Parental Policy in OMS Residency Programs is Necessary but Unavailable: Cross-sectional Survey of OMS Resident Attitudes toward Parental Leave

Abstract

Guidelines regarding parental leave in oral and maxillofacial surgery (OMS) do not exist. This inconsistency may contribute to gender disparities and an increase in resident burnout. The purpose of this study was to examine perceptions and attitudes of OMS residents toward parental leave.This was a cross-sectional study in which an anonymous 28-item questionnaire was electronically mailed to all current residents in OMS residency programs in the United States during August 2020. The survey consisted of 5 sections: 1) resident demographics (age, gender, parental status), 2) residency program information (geographic location, MD/non-MD status), 3) parental policy information (presence of formal parental leave policy, time allowed for parental leave, requirements associated with time off, on-call duties for parental leave), 4) attitudes regarding parental leave (regarding additional on-call time, performance, emotions toward parental time off, program support during pregnancy), 5) resident well-being (lactation facilities, availability of childcare).Statistical analysis was completed using R statistical software (Version 4.0.3). Descriptive statistics were completed. Univariate analyses were performed using the Wilcoxon Rank Sum test for ordinal outcome and categorical exposure. Fisher exact test for categorical outcome and categorical exposure and the Spearman test to analyze correlation between an ordinal outcome and an ordinal exposure were conducted. Statistical significance was 2-sided P-values < .05.Surveys were sent to 860 OMS residents; 220 completed the questionnaire (25.6%). The majority of respondents were male (n = 156, 70.9%) between the ages of 26-30 (n = 114, 51.8%). Respondents had no children (n = 135, 61.4%), had at least 1 child during residency (n = 60, 27.3%), were currently expecting (n = 14, 6.4%), or had a child prior to residency (n = 11, 5%). Half of the respondents did not know whether their OMS program had a formal parental leave policy (n = 110, 50%). Almost one-third of OMS residents reported that their program did not have a policy regarding parental leave (n = 60, 27.3%). Some programs had a policy regarding parental leave (n = 38, 17.3%) or only regarding maternity leave (12, 5.5%). Most programs allotted 2-6 days (n = 26, 11.8%) or 1-2 weeks (n = 16, 7.3%) off.Residents felt that their co-residents usually gave enough notice for parental leave (n = 74, 33.6%). Pregnancy was reported to the program director in the first trimester (n = 25, 11.4%) or second trimester (34, 15.5%). Some residents reported no negative emotions from the program (n = 43, 19.6%) and co-residents regarding parental leave (n = 51, 23.2%). Most respondents felt that parental leave is fair in their program (n = 170, 77.3%). During parental leave, residents found support in family (n = 45, 20.5%), co-residents (n = 20, 9.1%), and/or attendings (n = 3, 1.4%).Some residents believed that becoming a parent positively impacted their performance (n = 28, 12.7%). Some residents believed that residency had a negative impact on their performance as a parent (n = 41, 18.6%). Parenthood did not prevent pursuit of fellowship training (n = 44, 20%). The majority of co-residents indicated that parenthood had a neutral (n = 64, 29.1%), negative (n = 18, 8.2%), or positive (n = 16, 7.3%) impact on the performance of their colleagues. Respondents indicated that their program/hospital has lactation facilities (n = 57, 25.9%) and/or childcare services (n = 47, 21.4%).The researchers found that most residents are supportive of parental leave despite the lack of a formal policy in their programs. For those residents who conceived during residency, the time allowed for parental leave was on average 1-2 weeks in length, considerably less than what is allowed in the Family and Medical Leave Act of 1993 (FMLA). Additionally, parental status did not have an effect on a resident's decision to pursue fellowship training. In conclusion, parental leave guidelines within the OMS specialty are needed to support the integration of family with postgraduate OMS training and to encourage the pursue of the specialty.