Early-career oncologists experience inadequate parental leave, lactation support policies
Click Here to Manage Email Alerts
Key takeaways:
- Survey respondents reported an average duration of parental leave of less than 6 weeks.
- Half of respondents reported feeling pressured to work while on parental leave.
Trainees and early-career faculty in oncology experienced stress, guilt and perception of inadequate resources when returning to work after parental leave, according to survey results.
The findings, published in JCO Oncology Practice, also showed those surveyed reported unclear workplace parental leave and lactation policies.
Quantifying the problem
“Personal experience with having my child during training and also talking with others in medicine — especially women who had been in this situation — helped me realize that most workplaces do not have the necessary facilities to support new parents, including parental leave, provision of time and facilities for pumping breaks and resources at return to work,” Sindhu Janarthanam Malapati, MD, assistant professor of medicine in the division of medical oncology in the department of internal medicine at University of Arkansas for Medical Sciences, told Healio.
“Trainee and early career years are when physicians most commonly plan families and also the years where they have the least say in workplace policies — due to the hierarchical structures of medicine,” she continued. “There is very little awareness of this as an issue at the level of policy makers with institutions and governing bodies. Quantifying the problem is the first step on the road to fixing it, which is why we did this study.”
Investigators distributed an anonymous 43-question cross-sectional survey via email and social media between May and June 2021 to 275 oncology trainees and early-career physicians within 5 years of final training in the U.S., as well as 23 program directors or associate program directors of training programs in hematology/oncology or radiation oncology.
Pressured to work
Results showed an average duration of parental leave of less than 6 weeks among all survey respondents.
For those who utilized parental leave, researchers found that 50% felt pressured to work while on parental leave, 60% felt guilty asking coworkers for help, and 79% felt overwhelmed by the demands at work and home.
Of note, only 27% reported having resources available at their workplace to assist with the transition back to work.
Results also showed that among women who breastfed at return to work, 31% reported no access to lactation rooms, while more than half (56%) did not have adequate pumping breaks and 66% did not have pumping breaks mandated in their contract.
“The dismal numbers of average duration of parental leave, poor resources for support at return to work, overwhelm experienced by new parents at return to work, pressure felt to work during parental leave, no access to lactation rooms and inadequate pumping breaks, unfortunately did not surprise me,” Malapati said. “This has been reflected in the experiences so many parents in medicine have expressed in conversation in the past.”
Overcoming stigma
This is a wide-ranging issue, and there is no one solution to fix it, according to Malapati.
“Competency-based graduation requirements in training and board examination eligibility instead of current rigid timelines will allow for extension of parental leave and timely completion of training without compromising on quality of training,” she said. “The Accreditation Council for Graduate Medical Education [ACGME] has made a step forward by mandating a minimum of 6 weeks of parental leave. I would like to recognize this progress and also point out that the American Academy of Pediatrics supports 12 weeks of paid parental leave which is still much lower than what is provided in the rest of the developed world.”
Overcoming the stigma in medicine associated with not putting professional above personal priorities is also a challenge in being able to move forward with meaningful conversation that can institute change, Malapati added.
“Organizations like ASH and ASCO may be able to help raise awareness among those in leadership positions about the needs of trainees and early career faculty,” she said. “With early career faculty, there is no uniform body of oversight over practices and hospitals like the ACGME for trainees, so I am unsure what scalable solution is available for this group. In the meanwhile, individuals should look for mentors and sponsors within and outside their organization who will help them advocate for themselves while negotiating increase in parental leave and/or better lactation facilities.”
There is a need for structural change with involvement by people in leadership positions to bring this to fruition, Malapati continued.
“We need pilot programs in institutions with committed leadership to assess the effect of improved parental leave and lactation facilities on burnout, quality of life, clinical competency at graduation and financial implications for the institution,” she said. “This will help provide the information required to implement these policies on a larger scale.”
For more information:
Sindhu Janarthanam Malapati, MD, can be reached at smalapati@uams.edu.
Collapse
Read more about
Click Here to Manage Email Alerts