Evolution of Leave Policies in Medical Boards
Kaitlyn Kasemodel, BS1; Wendy Chen, MD2; Chelsea Wallace, MD1; Debra A Bourne, MD1
1Division of Plastic and Reconstructive Surgery, University of Kentucky, Lexington, KY 2Department of Plastic Surgery, University of California Los Angeles, Los Angeles, CA
Background: In 1993, The Family Medical Leave Act mandated employers allow 12 weeks of parental leave to employees without losing their position. The amount of time a resident can take for parental leave without extending training is dictated by the American Board of Medical Specialties (ABMS) for their specialty. Starting July 2021 the ACGME will require all ABMS specialties with two or more years of training to allow for a minimum of six weeks from training for the purposes of parental, caregiver, and medical leave without exhausting vacation/sick time or extension of training. This study aims to assess the current policies of ABMS specialties with regard to parental leave and breastfeeding policies.
Methods: This is a cross-sectional observational study of all primary specialties recognized by the ACGME. Each leave policy was reviewed, and the number of weeks of leave allowed, without delaying graduation, was recorded. Additional leave flexibility, such as merit-based advancement and options to average weeks of absence over training years, were noted. Breastfeeding accommodations during board exams were reviewed. Leave policies of 2020 were compared to those from 2006.
Results: The median time allowed for parental leave without the extension of training was 5.5 ± 2.0 (range 4-12) weeks. Plastic surgery and Obstetrics/Gynecology were the only programs to allow for 12 weeks. There was no significant difference in the mean length of leave between 2006, 2018 and 2020 (5.1 ± 1.2, 4.9 ± 1.2, 5.5 ± 2.0 respectively, p=0.585). There was no significant difference between medical (5.0 ± 1.3) versus surgical (6.4 ± 2.6) specialties (p=0.135). All specialties, except five, guarantee accommodations for lactating mothers during the written board examination.
Conclusion: The American Board of Plastic Surgery’s updated 12-week parental leave policy remains a progressive outlier among ABMS specialties. For a majority of specialties, a 12-week parental leave would result in a delay in graduation, a fact largely unchanged from 2006. Specialty boards should allow all residents to take up to 12-weeks parental leave without delay of graduation or board eligibility as long as educational milestones and operative requirements are met.
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