Survey: OB/GYN residents, early-career faculty face parental leave challenges
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Key takeaways:
- OB/GYN trainee and faculty respondents reported various barriers and challenges when taking parental leave.
- Respondents reported variations in average parental leave from 11 to 12 weeks to no leave.
Obstetrics and gynecology residents, fellows and early-career faculty report experiencing significant challenges when it comes to childbearing and parental leave, according to survey results published in Clinical Obstetrics and Gynecology.
In February 2020, the American Board of Obstetrics and Gynecology (ABOG) changed its leave policy to allow residents to take up to 12 weeks of parental or medical leave without extending training. In addition, in July 2022, the Accreditation Council of Graduate Medical Education (ACGME) now requires that trainees receive a minimum of 6 weeks parental leave without stipulating compensation.
“Although the medical field routinely advocates for the benefits of parental leave for both patients and providers, childbearing and nonchildbearing residents and fellows face significant challenges when planning for and taking parental leave during training,” Larissa H. Mattei, MD, a gynecologic oncology fellow at the University of Massachusetts, and Rosa M. Polan, MD, a gynecologic oncology fellow at Wellstar Health System, told Healio. “These challenges also extend to early-career faculty who choose to become parents as they navigate their first few years of independent practice.”
Mattei and Polan developed a web-based survey disseminated to obstetric and gynecology trainees and early-career faculty on social media and through the obstetrics and gynecology program managers’ listserv in April 2022. The survey included questions about parental leave policies, coverage practices, effects of becoming a parent on training, personal experience with parental leave during training and awareness of contemporary ACGME and ABOG policy changes.
Overall, 454 responses (median age, 33 years) were included for analysis, 43.4% were from residents, 41.4% were from faculty and 15.2% were from fellow trainees.
Regarding leave length, 14.3% of respondents reported an average of more than 8 weeks of parental leave, 24.1% reported 7 to 8 weeks, 47.7% reported 5 to 6 weeks, 7.9% reported 3 to 4 weeks, 1.1% reported 1 to 2 weeks and 0.8% reported no parental leave. Researchers also observed reports that trainees need to use vacation and sick time (57.9%) or take unpaid (27.1%) parental leave.
Half of trainee respondents reported becoming pregnant or having a partner who became pregnant during training with 37.6% delivering a child, of whom 95% took parental leave. Of obstetrics and gynecology faculty respondents, 44.7% delivered a child during training and 95.2% took parental leave. Compared with faculty, residents and fellows were more likely to have taken more than 8 weeks or 7 to 8 weeks of parental leave during training (16.7% vs. 52%; P < .001). When asking parents how many weeks of parental leave childbearing residents should be able to take without training extension, 57.1% of faculty and 70% of trainees responded 11 to 12 weeks. These responses differed when asking about the length of parental leave for nonchildbearing residents with 41% of trainees and 33.3% of faculty responding 11 to 12 weeks and 19% of trainees and 21.4% of faculty responding 5 to 6 weeks.
Trainees and faculty were equally like to agree or strongly agree that residents should be required to make up calls when returning from leave, and most trainee and faculty parents agreed that residents and fellows who take parental leave do not have lower surgical case numbers and less patient care experience.
The following themes were observed when analyzing respondent perspectives regarding parental leave during training:
- burden to colleagues;
- lack of support;
- inadequate time off;
- breastfeeding challenges;
- making up call;
- concern regarding clinical experience; and
- suggestion for improvement.
Nearly two-thirds of faculty (60.6%) and 65.8% of trainees were aware of ABOG changes while 83.5% of residents and fellows were aware of a policy regarding childbearing trainees and 32% were aware of a policy for nonchildbearing trainees.
According to Mattei and Polan, despite awareness of parental leave policy in 2020, substantial work lies ahead to ensure workplace culture aligns with and supports this policy.
“In a qualitative analysis of free text responses, several suggestions for improvement were made including increasing compensation for residents who take extra calls to accommodate parental leaves for their colleagues, policies to ease the transition back to clinical service, scheduled breaks for lactation and increased ancillary support,” Mattei and Polan said. “There was also a call for parity between childbearing and nonchildbearing residents in terms of parental leave length.”