https://orcid.org/0009-0004-5562-1469
Medical training should develop the whole person and promote work-life integration. Corbisiero et al’s recent review, “Formal Parental Leave Policies and Trainee Well-Being in US Graduate Medical Education: A Systematic Review” highlights how current parental leave policies are inadequate in duration, leaving trainees at increased risk for burnout and post-partum depression, and are associated with perceived negative career impacts and stigmatization.1 Despite longer parental leave in Canada, new parent trainees report similar perceptions of career impact and stigma upon their return to work.2 With the mounting pressures on new parents, and the rising rates of burnout among residents and fellows, I believe it is time to challenge the current training culture and adopt time-flexible postgraduate medical education.
Parenting today is no small feat. My own journey as a parent began midway through my pediatric critical care fellowship, during which I took an 11-month parental leave. Despite program support and a gradual re-entry, I felt considerable pressure to balance my performance at work and as a parent. Parental stress and mental health challenges are well-known adverse childhood experiences, a topic recently addressed by the US Surgeon General.3 In his introduction to the advisory, Dr Murthy says, “The work of raising a child is work, no less valuable than the work performed in a paid job and of extraordinary value when it comes to the impact on the future of society….society as a whole must see itself as sharing in this responsibility—and shaping policy, programs and individual behavior accordingly.”2 These pressures, coupled with concerns of negative career impacts and strained collegial relationships, are common obstacles faced by trainees returning to work after parental leave.1,3 It behoves us as a profession to rethink how new parent trainees are supported during training.
Postgraduate medical education is the first stage of a physician’s career journey. We must shift away from rigid, time-based residency training and view residency and fellowship as growth opportunities, not races to a finish line. The United Kingdom (UK) implemented alternative, less-than-full-time (LTFT) training options, as early as the 1960s.4 In 2022 17.1% of UK trainees were working LTFT, with the trend increasing each year.4 These programs have been widely accepted by trainees despite some administrative obstacles, such as scheduling and pay problems.4 Such models could support new parents in their transition back to work while ensuring that physician trainees gain the depth and breadth of experience they need to develop competency.5 Similar to work-hour restrictions, time-flexible training can maintain patient safety and quality of care as core priorities in medical training. Neither being a physician nor a parent is easy, but by adopting time-flexible training models, we can reduce burdens and foster a supportive environment for our future.
The author would like to thank Dr Julie Nyquist and Dr Velyn Wu for their mentorship.
