Issue: January 2022
Disclosures: The authors report no relevant financial disclosures.
December 02, 2021
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Shorter paternity leave among surgical residents may be due to stigma

Issue: January 2022
Disclosures: The authors report no relevant financial disclosures.
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Male residents in fear of stigma do not take long paternity leave, even though they would like more time off, according to perspectives from surgical program directors published in JAMA Surgery.

“Recent literature on parental leave during residency has focused on the importance of supporting new mothers, but the needs and challenges faced by expectant nonchildbearing residents are less well described,” Erika Rangel, MD, MS, of the Brigham’s division of general and gastrointestinal surgery and Brigham’s Center for Surgery and Public Health, told Healio Gastroenterology. “Male residents are more likely than their female counterparts to have children during surgical training and experience similar stressors, including child care and conflicts between work and home priorities. As men of this generation become more involved in childrearing, the need to establish parental leave policies for both genders is essential.”

Erika Rangel headshot
Erika Rangel

Male residents’ perspectives

From October 2018 to June 2019, Rangel and colleagues collected transcripts from semi-structured interviews of 40 U.S general surgery program directors. Of these, 28 were men. Questions were on the presence of defined leave policies, barriers for directors against implementing leave, impact of leave on residents’ quality of work and the challenges of offering mentorship for work-life integration.

Paternity leave served as the primary exposure and the main outcome included perspectives from the program directors on paternity leave. These perspectives were then stratified into common themes.

“Interviews with general surgery program directors for this study showed us paternity leave for residents remains very inconsistent and is often improvised in terms of finding ways to provide clinical coverage,” Rangel said. “Between this ad hoc approach and male residents perceiving a pressure to adhere to a traditional surgical ethos of ‘work above all else,’ trainees usually receive less leave than they would like.”

Investigators noted 20 program directors reported providing a 1-week paternity leave.

Common themes in paternity leave

The five themes identified included:

  • Paternity leave policies are poorly defined and require residents to self-initiate.
  • Residents do not always take the full amount of time provided for leave.
  • It is common for there to be stigma against male residents taking paternity leave. This may be greater than what women face when taking maternity leave.
  • Paternity has little to no effect on colleagues’ workload.
  • Men wish they had longer leave compared with what they are currently offered. In addition, they would like to receive the same time off compared with childbearing parents.

“Surgical and medical leadership have embraced the need for strengthened parental leave policies, with national governing bodies, including the American College of Surgeons, the American Board of Surgery, and the American Board of Medical Specialties, highlighting the need to provide time for infant-parent bonding and extending the duration of time permitted away from training for this purpose,” Rangel said. “It is important that we reshape complementary local policies at the training program level to allow new fathers to utilize leave without fear of stigma or reprisal. Cultivating a culture of support for personal needs will stimulate future recruitment efforts and improve the well-being of our current trainees.”