Taking Leave During Breast Surgical Oncology Fellowship: A National Evaluation of Policy and Practice

The American Board of Medical Specialties and the Fellowship Council provide general leave recommendations for many surgical fellowships, yet no standardized policy exists for Breast Surgical Oncology (BSO) programs. Leave is granted on a case-by-case basis by institutions and governing bodies including the Society of Surgical Oncology (SSO) and the American Society of Breast Surgeons (ASBrS). This study characterized the frequency, duration, and types of leave taken by BSO fellows, evaluated institutional leave policies, and barriers to leave implementation.

An anonymous electronic survey approved by the SSO Research Committee was distributed to program directors and associate PDs of all accredited BSO fellowships in October 2025. Redacted SSO/ASBrS Fellowship Training Committee meeting minutes (2015-2025) were reviewed. Qualitative data on barriers to leave were analyzed using thematic analysis.

The survey achieved a 73% response rate (48/66 fellowships). Two-thirds of responding programs reported a leave policy, and 75% had at least one fellow take leave during training. Review of Training Committee minutes identified 13 fellows who extended training following leave. Maximum leave duration without training extension varied across programs (median 4 weeks, range 0-12) and by type of leave. Thematic analysis identified four recurring barrier themes; the most commonly cited concern surrounded completing fellowship requirements without extending training.

Although leave during BSO fellowship is common, one-third of programs lack a formal policy and durations vary considerably, underscoring the need for a standardized leave framework to ensure equitable trainee experiences.