. For instance, Quebec allows relief from call duties at 20 weeks' getation, while Manitoba, Nova Scotia, and Saskatchewan mandate waiting until 28 weeks. Duty-hour restrictions vary across provinces, with British Columbia setting a limit of 12-hour shifts and Quebec setting it at 8 hours. Pay during parental leave also varies, with top-ups ranging from 84% to 100%, inconsistently available to nonbirthing or adoptive parents. Current agreements fail to support informed family planning decisions and lack robust strategies for risk mitigation. We propose implementing a standardized national guideline based on the BOA model. This guideline would offer clear policies for trainees during pregnancy, parental leave, and return to work, along with strategies to minimize occupational hazards. Adoption of such a guideline would empower trainees, promote inclusivity, and encourage more women to consider careers in orthopedic surgery.