Evaluation of Faculty Parental Leave Policies at Medical Schools Ranked by US News & World Report in 2020

Abstract

ImportancePhysician parents, particularly women, are more likely to experience burnout, poor family-career balance, adverse maternal and fetal outcomes, and stigmatization compared with nonparent colleagues. Because many physicians delay child-rearing due to the rigorous demands of medical training, favorable parental leave policies for faculty physicians are crucial to prevent physician workforce attrition.ObjectiveTo evaluate paid and unpaid parental leave policies at medical schools ranked by US News & World Report in 2020 and identify factors associated with leave policies.Design, Setting, and ParticipantsThis cross-sectional national study was performed at US medical schools reviewed from December 1, 2019, through May 31, 2020, and February 1 through March 31, 2021, due to the COVID-19 pandemic. All medical schools ranked by US News & World Report in 2020 were included.Main Outcomes and MeasuresThe primary outcome was the number of weeks of paid and unpaid leave for birth, nonbirth, adoption, and foster care physician parents. Institutional policies for the number of weeks of leave and requirements to use vacation, sick, or disability leave were characterized. Institutional factors were evaluated for association with the duration of paid parental leave using χ2 tests.ResultsAmong the 90 ranked medical schools, 87 had available data. Sixty-three medical schools (72.4%) had some paid leave for birth mothers, but only 13 (14.9%) offered 12 weeks of fully paid leave. While 11 medical schools (12.6%) offered 12 weeks of full paid leave for nonbirth parents, 38 (43.7%) had no paid leave for nonbirth parents. Adoptive and foster parents had no paid leave in 35 (40.2%) and 65 (74.7%) medical schools, respectively. Median paid parental leave was 4 (IQR, 0-8) weeks for birth parents, 4 (IQR, 0-6) weeks for adoptive parents, 3 (IQR, 0-6) weeks for nonbirth parents, and 0 (IQR, 0-1) weeks for foster parents. About one-third of medical schools required birth mothers to use vacation (29 [33.3%]), sick leave (31 [35.6%]), or short-term disability (9 [10.3%]). Among institutional characteristics, higher ranking (top vs bottom quartile: 30.4% vs 4.0%; P = .03) and private designation (private vs public, 23.5% vs 9.4%; P < .001) was associated with a higher rate of 12 weeks of paid leave for birth mothers.Conclusions and RelevanceIn this cross-sectional national study of medical schools ranked by US News & World Report in 2020, many physician faculty receive no or very limited paid parental leave. The lack of paid parental leave was associated with higher rates of physician burnout and work-life integration dissatisfaction and may further perpetuate sex, racial and ethnic, and socioeconomic disparities in academic medicine.

Childbearing, Infertility, and Career Trajectories Among Women in Medicine

“…More than one-quarter of respondents reported taking an extended leave of 12 weeks or greater, notably higher than the 14.9% of US medical schools currently offering faculty 12 weeks or more of fully paid maternity leave. 32 In support of single-center data, 14 nearly half of women with children in our study reported passing up opportunities for career advancement and reducing work hours to accommodate parenthood. Results from a 2019 prospective study 15 of early-career physicians suggested that these accommodations may be more prevalent among women vs men physicians and may begin soon after completion of training; within 6 years of training, 22.6% of women physicians worked part time vs 3.6% of men physicians, and 77.5% of those working part time cited family as the most influential factor in this decision.…”

“…Furthermore, our results highlight the degree to which women in medicine altered their careers to accommodate pregnancy and parenthood. More than one-quarter of respondents reported taking an extended leave of 12 weeks or greater, notably higher than the 14.9% of US medical schools currently offering faculty 12 weeks or more of fully paid maternity leave . In support of single-center data, nearly half of women with children in our study reported passing up opportunities for career advancement and reducing work hours to accommodate parenthood.…”

“…Collectively, these data highlight a need to support women physicians in balancing family and career. Paid parental leave is not federally mandated in the US, and nearly half of top-ranked medical schools do not provide paid parental leave for birth (42%) or nonbirth (44%) faculty . Encouragingly, a recent Accreditation Council for Graduate Medical Education mandate specifies that sponsoring institutions must have policies including 6 or more paid weeks of parental leave .…”

Work-Life Integration in Medicine: A Movement, Not a Mandate

“…Slostad and colleagues provide an in-depth 2020 update of parental leave policies for physicians at medical schools ranked by US News & World Report . This study provides useful data regarding the scarcity of institutions who follow the American Academy of Pediatrics’ recommendations for 12 weeks of paid parental leave.…”

“…Through this lens, efforts should include family benefits for those who may become parents through less traditional routes and should promote the well-being of physicians without children. Slostad et al provide valuable insight into the paucity of support for adoption and foster care, routes to parenthood often pursued by same-sex couples and the 1 in 4 female physicians experiencing infertility . Policies that perpetuate gender- and sexual orientation–based inequalities must be amended.…”