Introduction: Surgical trainees spend key years of their reproductive potential in training. However, their family planning needs are seldom addressed and remain poorly understood. This study was designed to understand the current landscape of family planning among General Surgery (GS) trainees and to identify the career-specific barriers they face.

Methods: We created a 26-question survey to assess GS trainee experiences surrounding family planning. The survey was distributed to residency and fellowship program directors nationwide. Outcome measures were evaluated using Pearson's Chi-Square test and Fisher's exact test.

Results: Two hundred thirty-four US GS surgical trainees completed the survey (male = 32.1%, female 66.2%, unreported = 1.7%). Work hours (p = 0.007) and female gender (p = 0.002) were associated with delayed childbirth. Time (93.2%), career/education goals (63%), and cost (59.5%) were most reported to prohibit childbearing. Females were significantly more impacted by time (p = 0.021) and career/education goals (p = 0.001) and more frequently considered fertility preservation (p < 0.001).

Conclusion: Time constraints and career goals are disproportionally more prohibitive to female surgeons when considering childbearing. Institutional resources should be tailored to gender-specific needs and address barriers to family planning.