Parental Leave During Anesthesiology Fellowship

Abstract

Introduction: Parental leave is an important consideration for many residents and fellows as they choose programs balancing their career goals with their goals for family planning. Benefits of parental leave are decreased infant mortality and increased breastfeeding, which has health benefits for infants and mothers. In 2018, one study found only 7 of 15 residency training institutions in the local area had an institutional GME policy providing paid designated childbearing leave. A study at Mayo Clinic at 269 programs found that 40% of residents and fellows planned to have children during training. 89% of fathers rated parental leave as an important benefit, and pregnancy and childbirth plans altered choice of GME program in women more often than in men. The ACGME encourages allowances for parental leave but does not provide specific recommendations on how to manage the leave, giving programs institutional control over their own policy. Leave policies can be complicated by requirements from Centers for Medicare and Medicaid Services, Health Resources and Services Administration, the Veterans Health Administration, and the National Institutes of Health, depending on allocations for resident/fellow salary. Objective: As prospective anesthesiology fellows research programs with family planning in mind, how accessible are these local GME policies on parental leave? Methods: We compiled a list of all 140 ACGME-approved anesthesiology fellowship programs including 60 pediatric, 74 adult cardiothoracic, 63 critical care, 39 regional and acute pain medicine, 41 obstetric, 111 chronic pain medicine & 1 clinical informatic program. We performed online searches of each program’s website to look for institutional GME policies on parental leave. If we could not find the results within 10 minutes, it was considered not easily accessible. Results: Out of 140 anesthesiology ACGME-approved fellowship programs, 99 programs had parental leave policies easily accessible online (71%) whereas 41 programs did not have policies easily accessible online (29%). Of these 41 programs, 6 of them required a log-in for access to their parental leave policies. Discussion: Anesthesiology fellowship programs should consider having a generous parental leave policy and making this policy easily accessible online to demonstrate support for physician well-being and work-life balance. We found that many anesthesiology fellowship programs do not have parental leave policies easily accessible online for interested applicants. Reasons many trainees don’t use parental leave include the sense of being a burden to colleagues, anticipation of a heavier workload later, delayed program completion, not needing the time, or not being the primary caregiver. Additional research should pursue opportunities for competency-based training, flexible scheduling of work hours or start dates, part-time options, and childcare benefits to meet the rising demands of the current workforce. Conclusion: Parental leave is an important public health priority and an important aspect to physician well-being. Residency and fellowship programs should ensure they have established institutional GME policies and share them publicly in an easily accessible format online with interested applicants to remain competitive and guarantee a diverse applicant pool.