Restrictive Family Leave Policies Found At Top U.S. Medical Schools

Parental leave policies at top medical schools fall short of the recommendations by the American Academy of Pediatrics (AAP) that employees be given 12 weeks of paid family leave, according to a report published in JAMA earlier this year. The authors of the report found that salary, leave duration, and who qualified as “primary caregiver” varied widely among the institutions examined. Such policies are increasingly seen as disadvantageous to women.

“Retaining women during childbearing years is central to gender parity, as even short workforce interruptions can have long-term consequences—and may partially explain the gender wage gap,” wrote Christina Mangurian, M.D., and colleagues. Mangurian is an associate professor of clinical psychiatry at the University of California San Francisco (UCSF) School of Medicine and the UCSF Department of Psychiatry’s vice chair of diversity.

The authors reviewed family leave policies at 12 top-tier medical schools between September 2016 and August 2017. On average, full salary support was 8.6 weeks, but varied widely among the institutions. Three schools provided more than 8 weeks with full pay and eight schools allowed leave extension (typically for medical reasons).

The mean length of family leave at the 12 institutions was 17.9 weeks. Four schools provided more than 8 weeks of some salary support, with varied salary coverage.

“Most policies had restrictions such as being at the discretion of the department (three schools) or only available to ‘primary caregivers’ who care for a child more than 50% of the time (five schools),” the authors wrote. “Restricting family leave availability to the primary caregiver prevents partners from taking any leave, potentially contributing to the attrition of women by not facilitating cooperative parenting.”

Mangurian told Psychiatric News that the results were used to successfully advocate for 12 weeks of childbearing leave at UCSF. (Beginning in July 2019, all faculty will be entitled to 12 weeks of paid childbearing leave.) She said the group then decided to disseminate the findings to help other advocates build the case for expanding leave policies at their home institutions.

“It’s all about leadership,” she said. “I think some schools are more progressive because they have leaders who understand these policies are necessary to retain talent.”

The report comes 25 years after the Family and Medical Leave Act first made qualifying employees eligible for up to 12 weeks of unpaid family and medical leave, Mangurian noted.

“We still have a long way to go,” she said, pointing out that today the United States is the only developed nation without mandated family leave.

“Despite the benefits of paid childbearing leave for parent and infant, no federal law requires U.S. employers to provide paid childbearing leave,” the authors wrote. “Future longitudinal studies are needed to assess policies at other institutions and examine the association between leave policies and retention of women in academic medicine, adjusting for characteristics affecting retention, such as child care availability and costs, household characteristics, job satisfaction, and burnout.” ■

“Paid Family Leave Policies at Top U.S. Medical Schools” can be accessed here.