From Requisite to Right: Assessing and Addressing Paid Maternity Leave in US Psychiatry Residency Programs

Abstract

Objective Data on the physical and mental health benefits of paid maternity leave for mothers and infants is abundant. Data on the make-up of current maternity leave policies in US psychiatry residency programs is not. This survey of program directors was undertaken to assess the components of their program’s policies and the perceived impact of maternity leave on the training of childbearing residents, co-residents, and programs. Methods An anonymous 19-question survey was emailed to US psychiatric residency program directors. Questions assessed demographics for respondents and their programs, composition of maternity leave including paid and unpaid components, and the perception of effects of maternity leave on childbearing residents, co-residents, and programs (with optional free-text elaboration). Results The response rate was 19.5% (49 out of 262 program directors). Many programs require the use of FMLA (81%), vacation days (75%), sick days (75%), and short-term disability (30%) for maternity leave. Around a third (34%) offer separate paid time off varying from 2 to 12 weeks at 80–100% of pay. Most respondents relate a neutral to strongly positive impact of leave on the psychiatric training of childbearing residents (98%) and co-residents (84%), citing benefits like improved empathy, compassion, and patience. Conclusions Maternity leave is seen to have minimal negative impact on training received within psychiatry residency programs. A minority of residents have access to paid maternity leave policies that would best support their health and career trajectories.

Supporting Our Parent-Trainees: Exploring Curricular and Cultural Challenges That Limit the Utilization of Parental Leave by Residents

“…In his faculty viewpoint, Dr. Shankar says that the "most important" factor affecting decisions about parental leave was "not having a work culture where there was modeling or encouragement to [take] time off as a new father" [1]. Dillinger identified "culture and support"described further as an environment that promotes "wellness" and "work-life balance"as a frequently mentioned theme driving decisions regarding maternal leave [3]. Institutional culture can clearly influence the realworld implementation of policies that may represent an idealized goal not practiced in reality.…”

“…While psychiatric educators have an important voice in these broad-reaching conversations, we focus here on the culture of individual training programs. As the articles published in this issue of Academic Psychiatry demonstrate, individual programs shoulder great responsibility in crafting and implementing their own parental leave policies and shaping the culture in which the policies are carried out [2,3]. Leaders in training programs can play a critical role in encouraging rapid assessment of cultural values and implementation of changes to address identified shortcomings.…”

“…Parental leave has occupied a prominent role in these discussions, and this issue of Academic Psychiatry sheds further light on the issue for trainees. Ravi Shankar provides a faculty viewpoint article about his experiences with paternal leave as a trainee and faculty member [1], Leandre et al report a national survey of psychiatry program directors about parental leave generally [2], and Dillinger reports a survey of psychiatry program directors about maternal leave specifically [3]. While these authors highlight the wide adoption of maternal leave policies in psychiatry residency programs -94.1% of programs according to Leandre et al and 95.9% according to Dillingerparental leave for resident physicians remains wanting.…”

“…These challenges persist despite the American Board of Medical Specialties providing guidance to residency training programs about parental leave policies for trainees [12] guidance that is vague and, ultimately, leaves the development and implementation of parental leave policies for trainees with residency program directors. Leandre et al and Dillinger take note of this reality, offering suggestions for program-level policy changes that may improve parental leave utilization by trainees [2,3].…”