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Gracey LE, Cronin M, Shinkai K, Mathes EF. Program Director and Resident Perspectives on New Parent Leave in Dermatology Residency. JAMA Dermatol. 2018;154(10):1222–1225. doi:10.1001/jamadermatol.2018.2878
New parent leave (NPL) has been defined as leave from work for all parents after welcoming a child regardless of how they became parents (including giving birth to a child, adoption, surrogacy, or fostering). New parent leave is essential for the well-being of the infant and family. Of note, the United States and Papua New Guinea are the only 2 nations in the world that do not have statutory paid leave.1
A study reported that 64.1% of dermatology residents are women, most of childbearing age.2 A recent survey found that female dermatologists were most likely to have a child during residency (51%) compared with during other stages of their training and career.3 Residents have a finite time to learn their medical specialty and are subject to rules of the American Board of Dermatology (ABD)4 and varying institution-specific policies for absences during their training. The goal of our work was to investigate how NPL is currently handled in dermatology residency programs and how the policies are perceived by program directors (PDs) and residents.
The resident and PD surveys about NPL were sent via the Association of Professors of Dermatology email listserv, which includes the PD and chairs of 91 discrete residency programs, who then forwarded the resident survey link to members of their residency program; responses were collected from October 16, 2017, to March 13, 2018. The resident response rate could not be calculated owing to this distribution method. Survey answers were deidentified and analyzed using Excel (Microsoft Corp). This study was granted exempt status by the University of California, San Francisco Institutional Review Board. Participation was optional, and participants had to provide informed consent before accessing the survey.
Of the 91 programs surveyed, 54 PDs (59.3%) and 139 residents responded. The PDs reported that their residency programs consisted of 261 women (65.3%) and 245 men (34.7%). During the past 5 years, programs had a mean of 4.4 pregnant residents and 2.1 nonpregnant residents take NPL. Only 1 PD reported having a resident who had to delay taking the board examination. The NPL policies varied in their inclusion of pregnant residents (49 [100%]), nonpregnant partners (39 [79.6%]), adoptions (22 [44.9%]), and fostering or surrogacy (11 [22.4%]).
For the resident survey, of the 139 responders, 98 (70.5%) were women, 40 (28.8%) were men, and 1 (0.7%) was a person of nonbinary gender. The mean (SD) age of residents at the beginning of residency was 27.8 (2.3) years (range, 24-39 years). Of the responding residents, 37 (29.8%) became parents during residency.
As indicated in Table 1, the 12 residents who were pregnant and gave birth to a child took a mean (SD) leave of 6.8 (2.6) weeks (range, 4-14 weeks). One resident was active duty military and took 14 weeks, which was the longest reported in the study; the military guarantees 12 weeks paid leave. The 6 male residents who became new parents had a mean (SD) leave of 2.0 (2.6) weeks (range, 0-8 weeks). Resident and PD perceptions of NPL are presented in Table 2.
We observed significant variation among dermatology residency programs for how NPL was handled. Many PDs commented that a lack of clarity on the rules from the ABD results in variable lengths of leave, usually erring on very short leaves. The number of male and female residents who reported their length of leave was low (n = 18), possibly because of survey question fatigue or concern about negative consequences for themselves, the program, or future parents.
We were struck by the baseline lack of awareness by residents of NPL policies despite most programs having policies in place. We also noticed a discrepancy between PDs and residents when it came to opinions of sufficiency of NPL and pumping facilities. A limitation of our study was an inability to determine which programs were being represented by the deidentified PD and resident surveys. Our findings suggest that residency programs and the ABD should examine and clarify NPL policies for residents to ensure that they support new parents and safeguard their physical and mental health as well as career development.
Accepted for Publication: June 25, 2018.
Corresponding Author: Lia E. Gracey, MD, PhD, Baylor Scott & White Health, 200 Medical Pkwy, Ste 270, Lakeway, TX 78738 (firstname.lastname@example.org).
Published Online: August 29, 2018. doi:10.1001/jamadermatol.2018.2878
Author Contributions: Drs Gracey and Mathes had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Cronin, Shinkai, Mathes.
Acquisition, analysis, or interpretation of data: Gracey, Cronin, Mathes.
Drafting of the manuscript: Gracey, Shinkai, Mathes.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: Gracey.
Supervision: Shinkai, Mathes.
Conflict of Interest Disclosures: None reported.
Disclaimer: Dr Shinkai is Editor of JAMA Dermatology, but she was not involved in any of the decisions regarding review of the manuscript or its acceptance.
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