Thursday, June 23, 2011

Maternity Leave and Psychiatry Residency

I'm not a psychiatry resident, but I have two female friends/acquaintences in psychiatry residency at two different programs who are both going through some issues with their maternity leave and I was wondering if anyone has any thoughts to help them out:

Apparently, one year of psychiatry residency involves an outpatient continuity clinic. Due to the rules of residency, you cannot miss more than six weeks of this year at risk of repeating the entire year.

So despite the FMLA guaranteeing 12 weeks of leave, a woman having a baby that year can only take a maximum of 6 weeks off, or else repeat the entire year. Even if you have a C-section.

I just got off the phone with my friend, who is in tears over this. She was ready to make up any time she missed, but not repeat an entire year. She's gone over the situation with her chief resident and he claims there's no way around it.

Has anyone had any experience with this and has any advice? (Beyond "suck it up"?)

18 comments:

  1. Is there someone (such as a program director) higher up than the chief resident that your friend can discuss this with? In my experience, seemingly inflexible rules can often be bent if the right person in authority becomes involved and advocates for the resident. Alternatively, is there a residents association/union that she can speak with? Best of luck.

    ReplyDelete
  2. Our fellows have similar issues. We usually have them add half a day of clinic before they leave or do a straight month of clinic/ambulatory time. This is also easier on them in Pregnancy than in patient wards since the hours are more predictable. She can ask if this would be possible. I would concur that she should ask the program director not the chief resident.

    ReplyDelete
  3. Or, can she start the continuity clinic early (this year), thereby doing a whole year of it with 6 weeks or less of leave, and finish up whatever rotations she would otherwise be doing this year when she returns?

    I second talking to a program director and/or department chair- this should not be a decision the chief resident makes on his own.

    Let us know the outcome!

    ReplyDelete
  4. Residents can take more than 6 weeks off? I'd never actually heard of that happening. At my institution, anyway.

    ReplyDelete
  5. Our program makes it work just fine. You don't have to repeat the entire year. If you read the actual requirements, it's just that you need 12 months of continuity clinic overall... and it can't be totally disjointed, but it doesn't have to be "without a break or repeat the year".

    Definitely talk to the program director(s). If it's not allowed, it's either the school or their particular interpretation of the rules. It's not universal for psych residencies.

    ReplyDelete
  6. I'm glad I'm doing residency in Canada. We're allowed three months of mat leave without having to make up the time. We're also eligible for 17wks paid leave (at a certain percentage of salary). I can only imagine how difficult and heartbreaking it would be to backed into a corner like that.

    ReplyDelete
  7. i'm not a psych resident either but i think this is probably a misinterpretation or exaggeration of the rule...i know that as an ob/gyn resident, the rule is that we can only miss 8 weeks for any reason (including maternity leave) in each of the first three years and 6 weeks in the fourth year. (i believe this rule is per ABOG, in order to be board-eligible...but it might actually be an acgme rule. not sure.) however, if you miss more than that, you make up whatever excess time you missed, not the year. So, if you took 12 weeks maternity leave as a second year, you would do an extra 4 weeks of residency at the end of your fourth year...if you took 12 weeks as a fourth year, you would do 6 extra weeks.

    i doubt this is completely unique to ob/gyn, since i remember many residents in my husband's (family practice) program also making up additional leave time at the end of their last year...i can't imagine that psych is so different that you would need to repeat the whole year. i also think it sounds like your friend needs to talk to her program director rather than the chief.

    ReplyDelete
  8. i agree - talk to the program director. worst case scenario (and still not right would be to come back for 1/2 day clinic for second six weeks and no other work during that time. If program director still not helpful, I'd consider going to the ACGME.

    ReplyDelete
  9. Our residency did a 4-week "research" rotation - residents on it did 1/2 day of clinic a week to maintain continuity and the rest of the time was spent on some sort of research project, culminating in a noon conference.
    The research guidelines were pretty lenient and allowed for plenty of home time.

    ReplyDelete
  10. When I was a chief resident I understood the rule to be a GME issue. You can actually take as much time as you want off, but more than 6 weeks must be made up.

    When in training it seems impossible to miss more than 6 weeks. The idea of not finishing on time can be very scary.

    In reality it is not a big deal. Most people take time off between residency and their first job. If you are matching for fellowship you can often negotiate another 6 weeks to start late.

    Certainly there are a load of other issues- that are well represented on this blog- why women curtail time off during medical training.

    Bottom line, I hope your friends do what they feel is best for themselves and their families.

    ReplyDelete
  11. Oh, this is definitely a misinterpretation of the rules. You have to make up anything more than 6 weeks of leave in one year. BUT, make up does NOT equal repeating a year. That is crazy. She needs to talk to the program director.

    ReplyDelete
  12. Thanks for all your thoughts... I'll pass them on to my friend.

    I thought she was in some sort of crazy program or was misinterpreting the rules, but then when I heard about the other psychiatry resident having the same issue (a friend of a friend), I thought maybe this was something weird that was unique to psychiatry. Apparently, all they do during the third year is continuity clinic, so it's not like a half day per week or anything.

    ReplyDelete
  13. I would ask to start the clinic in the 2nd year so she has the 12 months unbroken of clinic. I think this is an ACGME rule but a reallt strict interpretation. I would talk to program director. You will have to "pay back" time but should not have to do another year.

    ReplyDelete
  14. She needs to talk to her program director AND if that fails, her GME (graduate medical education) office. I bet the situation isn't a dire as it sounds. AND suspect the chief (a dude) doesn't want to deal with re-working the schedule, a typically chief duty. but I have no way of knowing this last part...just a suspicion. AND liekly she'll just have to make up the weeks. I took 6 weeks plus vacation to total 9 weeks...I'm making up the 6. Word of warning though, the chief resident sounds like he is going to make it hard for her even if she only take 6 weeks.

    ReplyDelete
  15. misinterpretation of the rules, any lawer will tell you that!

    ReplyDelete
  16. The thinking of the people you are going to approach with this problem would be nice to know in advance. I can help you with that. Leave me an email at my web site, http://emilysinsight.com. See the testimonials there; I have several clients who are M.D.s I will examine this situation for you without charge, once.

    ReplyDelete
  17. I did psychiatry residency at one of the Harvard programs and was able to take a full 12 weeks off for maternity in my PGY-3 clinic year, with 6 weeks identified as a research/reading elective. My 12 months of clinic included any outpatient work I did in my PGY-4 year. Talk to the program director, s/he knows how other directors apply the requirements. A chief resident has only 1 or 2 more years of experience than these poor residents!

    ReplyDelete
  18. Key point - that chief resident will be long gone before the question of how to make up the extra time comes up...

    ReplyDelete

Comments on posts older than 14 days are moderated as a spam precaution. There may be a delay between submitting your comment and its publishing. Thanks for commenting!