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Many young physicians don’t get doctor-recommended child and family leave


(Reuters Health) – – Physicians training at many of the top U.S. medical schools get much less time off for childbearing and family leave than the 12 weeks recommended by doctors, two new studies suggest.

Only eight of the 15 hospitals affiliated with the top 12 medical schools in the U.S. have paid family or childbearing leave for doctors in training, even though all of the schools have leave policies for faculty physicians, one of the studies in JAMA found. Trainee doctors got an average of 6.6 weeks of paid leave, compared with 8.6 weeks for faculty physicians.

This is significantly less than the 12 paid weeks that would be provided in a proposed federal law supported by the American Academy of Pediatrics (AAP). The AAP recommends three months of leave to support the health of both infants and parents, said lead study author Dr. Christina Mangurian of the University of California, San Francisco.

“This lack of family leave impacts the physician in training because it denies that person from important bonding time that benefits the infant and mother’s mental and physical health,” Mangurian said by email. “This lack of family leave impacts patients because study after study has shown that if physicians are happy and not burned out, they provide better patient care.”

Integrating career and family is challenging for physicians at all stages of professional development, but especially difficult during training programs that typically coincide with prime childbearing years, researchers note.

At the same time, hospitals depend on the clinical care their residents provide, the study authors also point out. Extended family leaves can affect staffing, as well as residents’ ability to develop needed skills.

Mangurian and colleagues assessed leave policies at hospitals affiliated with medical training programs at Columbia University, Duke University, Harvard University, Johns Hopkins University, the University of Michigan, the University of Pennsylvania, the University of Pittsburgh, the University of California San Francisco, Stanford University, the University of Washington, Washington University St. Louis, and Yale University.

Birth mothers generally fared better than other parents, with maternity leave including family leave available to childbearing mothers ranging from two to 10 weeks. In several cases, leave decisions were left up to individual departments, making it possible that new parents training in different specialties at the same hospital might have varying amounts of time off.

A second study in JAMA highlights one reason why leave policies might vary by department: medical specialty boards that set training requirements often cap how much time off is allowed.

For this study, researchers examined leave policies for 24 American Board of Medical Specialty (ABMS) member organizations, which set training requirements for surgeons and physicians in fields like dermatology, obstetrics and gynecology, radiology, and urology.

“It was surprising how much variation exists across specialty board policies regarding leave, as well as how much ambiguity exists within policies,” said study co-author Dr. Briony Varda of Boston Children’s Hospital.

“This variability and ambiguity adversely affects both trainees and programs when it comes to decision-making about maternity leave; and it may affect diversity across medical specialties,” Varda said by email.

Overall, the half of the specialty boards offered doctors in training at least six weeks off, without permitting them to extend the timeline for their training program, the study found.

However, most board policies lacked specific references to parental leave and most were ambiguous about whether training would need to be extended, which may create barriers to parents seeking leave, the study authors note.

Essentially, these policies may mean time off is determined at least in part by negotiating skills of individual parents.

“Female trainees do not come from a position of strength to negotiate leave, nor should they need to negotiate, Varda said. “The median six weeks of leave is not adequate for the mother or child.”

SOURCE: and JAMA, online December 11, 2018.

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