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Pregnancy Leave During Residency? Opportunities for Organizational Change!

Almost 50% of residents are women.  It is estimated that 20% of them will become pregnant during their training.  Is this a cause for alarm?

Program directors wonder: Who will cover the call schedule? Can the resident finish her educational requirements to graduate on time? The pregnant resident worries: What if I get sick or my baby is ill? Will I have enough time off to come back ready to finish my training?

Pregnancy during residency need not be as burdensome as some might believe. Creativity in educational opportunities are all around us—we just have to look with an open mind.

The fact remains that while prime child bearing years coincide with medical school and residency training, training institutions can respond to everyone’s needs. Unique solutions are emerging and are generalizable once we really think about them. These solutions run the gamut from off-site electives to using already present programmatic requirements (such as research rotations) to lighten the load for new mothers and fathers.

ETI member, Melanie Cree Green, MD reported on the experiences her institution had with one such solution–an elective for the parents of a newborn. Working with the ACGME (Accreditation Council for Graduate Medical Education), a non-core elective was created to make the at-home parent/infant neonatal period into a valid educational experience.

How did they do it?  Readings about neonatal development. Critiquing a “parenting” book, which then becomes part of the institution’s library.  Attending and reporting on their experiences at out-patient baby visits.  Taking a breastfeeding course.  Then the resident/new parent presents on a topic not usually covered in the curriculum to the other residents, faculty and medical students in pediatrics, obstetrics and gynecology, and family medicine, where the elective is pertinent and available.

The benefits for the trainees? Exposure to areas that may not be taught in the usual course of training but are questions they will have to field from new parents.  The trainee stays connected to “becoming a doctor” while experiencing work-life integration as a natural process. The experience makes the young doctor look at the “patient/parent” side of things differently. And finally, the resident can stay on track and finish on time.

The benefits for the hospitals and medical schools? Substantive contribution to the workplace knowledge and experiences. The residents stay “on-track,” with numerous benefits ranging from funding integrity to resolved scheduling issues. Residents with valuable communications skills who can now better empathize with new parents and their infant patients.  Their programs have an advantage for these highly valued residents.

Imagine how other situations can be transformed into educational experiences that are in keeping with the ACGME’s recommendations that “electives should be designed to enrich the educational experience of residents in conformity with their needs, interest and/or future professional plans.” At our institution, a pediatric resident had a child born with Down Syndrome who had serious cardiac problems. While he took time to care for the child, why not create an elective from his experiences?

A serious family illness might lead to an elective on hospice care, the care of transplant patients, or coordinating care for the elderly.  Now we have family medicine, internal medicine residents, geriatricians and even surgeons with new alternatives. Time taken off for one’s own health needs might be constructed into an elective about the healthcare issues facing a patient from access to rehabilitation, including pain management, choosing a physician and other such important issues.

No, pregnancy during residency need not be as burdensome as some might believe. Creativity solutions in educational opportunities are all around us.  Together we just have to look with an open mind and a little imagination.

6 Notes

  1. It would be a sad world if we didn’t let people take a break when they we’re pregnant. I don’t think they should get the entire time off but the last two months or so. Plus a month or two for the baby and to recover. It’s good that they are working with them on this.

  2. If you actually want to be the DOCTOR in the ER or OR, you’re going to have to go thogruh the whole college, medical school, internship residency deal just like any other M.D. There are other jobs working in the ER or OR (medical technician, for example) that you can do with less than a 4 year degree if you’re just interested in working in that environment.

  3. The surgery program at Washington University in St. Louis was described to me by two of its female residents as flexible. This was because they are training “academic surgeons” and have two years of research during which some of the residents found conducive to starting a family. I tried connecting to the chair at the program, however, was unsuccessful. Good luck in your career. I had my first child during a surgitcal (ENT) residency and so I know it can be done.

  4. Thank you! I love the positive nature of this post! Do you know specifically of any progressive surgery programs that are offering such electives or creative solutions?

    Thank you again

  5. I feel satisfeid after reading that one.

  6. None too soon to expound on this subject. Thanks.


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