“I haven’t had many options because the ACGME [Accreditation Council for Graduate Medical Education] is the body that governs time off. Six weeks a year is the maximum amount you can take and that includes sick time and vacations. With my second pregnancy, I took two weeks’ sick time and three weeks’ short-term disability, then couldn’t take vacations. Plus I had to make up calls for a year,” she said. “This time I’ll be taking five weeks’ maternity leave, and I’ve made up my calls in advance.”
Explore this issue:March 2017
Given the limits of official benefits, it is often incumbent upon the medical practice team to establish policies that are fair and cooperative. For numerous cultural and practical reasons, some specialties tend to be more flexible than others. Training programs in ob-gyn have led the pack in developing schedules to accommodate maternity. Drs. Woodson and Tieu both say that the culture of otolaryngology is more family-oriented than many other specialties; however, they note that other departments, such as general surgery, are much more rigid and tradition bound, recalling the days when pregnancy was regarded as an illness.
“A lot depends on the kind of group you’re in,” said Dr. Woodson. “You hope that they’ll give you time off without call if you need it in late pregnancy and that you can have enough time after the birth to stay at home without any clinical obligation. Some women want to come back and work part-time and some really want to go full force. You have to know what works for you—and negotiate for it.”
Ensuring a smooth and positive maternity experience requires thinking about how maternity leave affects patients, fellow physicians, and the rest of the clinical staff. “Obviously, the nurses who work for a physician planning to go on leave want to know whether they’re going to have a job while that doctor is away, whether there will be reduced hours and if there will be a forced vacation,” Dickey said. “The schedule may be divided among the remaining physicians [or] given to a locum tenens, or the number of patients will need to be reduced. Keep in mind that the providers are the producers, and what they do affects the practice’s bottom line.”
So, which is preferable? Having a child while in residency or waiting until you’re in practice? As any parent will attest, there is no ideal time. Dr. Tieu feels that, because residency is so intense, it might be better to wait until afterward if possible, as long as you’re young enough. Dickey points out that interns and residents work such long hours that going on leave might be hardest then.