A third-year pediatric ICU fellow at UCSF, Dr. Meesha Sharma fought alongside her fellow members of CIR’s UC Family Building Committee and the UC Bargaining Team to win historic family building benefits for physicians across the UC system this winter.

Can you tell me a little bit about yourself, your personal connection to this work? 

Throughout my training, from med school, to coming to the U.S. for grad school, to residency and then fellowship, my career was at the forefront of my decision making and plans. I didn’t really want to have children until I felt like I was in a stable space in my career where I felt good about having resources to then start on that journey. 

By the time I thought about building a family I was in fellowship. Around the same time, I also got diagnosed with endometriosis. My OBGYN told me that getting pregnant could help with the pain I was experiencing from endometriosis. But, as was the case with me, people with endometriosis are at a higher risk of infertility and often have to use assisted reproduction to help achieve their family building goals. But there were no fertility benefits available to trainees at UCSF at that time. So essentially, even though I had health insurance, I had no financial help to treat my health condition.

Like me, there are many trainees who don’t have access to such services. And they have given their lives, their entire young adulthood, to becoming amazing professionals, often treating conditions they themselves need to be treated for, struggling to access these treatments when they need them. I think that dichotomy is mind-boggling. 

How is the new family building benefit making a difference in your life, or how do you expect it to? 

My partner and I are undergoing the IVF process and so these benefits are monumental for us. We have access to $30,000 to help us in our family building process. There’s a list of services that are available through the benefits provider. It’s not just for infertility, there’s also fertility preservation, which is incredible and very important, as well as things like adoption and postpartum services. 

Can you talk about your experience on the CIR-UC Family Building Committee? 

I joined the Family Building Committee last year. The larger CIR-UC group was negotiating our contract and fertility was a part of those negotiations, and I wanted to get involved in something that was focused on these benefits. 

It is a wonderful, passionate and incredibly supportive group of people. When we formed the group, we did not have any benefits that supported family building but each one of us, through our own experiences and those of others, were convinced that this is a core need for trainees. We organized and identified who we needed to talk to. In October of last year, we met with the office of the Lieutenant Governor of California and told them our stories to highlight how much of an impact this has on our lives. They committed to pressing the University of California Office of the President for a Request For Proposal for trainee fertility benefits. We knew then that we were helping to move the conversation forward, knowing that every day, every week delayed was time lost for many trainees in the throes of fertility treatment/preservation.

Now that we have the benefits, we know the work is not done. We continue to meet as a group every month. We are now focused on making sure the benefits are disseminated equitably and accessible to everyone. We want to hear about the obstacles that trainees might be facing and take it back to the decision makers to highlight areas of improvement. We want to educate trainees about starting to think about fertility preservation early in their training. No one talks to us about this in medical school or residency. And we are also focused on other aspects of family building such as childcare – another huge need in our community.

What do you think are some of the connections between advocating for family building supports for trainees and equity in medicine?

Access to infertility treatment and fertility preservation technology through benefits like this is going to help reduce inequities in the medical workforce across gender, race and socioeconomic backgrounds. For too long, we (residents and fellows) have had to sacrifice our reproductive years to pursue our careers, working well into our 30s, exacerbating the disparity we see in the physician workforce. We have the technology to ensure trainees no longer have to choose between having families and pursuing their careers. But it is an expensive technology that is financially out of reach for most of us and disproportionately out of reach for underrepresented populations. This new benefit is a great step towards ensuring that all of us, regardless of race, gender, sexual orientation or socioeconomic background, have an equal opportunity to build a family when and how we want.

What would you say to other residents or fellows who want to fight for a family building benefit at their hospital? 

The time is now. We need to keep showing the decision makers how this affects our lives, why it is important and that this is absolutely a fight for social justice. And you are not alone! The members of the UC Family Building Committee support you and are here for you if you want to reach out – we’re happy to talk and brainstorm. 

How do you feel going forward? 

I think people across the country are realizing that this is the need of the hour. I am hopeful that other medical institutions and hospitals will take a leaf out of the UC book and give their trainees the fertility benefits they deserve.