Life and medicine

Having a baby in residency? A call for standardized parental leave

AOA House of Delegates calls for a uniform parental leave policy across all residency programs.

Jennifer Patterson, DO, is ready for the culture of medicine to change when it comes to childbearing.

“The stress of residency alone, and then the stress of having to go back to work while having a newborn—it’s unkind,” Dr. Patterson says. “It’s very hypocritical of our profession to not take care of its own.”

Most medical trainees’ peak child-bearing years overlap with residency. In an Academic Medicine survey, nearly 40% of trainees reported they planned on having children during residency or fellowship training. Parental leave policies in residency vary drastically across programs, and this discrepancy is unacceptable, say Marisa DeSanto, OMS III and Brylie Schafer, OMS III.

This year, the AOA House of Delegates passed a resolution calling for the Accreditation Council for Graduate Medical Education (ACGME) to adopt a standardized parental leave policy for medical residents, an action members say could help remove barriers faced by resident physicians who plan to start families during their peak childbearing years.

DeSanto and Schafer wrote the resolution with the hopes of creating awareness of the wide variation in residency parental leave policies.

“We interpreted the lack of consistency in leave policies as a way to discourage residents, specifically those in competitive specialties, from having children or taking time off,” DeSanto says. “By encouraging ACGME programs to reinforce leave policies that follow the Family and Medical Leave Act, we hope to reduce the stigma that surrounds taking leave during residency.”

ACGME should adopt a standard parental leave policy for all programs, and it should align with the 12-week unpaid leave guaranteed to many American workers by the Family and Medical Leave Act (FMLA), say DeSanto and Schafer, who attend Ohio University Heritage College of Osteopathic Medicine.

Taking leave after having a baby in residency

FMLA guarantees that Americans who work for certain employers for at least one year can take 12 weeks of unpaid leave to care for an infant.

Dr. Patterson took FMLA for a full 12 weeks after having her son during the second year of her family medicine residency. Although her program was accommodating, she wasn’t aware of any specific policy for her residency program.

“Taking leave typically wasn’t done. Not many residents want to extend their residency,” Dr. Patterson says. “The culture of medicine is that you don’t take time off.”

Not all residency programs have policies on parental leave. For example, 90% of pediatric residency programs have established maternal leave policies, as compared to 36% of plastic surgery residency programs. Researchers also found that 26% of plastic surgery trainees had an elective abortion during residency.

For surgery trainees, challenges such as negative attitudes from peers and faculty and inflexible work schedules contributed to 39% of pregnant trainees considering leaving their residency program and 30% saying they’d advise female medical students to pursue other specialties, a study in JAMA Surgery found.

Kara Hessel, DO, gave birth during the third year of her surgery residency at the University of Kansas Medical Center. At the time, there wasn’t a standard maternity leave policy in the program in place. She took five weeks of maternity leave to avoid any disruptions in her program’s night float system distribution. This also allowed her to graudate on time.

“Whether we like it or not, we’re putting hardships on our co-workers and staff by taking that time. A standardized option would be beneficial to help programs plan and ensure everyone would take the same amount of maternity leave,” Dr. Hessel says.

The health of mothers in residency

Complication rates for pregnant orthopedic surgery residents were double compared to the general population, one study found. These residents were also more at risk for preterm delivery and preterm labor.

“We have to embrace a standard policy as a profession. It is better for everyone when we take care of mothers and infants,” Dr. Patterson says.

DeSanto is hopeful that the AOA’s resolution will raise awareness of the lack of consistency in residency leave policies.

“We also hope the passing of this resolution generates action to address this issue,” she adds. “Our intent is that these leave policies will be completely transparent for future residency classes.”

Further reading:

Giving birth during medical school

10 moms give 10 pieces of advice about parenting in med school and beyond

4 comments

  1. It’s a problem on both ends
    I was a urology resident when my wife at the time was an OB resident gave birth to our first daughter. I remember on my end my chief resident gave me three days off (which I was actually surprised I got three days off) and one of the attending surgeons told her….”you better watch how much time we are giving him off …3 days is too much and it’s setting a precedent “…..my chief basically told him to bugger off
    (Again I was surprised) ….
    Looking back, I think our attitude in medicine about putting everything and everyone else first is ridiculous (25 years later) ….our families and children suffer for our dedication to our profession. And we get…what ? Cost plus 2% from CMS for our dedication?
    That being said …residency call schedules and training is vigorous call schedules …fatigue….you have to be trained as well….and when you as a resident take time off the burden goes on your fellow residents ….is that fair to your colleagues? Puts Alotta burden on them as well.
    So what’s the answer? I dunno ? But I can tell you if I had to do it over I don’t think I would be hauling my kids around making rounds and running them into the nurses lounge while I did an emergency surgery ….we act like our professoion doesn’t have a negative impact on our families and children but it does
    Think about that before you go into medicine thinking you are gonna have children later

  2. Agree with the above. 3 of my residency classmates became pregnant during residency. One had a difficult pregnancy, requiring bedrest for months. The rest of us were left to pick up the call. No one ever said thank you, nor did anyone make up the missed call. Its a problem at both ends. My wife had our first as a 3rd yr and took the prescribed 6 weeks off. 4 weeks leave and 2 weeks vacation. Residency is arduous, especially in the surgical specialties. I’m not sure how residencies can give 12 weeks off when over half the grads are women.

    1. The hospital should hire an NP or locums attending to fill the resident’s place during maternity leave. The guilt of putting more work on colleagues should never be at play.

  3. I am addressing, those ,like myself, who have been practicing medicine. Professionally @#22years, +, ie, since starting PGY I, then starting to moonlight in PGY II, and PGY III years,, and have not looked back since, working @#118 hrs q week, for first #12 years as attending physician, and last 8+,yrs, to current @68+q week, I love practicing medicine, you have to love it, if, a resident is “burning out”, that is what we should focus on, and develop a tool. To screen all possible medical students in usa,. After 4 years, of undergraduate and #4 graduate, then @ minimal #3 years “postgraduate”, #11 years!!!, And to have a sense of “dread “, after all that intense training education, time, discipline, $$$/loans, students need to be screened/ shadow etc, and fully grasp what a physician does.This is “chess”, not checkers, I agree with FMLA, and residents starting families, they need to get our associations resources,. They should get paid the #12 weeks, ???, I respect and agree 100% with helping residents who are starting families, I. Myself, had my first child in may of my PGY I year,. I understand, I also agree, that us “old heads”, lol, worked, in humane hour’s in our postgraduate studies, years,. I am glad they changed, we actually worked,@2.125X’s, longer, we had no limits, you all remember,. We were “pimped out”, and openly embarrassed in front of entire, medical units. And their staff, by our attending, lol,. God bless medicine, don’t give up, it can be fun/rewarding 100%

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