A Structured Neonatal Parenting Elective: An Approach for Parenting Leave During Residency

Pregnancy is common during residency, yet the duration of allowed paid leave is inadequate and utilizing unpaid family medical leave act (FMLA) time has financial and professional consequences. We evaluated the effectiveness of a novel parenting elective, consistent with educational goals for pediatric residents, on resident parents' financial, academic, and family outcomes.

In 2010, a 2-4 week structured at-home elective of outpatient neonatal care with full pay was implemented. Data were collected from all new parents in a large academic pediatric residency from 2002 to 2018, including duration of leave, on-time graduation, choice to pursue postresidency training, and unpaid FMLA leave. Data were compared from before/after implementation and by parent type (mothers or resident partners of mothers).

Twenty-two pregnancies occurred prior to implementation and 42 afterward. In mothers, leave duration was similar (7.9 ± 3.5 weeks before, 8.0 ± 0.3 after, P = .50) but the minimum time increased from 2 to 6 weeks and those taking ≥7 weeks increased (54% vs 96%, P = .002). Mothers using unpaid FMLA time decreased (38% vs 7%, P = .04) although on-time graduation (69% vs 93%, P = .13) and postresidency training rates were similar. Among partners, leave duration increased (0.8 ± 0.4 weeks vs 4.0 ± 1.7, P < .001) and 79% took ≥4 weeks, compared to 0% pre-elective (P < .001). In partners, postresidency training, FMLA, or on-time graduation rates did not change.

Parenting a neonate provides learning opportunities for pediatric residents that can be encompassed in an elective consistent with training requirements. This elective improved outcomes for mothers and partners and is generalizable to any training program.