Fellowship or Family? A Comparison of Residency Leave Policies With the Family and Medical Leave Act

J Surg Res. 2019 Sep:241:302-307. doi: 10.1016/j.jss.2019.03.004. Epub 2019 Apr 29.

Abstract

Background: In 1993, the Family and Medical Leave Act (FMLA) mandated 12 weeks of unpaid, job-protected leave. The current impact of taking 12 weeks of leave during residency has not been evaluated.

Methods: We examined the 2018 Accreditation Council for Graduate Medical Education (n = 24) specialty leave policies to determine the impact of 6- and 12-week leave on residency training, board eligibility, and fellowship training. We compared our findings with a 2006 study.

Results: In 2018, five (21%) specialties had policy language regarding parental leave during residency, and four (16%) had language regarding medical leave. Median leave allowed was 4 weeks (IQR 4-6). Six specialties (25%) decreased the number of weeks allowed for leave from 2006 to 2018. In 2006, a 6-week leave would cause a 1-year delay in board eligibility in six specialties; in 2018, it would not cause delayed board eligibility in any specialty. In 2018, a 12-week (FMLA) leave would extend training by a median of 6 weeks (mean 4.1, range 0-8), would delay board eligibility by 6-12 months in three programs (mean 2.25, range 0-12), and would delay fellowship training by at least 1 year in 17 specialties (71%). The impact of a 12-week leave was similar between medical and surgical specialties.

Conclusions: While leave policies have improved since 2006, most specialties allow for 6 weeks of leave, less than half of what is mandated by the FMLA. Moreover, a 12-week, FMLA-mandated leave would cause significant delays in board certification and entry into fellowship for most residency programs.

Keywords: FMLA; GME; Gender bias; Leave; Maternity; Paternity.

Publication types

  • Comparative Study

MeSH terms

  • Accreditation / legislation & jurisprudence
  • Cross-Sectional Studies
  • Female
  • Humans
  • Internship and Residency / legislation & jurisprudence
  • Internship and Residency / statistics & numerical data*
  • Legislation, Medical
  • Male
  • Medicine / statistics & numerical data*
  • Parental Leave / legislation & jurisprudence
  • Parental Leave / statistics & numerical data*
  • Policy
  • Specialty Boards / legislation & jurisprudence
  • Time Factors
  • United States
  • Work-Life Balance / legislation & jurisprudence
  • Work-Life Balance / statistics & numerical data*