Between 2016 and 2017, the mean paid childbearing leave for faculty physicians at 12 top United States medical schools was just 8.6 weeks.1 For physicians in residency training, parental leave duration is further complicated by the training requirements put forth by specialty boards. Institution-level policies and residency program directors also dictate parental leave experiences for residents. According to data from 2 studies published in JAMA, policies from both the specialty boards and the medical institutions fail to accommodate residents appropriately during childbearing years.2,3

One study identified specialty board leave policies using the websites of 24 American Board of Medical Specialty member organizations.2 Twenty-two of the 24 board websites described leave policies, but just 11 mentioned parental leave specifically. Notably, none of the websites had a separate leave policy for parental leave. Additionally, 20 boards had time-based training requirements for board eligibility, allowing a median value of 6 weeks’ leave during any 1 year. Eight boards allowed program directors to seek exemption for physicians from time-based training requirements. According to board policies, resident physicians are thus allowed a median of 6 weeks of parental leave, more than that allotted faculty physicians. However, few boards had explicitly defined policies for parental leave. Lack of support during parental leave may contribute to sex disparities in certain specialties, dissatisfaction with work-life balance, and increased risk for burnout. As such, it is important for boards to enumerate explicit policies for parental leave. Authors also suggested a competency-based approach to training — rather than a time-based approach — to lessen restrictions on parental leave duration.

Another study3 identified the institution-level childbearing and family leave policies for 15 graduate medical education (GME)-sponsoring institutions associated with the 12 medical schools studied previously. Policies were identified from publicly accessible websites or requested from GME offices. Just 7 of 15 GME-sponsoring institutions had policies providing paid childbearing leave for residents, with a mean duration of 5.7 weeks (range, 2-8 weeks). The mean duration of maternity leave was 6.6 weeks (range, 2-10 weeks). Six of the 7 institutions also had policies on paid family leave for non-birth parents, using “inclusive language” for same-sex couples and adoptive parents. One of these institutions also had policies for “paternity” leave specifically. The mean paid family leave for non-birth parents was 3.9 weeks (range, 1-8 weeks). Although limited to just 15 GME-sponsoring institutions, these data underscore the restrictive nature of residency on parental leave. Fewer than half of assessed institutions had policies for family leave, and those with policies provided leave time that was less than the 8.6 weeks allotted faculty.

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The American Academy of Pediatrics supported a proposed federal law which would provide 12 weeks of family leave to physicians.4 First introduced in 2015, the Family and Medical Leave Act requires large employers to provide 12 weeks of unpaid leave, although only after 12 months of employment.2 Although this act has not been passed, support from the Academy of Pediatrics suggests that an overhaul of family leave policies in the medical field may be necessary — and long overdue.

References

  1. Riano NS, Linos E, Accurso EC, et al. Paid family and childbearing leave policies at top US medical schools. JAMA. 2018;319(6):611-614.
  2. Varda BK, Glover M IV. Specialty board leave policies for resident physicians requesting parental leave. JAMA. 2018;320(22);2374-2377.
  3. Magudia K, Bick A, Cohen J, et al. Childbearing family leave policies for resident physicians at top training institutions. JAMA. 2018;320(22);2372-2374.
  4. American Academy of Pediatrics. Major Pediatric Associations Call for Congressional Action on Paid Leave [news release]. https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/FAMILYLeaveAct.aspx. March 20, 2015. Accessed January 14, 2019.