Parental leave during pediatric fellowship training: A national survey

Abstract

Background: Until recently, no uniform requirements for parental leave (PL) existed in graduate medical education. We implemented a national survey, with the objective of ascertaining fellows' perceptions of PL policies and their impact. This is the first study to focus exclusively on pediatric subspecialty fellows.

Methods: An online survey instrument was created targeting pediatric fellows.

Results: The survey was accessed by 1003 (25%) of the estimated 4078 pediatric subspecialty fellows and 853 (21%) submitted surveys. Respondent demographic data paralleled the data reported by the American Board of Pediatrics. Half of respondents did not know whether their program had a written PL policy. Over 40% reported ≥ 5 weeks of paid PL. Most indicated that fellows use vacation, sick leave, and unpaid time for PL. Almost half of respondents (45%) indicated that their program's PL policy increases the stress of having a child. Fellows chose establishing/extending paid leave and intentionally fostering a more supportive program culture as the most crucial candidate improvements. The importance of equitable PL polices between parent fellows and co-fellows was an important theme of our qualitative data. Fellows feel there is a moral misalignment between the field of pediatrics' dedication to maternal and child health and current PL policies governing pediatric trainees.

Conclusions: PL policies vary widely among pediatric fellowship programs and are often not known by fellows. Fellows are not satisfied with PL policies, which often exacerbate stress for new parents and burden their co-fellows. Targeted modification of several aspects of PL policies may improve their acceptance.

Fig 1. Breakdown of survey responses.

Abbreviations: Pediatric Emergency Medicine (PEM). ^a American Board of Pediatrics 2019–2020 fellowship data. ^b Pediatric fellows at the University of Colorado. Data from the pilot study is not included in the data analysis of this manuscript. ^c The survey was distributed separately to PEM fellows via the PEM program director listserv. ^d An accessed survey is one where a respondent has clicked on the survey link and proceeded to the survey questions, after reviewing the welcome page of the survey. ^e A completed survey is one that was accessed, answered, and submitted. ^f An incomplete survey is one that was accessed and partially completed but not submitted. Partial answers were included in the data analysis of this manuscript. ^g An empty survey is one that was accessed but left unanswered for all questions.

Fig 2. Ranking of the proposed changes to fellowship programs.