Parental leave policies in graduate medical education: A systematic review

Humphries, Laura S.; Lyon, Sarah; Garza, Rebecca M.; Butz, Daniel R.; Lemelman, Benjamin T.; Park, Julie E.

doi:10.1016/j.amjsurg.2017.06.023

Cited by 64 publications

(62 citation statements)

References 46 publications

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“…1,6 The prevalence of formal policies among surgical programs was lower: 67% in general surgery, 42% in urology, and 37% in plastic surgery. 1,4,7 The variation among and within specialties and programs is partially due to the lack of an existing formal parental leave policy from the ACGME. The ACGME guidelines state that institutions must have a written policy for vacation and leaves of absence that are consistent with applicable laws, but it does not go beyond this generic statement to specifically address parental leave.…”

Section: Discussionmentioning

confidence: 99%

“…A systematic review by Humphries et al found that among other specialties, pediatric and radiology residency programs have the highest rates of formal maternity leave policies (90% and 88%, respectively) . The prevalence of formal policies among surgical programs was lower: 67% in general surgery, 42% in urology, and 37% in plastic surgery . The variation among and within specialties and programs is partially due to the lack of an existing formal parental leave policy from the ACGME.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…A recent systemic review of parental leave policies during graduate medical education (GME) found that existence of formal policies ranged between 22% and 90% across different specialties, and it reported persistent negative attitudes from program directors (PDs) toward becoming a parent while in training. 1,2 Female physicians planning a pregnancy during residency face unique challenges, especially those women training in otolaryngology and other surgical subspecialties. The extensive training requirements, long work hours, physical strain, work exposures, and overall stress have been thought to contribute to an increased number of pregnancy complications and discouragement of family planning for female residents.…”

Section: Introductionmentioning

confidence: 99%

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Maternity and paternity leave in otolaryngology residency training in the United States

Tang

Miller

Hauff³

et al. 2018

The Laryngoscope

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Objectives/Hypothesis This study evaluates the existence and nature of maternity and paternity leave policies for residents during otolaryngology training. The study sought to survey program directors (PDs) on the impact of parental leave. Study Design Cross‐sectional survey. Methods An electronic survey was sent to 103 otolaryngology residency PDs. A link to a 10‐page, 30‐question survey was provided. Descriptive statistics and comments were collected. Results Forty‐one respondents (39.8%) completed the survey, all of whom were from university‐based programs. Programs from the Midwest (n = 11, 26.8%), Northeast (n = 12, 29.3%), South (n = 12, 29.3%) and West (n = 6, 14.6%) were represented. Sixteen (42%) programs reported having a written formal maternity leave policy for trainees, and 13 (32%) programs had a paternity‐specific policy. Four programs reported using short‐term disability, whereas 11 programs reported using the Family Medical Leave Act to accommodate parental leave. Policies primarily followed the Accreditation Council for Graduate Medical Education and American Board of Otolaryngology guidelines, with factors such as clinical duties and call schedules left to the programs' discretion. Although the majority of PDs (56%) reported support of residents who planned to become pregnant during training, many expressed concerns regarding the burden on co‐residents and the difficulty of fulfilling training obligations for the resident taking leave. Conclusions Many institutions do not have parental leave policies and logistics regarding leave are left to the discretion of individual programs. Surveyed PDs addressed the challenges of becoming a parent during training and the potential burden placed on the program when trainees take leave. Level of Evidence 4 Laryngoscope, 129:1093–1099, 2019

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Maternity and paternity leave in otolaryngology residency training in the United States

Tang

Miller

Hauff³

et al. 2018

The Laryngoscope

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“…1,7 Moreover, those who take parental leave often perceive a negative impact on their careers. 7,8 The reality of many surgical specialties, and especially subspecialties in which there are few qualified personnel, is that it can be extremely Attitudes toward women in surgery appear to be shifting in a positive direction. Why, then, do women still represent only 27% of surgeons in Canada?…”

mentioning

confidence: 99%

A solution to gender inequity in surgery? Better caregiving policies

Acai

Steyn

Reid

et al. 2018

cjs

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Delay of Pregnancy Among Physicians vs Nonphysicians

et al. 2021

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IMPORTANCE Women physicians may delay childbearing and experience childlessness more often than nonphysicians, but existing knowledge is based largely on self-reported survey data.OBJECTIVE To compare patterns of childbirth between physicians and nonphysicians. DESIGN, SETTING, AND PARTICIPANTS Population-based retrospective cohort study of reproductive-aged women (15-50 years) in Ontario, Canada, accrued from January 1, 1995, to November 28, 2018, and observed to March 31, 2019. Outcomes of 5238 licensed physicians of the College of Physicians and Surgeons of Ontario were compared with those of 26 640 nonphysicians (sampled in a 1:5 ratio). Physicians and nonphysicians were observed from age 15 years onward. EXPOSURES Physicians vs nonphysicians. MAIN OUTCOMES AND MEASURESThe primary outcome was childbirth at gestational age of 20 weeks or greater. Cox proportional hazards models were used to examine the association between physician status and childbirth, overall and across career stage (postgraduate training vs independent practice) and specialty (family physicians vs specialists).RESULTS All physicians (n = 5238) and nonphysicians (n = 26 640) were aged 15 years at baseline, and 28 486 (89.1%) were Canadian-born. Median follow-up was 15.2 (interquartile range, 12.2-18.2) years after age 15 years. Physicians were less likely to experience childbirth at younger ages (hazard ratio [HR] for childbirth at 15-28 years, 0.15; 95% CI, 0.14-0.18; P < .001) and initiated childbearing significantly later than nonphysicians; the cumulative incidence of childbirth was 5% at 28.6 years in physicians and 19.4 years in nonphysicians. However, physicians were more likely to experience childbirth at older ages (HR for 29-36 years, 1.35; 95% CI, 1.28-1.43; P < .001; HR for Ն37 years, 2.62; 95% CI, 2.00-3.43; P < .001), and ultimately achieved a similar cumulative probability of childbirth as nonphysicians overall. Median age at first childbirth was 32 years in physicians and 27 years in nonphysicians (P < .001). After stratifying by specialty, the cumulative incidence of childbirth was higher in family physicians than in both surgical and nonsurgical specialists at all observed ages. CONCLUSIONS AND RELEVANCEThe findings of this cohort study suggest that women physicians appear to delay childbearing compared with nonphysicians, and this phenomenon is most pronounced among specialists. Physicians ultimately appear to catch up to nonphysicians by initiating reproduction at older ages and may be at increased risk of resulting adverse reproductive outcomes. System-level interventions should be considered to support women physicians who wish to have children at all career stages.

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Parental leave policies in graduate medical education: A systematic review

Cited by 64 publications

References 46 publications

Maternity and paternity leave in otolaryngology residency training in the United States

Maternity and paternity leave in otolaryngology residency training in the United States

A solution to gender inequity in surgery? Better caregiving policies

Delay of Pregnancy Among Physicians vs Nonphysicians

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