Fellowship Council Parental and Medical Leave Recommendation
The increased health risks that gestational parents may face during residency training has been demonstrated in recent studies. As a result, several groups have called for and encouraged training programs to support adequate leave to mitigate risks and support healthy family development. The ACGME and ABMS has now mandated at least 6 weeks of trainee parental leave for all specialty boards. However, recently there has been more focused interest on the specific increased risks associated with surgical training and, as such, the need for updated guidelines to support gestational parent surgery trainees and their non-gestational partners.
In response to the known risks and issues related to having a child during training, the FC is implementing a parental and medical leave recommendation. The FC acknowledges that there may be specific institutional policies in place regarding paid time off, and the FC recommendations cannot provide oversight for local human resource regulations. Additionally, the FC understands that certain state or federal laws may require that additional unpaid leaves of absence are provided. Despite these limitations, the FC recommends the following:
- Fellows who take parental, pregnancy or medical leave are required to perform a minimum of 44 weeks of clinical time during the fellowship year to successfully complete the fellowship program. An extension to the fellowship program may be provided to fellows who need more than 8 weeks of parental, pregnancy or medical leave.
- Gestational fellows and/or a non-gestational partner must be able to freely attend pre-pregnancy fertility visits, prenatal medical visits and pediatric appointments. Gestational parents must also be provided with lactation facilities and the time to address lactation needs during work hours, in accordance with state and federal law.
- Gestational parents should be allowed a total of 8 weeks parental and pregnancy leave—to include 6 weeks of parental leave plus an additional 2 weeks of allowed vacation time due to conditions related to their pregnancy, childbirth, or related medical condition. Gestational parents must also be permitted unpaid leave in accordance with state and federal law.
- Non-gestational parents should be allowed a total of 6 weeks parental leave—to include 4 weeks of parental leave plus an additional 2 weeks of allowed vacation time to care for a newborn baby or newly placed child for adoption or foster care. Accommodations should be available such that the fellow can choose schedule alterations that best fit their family’s needs.
- Special considerations should be given for altered work hours and reduced call schedules for the health of a gestational parent, especially during the third trimester. Overnight call during the last month of pregnancy should be avoided.
- Non-pregnancy related medical leave (personal illness, time needed to care for family members with illness, etc.) should also be provided for up to 8 weeks total (6 weeks medical leave plus up to 2 weeks of vacation).
- Graduating fellows are expected to meet all of their case/clinic/other FC requirements.
- A maximum of 8 weeks of leave is permitted during any fellowship, whether the fellowship is one or two years.
Any leave required in excess of the aforementioned, including unpaid leaves provided in accordance with state and federal law, shall be reviewed by the Change Sub-committee of the Fellowship Council, and each case will be considered on an individual basis. Extension of fellowship beyond the 12-month period may be required in some cases, with prior approval. EPA performance may be used as supplemental consideration in these cases.
Each program should consult their human resources department and employment and labor attorney for information regarding individual institutional policies.
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Casilla-Lennon M, Hanchuk S, Zheng S, et al. Pregnancy in physicians: A scoping review. Am J Surg. 2022;223:36-46. doi: 10.1016/j.amjsurg.2021.07.011.
Castillo-Angeles M, Smink D, Rangel E. Perspectives of General Surgery Program Directors on Paternity Leave During Surgical Training. JAMA Surg.2021 Dec 1;e216223. doi: 10.1001/jamasurg.2021.6223. Online ahead of print.
Terhune KP, Aarons CB. Parental Leave-Are We Implementing Perspectives Rather than Policies? JAMA Surg. 2021 Dec 1 doi: 10.1001/jamasurg.2021.6258. Online ahead of print