More than 40 percent of medical residents plan to have a child during their years in training. But the amount of paid time off those residents are given to care for infants varies widely across residency programs.
AMA policy on the subject “encourages residency programs, specialty boards and medical group practices to incorporate into their parental leave policies a six-week minimum leave allowance, with the understanding that no parent should be required to take a minimum leave.”
The AMA also calls on residency programs to develop written policies on parental leave, family leave and medical leave for physicians. Those policies should include guidance on whether leave is paid or unpaid, as well as whether time spent making up a leave will be paid.
Meeting that minimum threshold
The Family and Medical Leave Act requires employers to provide 12 weeks of unpaid family leave once an employee has worked 12 months. Formal policies that expand on that coverage in residency programs are far from uniform, however.
A 2018 JAMA study reviewed paid childbearing and family-leave policies for 15 graduate medical education (GME)-sponsoring institutions. Childbearing leave was defined as a leave of absence taken by birth mothers. Family leave was defined as additional leave provided to birth mothers after childbearing leave or to fathers or nonbirth parents with a new child. Most institutions allow residents to use vacation and sick leave in place of family leave.
The study found that:
- Seven of 15 institutions had an institutional GME policy providing paid designated childbearing leave with an average duration of 5.7 weeks.
- The average duration of paid maternity leave—encompassing both childbirth leave and designated family leave available to childbearing mothers—was 6.6 weeks.
- Six of the 15 programs, as well as one additional program that lacked provisions beyond sick or state-funded disability leave for birth mothers, had policies on paid family leave for nonbirth parents.
- All but one program in that group of seven used inclusive language for same-sex couples and adoptive parents.
Restrictive parental policies not unique to residents
The United States doesn’t guarantee paid parental leave by national law. In 2016, fewer than 15 percent of private workers were given the option to take paid family leave, according the National Compensation Survey, conducted annually by the U.S. Bureau of Labor Statistics.
Still, female medical residents get less paid maternity leave than physicians at other points in their careers. A prior JAMA study of academic faculty members at 12 U.S. medical schools found that full salary support during childbearing leave for that group was 8.6 weeks, two weeks more than the 6.6 weeks.
Efforts are underway to find additional resources and accommodations for expecting parents inside and outside of medicine. The FAMILY Act, introduced in the House and Senate in 2019, would create an insurance system allowing workers to take up to three months of paid leave for family care.
On the program level, authors of the 2018 JAMA study cited the complexities of developing specific policies for residents and fellows while highlighting the importance of doing so.
“Policies for paid parental leave for residents require balancing of multiple interests, including the need to support residents who are facing the physical and emotional needs of parturition and parent-child bonding, the duty to ensure clinical competence of all residents, and consideration of potential effects on care delivery in institutions that continue to rely heavily on residents to provide patient care,” they wrote.