It's About Time: An Evaluation of Parental Leave Within Military Graduate Medical Education

Time plays a crucial role in how trainees experience pregnancy and parental leave within graduate medical education (GME). Prior research mainly highlights the negative impact of time-related factors on trainee experience. However, a recent qualitative analysis within military GME challenged this antagonistic view of time, rather highlighting how it can be optimized to facilitate trainee personal and professional success. To date, there has been no formal quantitative analysis of how trainees manage time related to parental leave within military GME. As such, we investigated the impact of 12 to 18 weeks of parental leave on trainee parents' experiences within military GME programs.

We utilized a voluntary, anonymous web-based survey to query trainee parents, non-parent peers, faculty physicians, program directors, and associate program directors within U.S. military GME programs. The survey covered personal decision-making regarding parenthood within medical training as well as perceptions of parental leave policy and impact on training experience and career outcomes. Appropriate statistical analyses were utilized to summarize participant demographics and assess for differences between groups. Content analysis was utilized to assess open-ended responses.

The survey was fully or partially completed by 211 respondents from 24 different medical or surgical training programs across the Military Health System. There were similar numbers of male and female respondents who became parents during medical training, (35.3% vs. 32.3%, P = .77). Fifty-three percent of birth parents took 10 weeks or longer of parental leave while 50% of non-birth parents took 1 to 3 weeks of leave. Only 10% of birth parent trainees and about one-third of non-birth parent trainees would prefer a 6-week leave duration, the current minimum mandated within civilian programs. Birth parents were more likely to utilize an extension in training (45.2% vs. 8.3%, P = .00). Approximately one-third of all parents planned to, or did, utilize fewer weeks of parental leave than their program's allotment, most commonly (81.8%) because of a desire to graduate from training on time. Both birth and non-birth parents most commonly reported "no impact" of parental leave on the quality of their medical education. However, trainee parents did report more negative impact of an extension in training on career advancement when compared to non-parent peers, faculty, or program leadership.

This study demonstrates that parental leave durations of 10 weeks or greater have been successfully incorporated into military GME programs. Trainees commonly prefer durations of parental leave in-line with current Department of Defense policy, with minimal perceived effect on quality of medical education. However, challenges persist regarding training interruptions, extensions in training and military-specific impact of training graduation delays.