Addressing the need for change in surgical training culture.

Significant research has occurred over the last 2 decades outlining the disparities that female residents and residents who are underrepresented in medicine face. While there is an increasing number of institutional protocols and initiatives published in the literature attempting to improve these disparities, enrollment and retention of minority residents remain lower than expected. Designing and implementing measures to improve the recruitment, retention, and daily experience of women and underrepresented in medicine residents involves significant challenges because of the complex nature of the disparities that these residents experience. We describe our own experience with The Pregnancy Curriculum, an initiative that created sweeping culture changes and initially disruptive policies in our own institution to support pregnant residents. As we reflect on our own experience, we find that honoring the individuality of residents and their unique goals creates sustainable and effective changes to support residents. Herein, we outline the disparities residents face, current research in institutional protocols, and our own response to the challenges that residents experience.