Nav: Home

Medical training or a family? Residents, training programs seek balance

December 11, 2018

ANN ARBOR, Michigan -- A new analysis finds striking inconsistency in parental leave policies at the nation's top residency programs, illustrating the enormous challenge these programs face balancing training the next generation of doctors and supporting trainees' personal and family needs.

On the one hand: Hospitals depend on the clinical care their residents provide. Extended family leaves can affect staffing, as well as residents' ability to build competency. On the other hand: New parents have physical and emotional needs, and aspiring doctors should not have to delay having children beyond their peak years of fertility.

"Becoming a doctor includes a long period of training and service. At the same time, we are seeing growing attention in medicine to the integration of career and family. It's extraordinarily complicated and challenging to balance the competing demands here," says Reshma Jagsi, M.D., D.Phil., director of the Center for Bioethics and Social Sciences in Medicine at the University of Michigan, and co-senior author of the study.

She and colleagues at five other institutions assessed formal leave policies for residents who have a new baby. They looked at the top graduate medical education programs, according to two different published rankings. Using institutional websites, they searched for policies regarding parental leave for residents. Policies were verified by the institutions. Results are published in JAMA.

Of 15 teaching hospitals, eight had an institutional policy providing paid childbearing or family leave for residents. The average maternity leave was 6.6 weeks. For same-sex couples, adoptive parents or fathers, paid leave policies averaged 3.9 weeks.

"In my opinion, there is an urgent need for medical schools to create more generous family leave policies for all of their trainees," says co-senior study author Christina Mangurian, M.D., MAS, professor of psychiatry and vice chair for diversity and health equity at UC San Francisco. "Regarding birth-mothers specifically, I believe that expanding childbearing leave will not only benefit the mental and physical health of these mothers and their babies, but will also support our long-term goal to have women thrive in medicine by providing support when they need it most."

A recent report found that the average childbearing leave for faculty physicians at 12 top medical schools was 8.6 weeks. Of the institutions representing the residency programs studied, all of them had policies for faculty physicians.

"It's remarkable that nearly half of these institutions lacked a common institution-level policy for resident parental leave, even though they all had at least some policy to support faculty leave. In some cases, even where policies did exist, it was difficult to find out what they were. And the policies that did exist typically didn't cover common concerns, like whether on-call duties have to be paid back. Certainly, department-level policies exist in some cases and individual accommodations occur. But it's challenging for individuals to make family planning decisions when accommodations are ad hoc, expectations are opaque, and policies vary so widely," Jagsi says.

The authors emphasize that there's likely no magic formula for parental leave for residents. Instead, they encourage developing transparent and consistent policies that take into account both the importance of medical training and the need to honor childbearing years.

"Teaching hospitals are directing greater attention to the challenges of parenting during graduate medical training, amid a sharper focus on physician well-being overall. Change is certainly occurring, though not as quickly as we'd like," says study author Debra Weinstein, M.D., vice president of graduate medical education at Partners HealthCare and associate professor of medicine at Harvard Medical School.

"Failing to recognize and accommodate the physical and emotional needs of childbirth and parent-child bonding is inappropriate within a profession that, at its core, seeks to promote human health. Simply put: no one should have to choose a medical career at the cost of being able to have a family," Jagsi says.
-end-
Additional authors: Kirti Magudia, M.D., Ph.D.; Alexander Bick, M.D., Ph.D.; Jeffrey Cohen, M.D.; Thomas S.C. Ng, M.D., Ph.D.

Funding: None

Disclosure: None

Reference: JAMA, published Dec. 11, 2018, doi: 10.1001/jama.2018.14414

Michigan Medicine - University of Michigan

Related Medicine Articles:

Moving beyond 'defensive medicine'
Study shows removing liability concerns slightly increases C-section procedures during childbirth.
Artificial intelligence and family medicine: Better together
Researcher at the University of Houston are encouraging family medicine physicians to actively engage in the development and evolution of artificial intelligence to open new horizons that make AI more effective, equitable and pervasive.
NUS Medicine researchers can reprogramme cells to original state for regenerative medicine
Scientists from NUS Medicine have found a way to induce totipotency in embryonic cells that have already matured into pluripotency.
Protein injections in medicine
One day, medical compounds could be introduced into cells with the help of bacterial toxins.
Study reveals complementary medicine use remains hidden to conventional medicine providers
Research reveals that 1 in 3 complementary medicine (CM) users do not disclose their CM use to their medical providers, posing significant direct and indirect risks of adverse effects and harm due to unsafe concurrent use of CM and conventional medicine use.
Study of traditional medicine finds high use in Sub-Saharan Africa despite modern medicine
Researchers who have undertaken the first systematic review of into the use of traditional, complementary and alternative medicines (TCAM) in Sub-Saharan Africa found its use is significant and not just because of a lack of resources or access to 'conventional medicine'.
New techniques allow medicine to see the whole again
Medical diagnoses mostly focuses on resolving isolated issues. But, fixing one problem may create others and even invoke an overall health collapse.
Progress toward personalized medicine
A few little cells that are different from the rest can have a big effect.
CU School of Medicine's Kenneth Tyler article in New England Journal of Medicine
Kenneth Tyler, M.D., the Louise Baum Endowed Chair in Neurology at the University of Colorado School of Medicine, is author of a review article about acute viral encephalitis in the current issue of The New England Journal of Medicine.
An advance for precision medicine
Scientists have developed a method to quickly and efficiently recognize the subtypes of cells within the body for the first time.
More Medicine News and Medicine Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Making Amends
What makes a true apology? What does it mean to make amends for past mistakes? This hour, TED speakers explore how repairing the wrongs of the past is the first step toward healing for the future. Guests include historian and preservationist Brent Leggs, law professor Martha Minow, librarian Dawn Wacek, and playwright V (formerly Eve Ensler).
Now Playing: Science for the People

#565 The Great Wide Indoors
We're all spending a bit more time indoors this summer than we probably figured. But did you ever stop to think about why the places we live and work as designed the way they are? And how they could be designed better? We're talking with Emily Anthes about her new book "The Great Indoors: The Surprising Science of how Buildings Shape our Behavior, Health and Happiness".
Now Playing: Radiolab

The Third. A TED Talk.
Jad gives a TED talk about his life as a journalist and how Radiolab has evolved over the years. Here's how TED described it:How do you end a story? Host of Radiolab Jad Abumrad tells how his search for an answer led him home to the mountains of Tennessee, where he met an unexpected teacher: Dolly Parton.Jad Nicholas Abumrad is a Lebanese-American radio host, composer and producer. He is the founder of the syndicated public radio program Radiolab, which is broadcast on over 600 radio stations nationwide and is downloaded more than 120 million times a year as a podcast. He also created More Perfect, a podcast that tells the stories behind the Supreme Court's most famous decisions. And most recently, Dolly Parton's America, a nine-episode podcast exploring the life and times of the iconic country music star. Abumrad has received three Peabody Awards and was named a MacArthur Fellow in 2011.