New Article Shows That Pediatric Emergency Medicine Fellowships Lack Adequate Parental Scheduling Accommodations

Pregnancy and parental leave policies vary significantly across pediatric emergency medicine (PEM) fellowship programs nationwide. “A National Survey of Pregnancy and Parental Leave Policies in Pediatric Emergency Medicine Fellowship Programs” surveyed PEM program directors to characterize these policies, finding that while many programs offer some accommodations, there is little consistency in how pregnancy, parental leave, and return-to-work policies are implemented.

The American Academy of Pediatrics (AAP) recommends 6–8 weeks of paid parental leave for trainees, and a total of up to 12 weeks unpaid under FMLA — recommendations that are critical given the physical demands of EM training. Shift work, fatigue, and overnight responsibilities have been linked to adverse pregnancy outcomes including spontaneous abortion and preterm labor, while reducing infection exposure and increasing postpartum support remain essential. The newborn period is also vital for bonding and breastfeeding, both with significant benefits for infants.

Many programs still lack formal written leave policies, and despite no strict minimum shift requirements, fellows are often expected to make up missed shifts or extend training after leave. These findings are in spite of the fact that American Board of Pediatrics policy allows up to eight weeks missed without delaying graduation for otherwise competent fellows. Many programs remain more restrictive than this. Overall, the study shows most PEM programs fall short of AAP recommendations, underscoring the need for standardized, equitable leave policies supporting trainees.

As a resident applying to PEM fellowship, I found this eye-opening. I would think that all programs would follow the standardized ABP recommendations, and am surprised to find that is not the case. Instead, applicants may find themselves considering how any particular fellowship treats parental leave when evaluating programs. Women having children during training is not a new phenomenon. An applicant should not be forced to weigh any one program’s implementation of parental leave recommendations when deciding where to further their training in education. Instead, a standardized parental leave policy across programs would let fellows choose based on genuine fit, rather than which program best accommodates their family planning. However, this study shows that the current landscape falls short of that goal.