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Many Top Medical Training Programs Lack Paid Family Leave Policies, Study Finds

Mother and baby. (Courtesy of Juanedc/Flickr)
Mother and baby. (Courtesy of Juanedc/Flickr)

Medical residencies are notoriously grueling. Long hours, inflexible schedules, unrelenting workloads. Now imagine having a new baby on top of that.

For Dr. Kirti Magudia — radiology resident at Brigham and Women’s Hospital and lead author of a new study about parental leave policies for residents — the issue hits close to home. Three years ago, as a first-year resident, she gave birth to her second child. The radiology department allowed her to take eight weeks of paid leave.

“I was pleasantly surprised with how generous the parental leave policy was,” she says, “but I'm aware other residents and other specialties in other institutions aren't as lucky.”

It’s common to hear about mothers getting a few weeks of paid leave, and then using all of their vacation time to extend the period as long as possible, she adds. And when it comes to fathers or non-birth parents, the policies can be equally — if not more — undefined.

Magudia decided to study the landscape more formally after reading an article about paid leave for faculty physicians at the top 12 American medical schools. That study, published in February, showed that faculty receive an average of 8.6 weeks of paid leave.

Collaborating with six other doctors, Magudia's team analyzed paid family leave policies for 15 medical education-sponsoring institutions affiliated with those top schools.

“We found that half of the training institutions don't have paid parental leave policies for trainees, and those that do are much less generous when compared to policies for faculty,” she says.

Eight schools had an actual institutional policy for paid parental leave, and on average, gave 5.7 weeks of paid leave. (The figure rose to 6.6 weeks when they measured both childbirth leave and the designated family leave afforded to childbearing mothers.) Fathers, adoptive parents and parents designated as non-primary received an average of 3.9 weeks of paid leave at these eight schools.

Crafting a good paid parental leave policy requires balancing sometimes-competing needs — the pulls of parenthood, hospital staffing concerns and the importance of graduating competent doctors, the study says.  It is not prescriptive, though it does suggest a need for more research into optimal policies.

I spoke with Magudia about the study and some of her findings. Our conversation has been lightly edited.

What’s the big takeaway from the study?

We found that half of the training institutions don't have paid parental leave policies for trainees, and those that do are much less generous when compared to policies for faculty. At the training institutions without policies, trainees are really at the mercy of their program directors and departments for individual decisions in terms of parental leave.

What surprised you the most about the study?

I was very surprised at how difficult it was to find out about the parental leave policies. It's my belief that this information should be freely and publicly available so that medical students who are deciding where they want to go into training have this information and can take it into account.

How did policies affect mothers and fathers differently?

Fewer institutions have paid parental leave policies for men, and those that do are less generous compared to those for the childbearing parent.

And anecdotally, we know that often men get little to no leave, which seems extremely unfair because they're also a parent and in this day and age, we want both parents to contribute to the raising of the child.

What does your study tell us about the top training institutions in Boston?

Our study included Partners HealthCare, which is the organization that includes residents at both Brigham and Women's Hospital and Massachusetts General Hospital. At the time of this study, we had a parental leave policy in place, but these policies are constantly changing. Since the article went to press, Partners announced a new paid parental leave policy for residents that affords eight weeks for both men and women.

(In an email statement, Partners spokeswoman Bridget Perry clarifies that all Partners trainees are eligible for eight weeks of paid family leave. She says the new policy, which has been in the works for about two years, applies to mothers, fathers and adoptive parents equally. Under the old policy, only birth mothers received eight weeks of paid leave.)

Do we know anything about the institutions not counted in these top few? Are their policies better or worse?

I don't specifically have information about the institutions that we didn't survey, but I hope that the data from this study will motivate other institutions to develop paid parental leave policies if they don’t already have them.

What would an ideal policy look like?

I think that what Partners has in terms of eight weeks for both men and women is an incredible start. It shows that we're treating both men and women equally, as well as adoptive parents, and those who are adopting equally to those that are having the children themselves. I think a policy like this, if it became available to more people, would be very, very helpful.

Any last thoughts?

People assume residency is going to be difficult, but I think that that these assumptions are changing over time as we pay more attention to overall wellness and resident burnout. I think it’s good that we're thinking about how to promote the well-being of residents in their personal lives as parents, and also in their professional lives. A good paid parental leave policy is an extremely important part of promoting success for residents who also happen to be parents.

This article was originally published on December 12, 2018.

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Miriam Wasser is a reporter with WBUR's climate and environment team.

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