Parental Leave Impact and Experience: A Survey of the U.S. Graduate Medical Education System

Introduction: Prior work conducted within U.S. civilian graduate medical education (GME) programs has uncovered negative perceptions of parenthood related to trainee wellness and performance. However, this subject remains understudied within U.S. military GME which affords trainees 12-18 weeks of paid parental leave. Materials and Methods: We disseminated a web-based survey to trainees, faculty physicians and program directors (PDs) at U.S. military GME programs querying participants on the impact of parenthood and parental leave on trainee wellness and performance. Applicable statistical analyses were utilized to assess differences between groups. Content analysis was used to identify themes within participant open-ended responses. Results: The survey was completed by 211 respondents from 24 different medical or surgical specialties across the Military Health System. A majority of participants reported that their program’s parental leave policy either somewhat or significantly decreased the stress of trainee parents (trainee 50.5% vs. faculty 60.6% vs. PDs 61.9%). Participants reported no impact of parental leave on trainee dedication to patient care, clinical performance, scholarly activities or standardized test scores. Participants reported a somewhat negative impact of training interruptions on the training experience of peers, with no significant difference in how they rated birth and non-birth parents (birth parent 2.44 vs. non-birth parent 2.48, P = .10, d = -0.11). Technical skills and procedural volume were both rated lower for birth parents versus non-birth parents (technical skills: birth parent 2.50 vs. non-birth parent 2.60, P ≤ .001; d = −0.25, procedural volume: birth parent 2.32 vs. non-birth parent 2.41, P <. 001; d = −0.23). Content analysis uncovered themes consistent with the survey data but also revealed persistent stigma surrounding use of full parental leave benefits within certain GME programs. Conclusions: The current parental leave policy within U.S. military GME is perceived to decrease parental stress and can have a positive impact on trainee wellness. While this policy has been effectively implemented with limited perceived impact on trainee performance, work remains to be done to promote full acceptance of parental leave within military GME.