64 Implementation of Federal Dependent Care Policies for Physician Scientists at Top US Medical Schools

Abstract

Measures to support physician scientists with dependent responsibilities can help address the sex gap in academic medicine. In 2014 the federal government issued regulation in 45 CFR 75.474 allowing temporary dependent care costs for required research-related travel to be expensed to federal grants. We investigated whether institutional policies at top-ranked U.S. medical schools allow for implementation of this clause. We performed a cross-sectional survey of dependent care travel policies in 2019 at the top 51 U.S. medical schools through online searches. We identified and contacted administrators at each school to confirm accurate interpretation of policies. Of the 51 medical schools contacted, 48 provided details about institutional policies regarding dependent care. One school reported referring investigators to federal regulations for reimbursement of dependent care costs, though written policy was unavailable. Another school allows for reimbursement of such costs if both parents are required to travel or if the employee is a single parent. Four schools allow for reimbursement only for a bona fide business reason for the dependent to travel. Five schools reported allowing reimbursement of exceptional dependent care costs in the absence of an institutional policy. The remaining schools have policies that either classify dependent care as a non-reimbursable expense or do not reference dependent care. No school had a policy allowing for implementation of the dependent care clause as written in 45 CFR 75.474. While the federal government issued regulation to allow for the reimbursement of temporary dependent care travel expenses for required research-related travel, currently few physician scientists can access this support because no medical schools have implemented the clause in institutional travel policy. Implementation of 45 CFR 75.474 at U.S. medical schools is an actionable step towards supporting physician scientists with dependents and achieving sex equality in academic medicine.