Medical residency is an important part of a physician’s education, but it’s well-known as being challenging, and it becomes even more complicated when considering having a baby and needing maternity leave. However, it is possible to find a balance between being a mother and pursuing a career in medicine with sufficient support and resources. This article explores maternity leave options during medical residency and highlights the significance of taking an approach that acknowledges both the rigorous demands of medical training and the personal aspects of being a mother.
Overview of Maternity Leave Options in Residency
The landscape of maternity leave options is diverse, with each residency program setting its own rules, underscoring the need for residents to be acutely aware of their program’s specific policies as well as federal laws. Legislation regarding maternity leave include:
- Family and Medical Leave Act (FMLA): Offers eligible employees up to 12 weeks of unpaid, job-protected leave annually, while maintaining group health benefits.
- Pregnant Workers Fairness Act (PWFA) & Americans with Disabilities Act (ADA): Safeguards the rights of pregnant workers, mandating reasonable accommodations and prohibiting discrimination.
While each program has their own policies, some examples include:
- American Board of Medical Specialties (ABMS): Residents are entitled to at least six weeks of leave for parenting, caregiving, and medical reasons during their training, without extending their training duration.
- Accreditation Council for Graduate Medical Education (ACGME): Residents get a minimum of six paid weeks off for medical, parental, and caregiver leave.
- American Academy of Family Physicians (AAFP): Residents get 12 weeks of paid parental leave with the duration at the resident’s discretion.
There is a need for more uniform and comprehensive leave policies for the well-being of residents and their families, but until then, residents must be well-versed in their program’s policies and their entitlements under federal laws when considering maternity leave options.
Evaluating Leave Duration & Timing
The ABMS policy sets a baseline of six weeks for parental leave, yet returning to work after such a brief period can be daunting without robust support. When planning maternity leave, it’s important to find an equilibrium that honors both personal and programmatic needs, safeguarding the health of parent and child, fulfilling educational obligations, and ensuring continuous patient care.
Paid vs. Unpaid Leave
The type of maternity leave—paid or unpaid—can profoundly influence the experience of new parents financially, physically, and mentally.
Paid Maternity Leave
Paid maternity leave, where employers remunerate employees during their leave following childbirth or adoption, fosters advantages like better mental and physical health outcomes, reduced postpartum depression, enhanced child development, and higher breastfeeding rates. Unfortunately, paid maternity leave is fairly uncommon in the United States due to the absence of a national paid leave standard. But there have been legislative efforts to establish one, such as the Build Back Better Act and the Healthy Families Act. Additionally, some states and localities have enacted laws to broaden paid leave access.
Unpaid Maternity Leave
Unpaid maternity leave, as outlined by FMLA, offers job protection but lacks financial support. The majority of workers in the U.S. must use unpaid leave, which can lead to significant health, financial, and career repercussions, particularly for low-income workers.
Finding Paid Leave Opportunities
To discover paid leave opportunities, employees should consult their company’s HR department or employee handbook and stay informed about state and local laws that may offer expanded paid leave options.
Financial & Career Implications of Unpaid Leave
Opting for unpaid leave can have considerable financial consequences, potentially causing stress and adversely affecting the health of mother and child. Career-wise, extended time away from work can hinder career progression, especially in competitive fields.
Flexible Scheduling & Part-Time Residency
Navigating parenthood during medical training is challenging, yet achievable with flexible scheduling and support.
Flexible Scheduling
Flexible scheduling allows new parents the ability to balance their home and work lives by adapting their schedule as needed. The American Board of Surgery (ABS) General Surgery Family Leave Policy allows residents to use their yearly non-clinical time, including non-clinical time from other years of the program, to take leave, as well as extend their final year while still taking that year’s qualifying exam (with prior approval).
Part-Time Residency
Part-time residency, another viable option, affords residents the ability to balance professional and personal obligations. The ABS’s flexible approach to the 48-week requirement exemplifies this adaptability by allowing residents to spread their five years of residency over six (with prior approval).
Post-Maternity Leave Scheduling
Post-maternity leave, institutions should foster supportive policies for breastfeeding medical trainees, including adequate lactation facilities, protected time for breast milk expression or breastfeeding, and clear policy guidelines.
Extended Leave & Deferring Residency
Contemplating an extended maternity leave or deferring residency is a decision with far-reaching implications that demand thoughtful deliberation.
Extended Maternity Leave
The ABMS policy’s six-week leave baseline is a starting point, but programs vary in their paid leave offerings, and the FMLA only entitles residents to 12 weeks of unpaid, job-protected leave. Residents must weigh personal factors, including leave policies, financial stability, and support systems, when planning a pregnancy during residency.
Deferring Residency
Deferring residency is not as straightforward as deferring other educational pursuits. It typically involves taking a year off during medical school or between medical school and residency, the latter possibly affecting match rates. As for loans, current AMA policy and the AMA-endorsed Resident Education Deferred Interest (REDI) Act advocates for interest-free deferment on student loans for medical and dental interns and residents, potentially easing financial burdens.
Impact of Long-Term Leave
Extended leave can delay a resident’s training and graduation timeline. Residents considering such a leave should discuss potential implications with program directors and other relevant parties before deciding.
Navigating Leave with Special Circumstances
Maternity leave planning must be flexible to accommodate unique circumstances, such as health complications or multiple births. Personalized care plans, regular communication with healthcare practitioners, and informed decision-making are crucial.
Individualized Maternity Leave Plans
Personalized care plans should reflect each individual’s unique circumstances, ensuring safe and personalized care throughout the maternity journey.
Dealing with Complications
Managing pregnancy complications, from high blood pressure to mental health issues, requires close collaboration with healthcare teams to adjust maternity leave plans accordingly.
The Bottom Line: Know Your Maternity Leave Options
Taking a maternity leave in residency is complex due to the need for balance between work and home. There is a wide variety of leave options available, but significant variation in maternity leave policies across different residency programs can make it difficult to know which path is right while also considering personal circumstances, financial aspects, and career considerations. When planning a maternity leave, make sure to find out your program’s leave options, review FMLA, PWFA, and ADA policies, and talk to your program director. Additionally, stories from physicians highlight the importance of establishing a solid routine, maintaining open communication with family and colleagues, practicing stress management, and prioritizing self-care.
