P2A044: Experiences with Parental Leave Policies for Female Pediatric Physicians Reveals Inadequacies and Dissatisfaction

Background: Studies have shown that spending time with a newborn has physical and mental health benefits for both parent and newborn, and the American Academy of Pediatrics supports creation of federal policy providing up to 12 weeks of paid family leave. The United States is one of 41 nations without federally mandated paid parental leave. The demands of medical education and training add a layer of difficulty for female physicians seeking parental leave after the addition of a child to their family. Additionally, the pediatric workforce is >50% female. The objective of this study is to evaluate knowledge of and experiences with institutional parental leave policies and the approaches that female pediatricians and pediatric specialists utilize to take parental leave in different practice settings.

Methods: A survey was distributed via private female physician social media groups in October 2022, and anonymous responses were collected. “Pediatric physicians” includes pediatricians and pediatric subspecialists across medical and surgical disciplines. Descriptive and inferential statistics were used for analysis of responses.

Results: 3235 physicians completed the survey, and 25.9% (839) were pediatric physicians in the US. Of the 839 physicians, 51.5% were general pediatricians, 43.7% were medical subspecialists, and 4.8% were surgical subspecialists. Respondents were located in all US regions: 35% in the South, 22.8% in the West, 20.8% in the Midwest, 19% in the Northeast, and 0.6% in the Pacific. The mean age at first childbirth, adoption, fostering, or child via surrogate was 32.2 years (SD 3.4).

Physicians working at academic or university-affiliated institutions were significantly more likely to have a paid parental leave policy than those in private or community-based practices (71.2% vs 54.6%, p< 0.001). Of 671 respondents who had a child while at their current institution, the median length of paid leave offered was 6 weeks (IQR 0-8), and median length of any leave taken was 10 weeks (IQR 6-12). Of those who took parental leave and reported their institution had a parental leave policy, 64.7% (275/425) were dissatisfied with the parental leave policy and 61.4% (261/425) were dissatisfied with the length of their leave taken. Selected survey responses are in Tables 1 and 2. Of attending/faculty-level respondents who had RVU goals, 29.1% (83/285) reported that their RVU goals were adjusted based on parental leave.

Conclusion: Most female pediatric physicians were not satisfied with parental leave policies. The use of vacation, personal days, and short-term disability reflects inadequate availability of paid leave, and more than half of respondents took unpaid time for parental leave. RVU adjustments were not available for the majority of respondents when they took leave. Further work is needed to improve parental leave policies for female physicians in all types of practice.