Parenthood, Parental Benefits, and Career Goals Among Pediatric Residents: 2008 and 2019

Barriers to increasing paid parental leave in U.S. neurology residencies: a survey of program directors

BACKGROUND

The American Board of Psychiatry and Neurology (ABPN) and the Accreditation Council for Graduate Medical Education (ACGME) require that residency programs allow at least 6 weeks of parental leave. The American Medical Association (AMA) recommends 12 weeks of paid parental leave. Despite these recommendations, there is little information about parental leave policies across U.S. neurology residencies. The objective of our study was to assess parental leave policies in U.S. adult neurology residencies and barriers to increasing the duration of leave.

METHODS

We distributed an anonymous online survey to U.S. adult neurology program directors (PDs) to assess demographics, components and length of parental leave, perceived impact on residents' clinical training and academic development, and barriers to increasing the length of leave.

RESULTS

We contacted 163 PDs and received 54 responses (response rate of 33%). 87% reported policies for both childbearing and non-childbearing residents. The average maximal length of leave allowed without extension of training was 8.5 weeks (range 0-13) for childbearing and 6.2 weeks (range 0-13) for non-childbearing residents. Most PDs felt that parental leave had a positive impact on resident wellness and neutral impact on clinical competency, academic opportunities, and career development. The most common barriers to providing a 12-week paid policy were concerns about equity in the program (82%), staffing of clinical services (80%), and impact on clinical training (78%).

CONCLUSIONS

Although most programs in our study have parental leave policies, there is significant variability. Policies to improve parental leave should focus on addressing common barriers, such as additional solutions to staffing clinical services.

Pediatricians' Career Satisfaction and Wellbeing by Sex Before and During the COVID-19 Pandemic

OBJECTIVE

To compare pediatrician career satisfaction and wellbeing by sex during the coronavirus disease 2019 pandemic with prepandemic years using longitudinal survey data.

METHODS

Data from a cohort study, the American Academy of Pediatrics Pediatrician Life and Career Experience Study, were used to examine career satisfaction and wellbeing from 2012 to 2021 among 2002-2004 and 2009-2011 residency graduates (n = 1760). Mixed effects logistic regression, including key pediatrician characteristics, examined career satisfaction and wellbeing measures for sex (female vs male), pandemic year (2012-2019 vs 2020-2021), and their interaction effect. Adjusted predicted percentage values (PVs) were determined.

RESULTS

In total, 73.4% of participants identified as female. Adjusting for key pediatrician characteristics, differences were found by sex for satisfaction and 4 of 5 wellbeing measures, by pandemic year for 2 wellbeing measures, and the interaction of sex and pandemic year for 3 wellbeing measures. Female pediatricians reported higher levels of anxiety, sadness, and work stress, with greater differences during the pandemic. For example, female pediatricians (PV = 22.6, confidence interval [CI] = 21.0-24.3) were more likely than male pediatricians (PV = 14.2, CI = 12.0-16.4) to report anxiety during pre-pandemic years, and the difference between female pediatricians (PV = 29.3, CI = 26.7-32.0) and male pediatricians (PV = 12.4, CI = 9.3-15.5) increased during pandemic years (sex by pandemic year interaction, P < .001).

CONCLUSIONS

Compared with male pediatricians, female pediatricians reported worse anxiety, sadness, and stress at work, and the differences were more pronounced during the pandemic.

Examining Early Career Pediatrician Characteristics, Sacrifices, and Satisfaction

OBJECTIVE

Explore relationships between pediatrician characteristics, sacrifices made for career, and career and life satisfaction.

METHODS

Surveys of early career pediatricians (ECPs) who recently graduated residency (2016-18), as part of the AAP Pediatrician Life and Career Experience Study (PLACES) were administered in 2019. Logistic regression analyzed association of pediatrician characteristics with personal sacrifices (a lot vs some or no sacrifices) made for one's career and whether career was worth the sacrifices made to become a physician, and association of characteristics and sacrifices with overall career and life satisfaction.

RESULTS

Of 918 ECPs in the cohort, 90% responded to the 2019 survey. Seventy-seven percent agreed their career was worth the sacrifices and 40% reported they made a lot of personal sacrifices for their career. In multivariable analysis, female sex was associated with lower odds of viewing career as worth the sacrifices made [adjusted odds ratio [aOR] 0.45; 95% confidence interval [CI], 0.28-0.71], a higher odds of delaying starting a family [aOR 2.25; CI, 1.32-3.86] and making sacrifices in having children for career [aOR 2.60; CI, 1.48-4.58]. Those in fellowship training also reported making more sacrifices related to having children for their career [aOR 1.73; CI, 1.08-2.78]. ECPs who reported making a lot of sacrifices for their career were less likely to be satisfied with their overall career and life.

CONCLUSIONS

Most ECPs believe their sacrifices to become a pediatrician were worth it. Female pediatricians were less likely to feel personal sacrifices were worth it and reported more sacrifices related to having children.