Currently, the mean age for someone starting medical school in the US is 24 years. That means that the mean age for starting a Pediatrics residency is 28 years. These years of medical training coincide with the years when many adults begin having children.
However, even though pediatrics has one of the highest proportions of females, we don’t make it easy for our residents to have children during training. There are no standards for paid parental leave (the majority of residents take fewer than 8 weeks of parental leave), and the American Board of Pediatrics requires 33 months of clinical training for board eligibility.
How do these policies impact residents’ decisions about family planning? The Association of Pediatric Program Directors (APPD) LEARN Parenthood in Pediatric Residency Study Consortium conducted a survey of pediatric residents on this topic, and the results are being early released by Pediatrics, in an article by Dr. Kelly Dundon and colleagues from the University of Washington, Harvard Medical School, the University of Illinois at Chicago, and the APPD, entitled, “Parenthood and Parental Leave Decisions in Pediatric Residency” (10.1542/peds.2021-050107).
The authors invited 845 pediatric residents at 13 institutions to participate in an online survey, and 639 (76%) responded. 70% of respondents were female. 16% (64 mothers and 36 fathers) were parents; 45% had their first child before residency, and 55% had a child born during residency.
The vast majority of residents (85%) wanted to have children (either first or additional) in the future. Half reported that they were delaying having children, and this was a more common response for the females. Most common reasons for delaying having children were “busy work schedule,” “finances,” and “desire not to extend residency.”
More than one-quarter of maternity leaves were 6 weeks or less in duration; most partners took less than 2 weeks leave. The most common reason for the duration of leave was the desire not to extend residency training, and most expressed a wish that the leave could have been longer in duration.
There is so much to digest from this study. You will want to read the entire article to learn about the perceived impact of current parental leave policies on resident well-being, breastfeeding duration, and burnout.
It should be noted that this study was conducted in academic year 2019-2020. Beginning in July 2021, the American Board of Medical Specialties (including the American Board of Pediatrics) now allows for a single 6-week period away from training, separate from vacation or sick leave, and not necessitating extension of training. This is certainly a good start, and we’ll have to see what impact this has on family planning decisions for pediatric residents.
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