Department of Medicine, Stanford University School of Medicine, Palo Alto, CA.
Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA.
Acad Emerg Med. 2019 Mar;26(3):317-326. doi: 10.1111/acem.13684. Epub 2019 Feb 5.
With the rising number of female physicians, there will be more children than ever born in residency, and the current system is inadequate to handle this increase in new resident parents. Residency is stressful and rigorous in isolation, let alone when pregnant or with a new child. Policies that ease these stressful transitions are generally either insufficient or do not exist. Therefore, we created a comprehensive return-to-work policy for resident parents and piloted its implementation. Our policy aims to: 1) establish a clear, shared understanding of the regulatory and training requirements as they pertain to parental leave; 2) facilitate a smooth transition for new parents returning to work; and 3) summarize the local and institutional resources available for both males and females during residency training.
In Fall 2017, a task force was convened to draft a return-to-work policy for new resident parents. The task force included nine key stakeholders (i.e., residents, faculty, and administration) at our institution and was made up of three graduate medical education (GME) program directors, a vice chair of education, a designated institutional official (DIO), a chief resident, and three members of our academic department's faculty affairs committee. The task force was selected because of individual expertise in gender equity issues, mentorship of resident parents, GME, and departmental administration.
After development, the policy was piloted from November 2017 to June 2018. Our pilot implementation period included seven new resident parents. All of these residents received schedules that met the return-to-work scheduling terms of our return-to-work policy including no overnight shifts, no sick call, and no more than three shifts in a row. Of equal importance, throughout our pilot, the emergency department schedules at all of our clinical sites remained fully staffed and our sick call pool was unaffected.
Our return-to-work policy for new resident parents provides a comprehensive guide to training requirements and family leave policies, an overview of available resources, and a scheduling framework that makes for a smooth transition back to clinical duties.
随着女性医生人数的增加，在住院医师期间出生的孩子将比以往任何时候都多，而目前的系统不足以应对新住院医师父母数量的增加。住院医师的工作本身就充满压力且要求严格，更不用说怀孕或有新生儿的情况了。缓解这些压力过渡的政策要么不充分，要么根本不存在。因此，我们为住院医师父母制定了一项全面的返岗政策，并对其实施进行了试点。我们的政策旨在：1）建立对与父母休假相关的监管和培训要求的明确、共同的理解；2）为新返岗父母顺利过渡提供便利；3）总结住院医师培训期间男女可用的当地和机构资源。
2017 年秋季，成立了一个工作组来起草新住院医师父母的返岗政策。该工作组由我院的九位重要利益相关者（即住院医师、教师和行政人员）组成，包括三位研究生医学教育（GME）项目主任、一位教育副主席、一位指定机构官员（DIO）、一位首席住院医师和我们学术部门人事事务委员会的三位成员。工作组是根据其在性别平等问题、住院医师父母指导、GME 和部门管理方面的个人专业知识而选定的。
政策制定后，于 2017 年 11 月至 2018 年 6 月进行了试点。我们的试点实施期间有 7 位新住院医师。所有这些住院医师都获得了符合我们返岗政策返岗排班规定的排班，包括无夜班、无值班和连续不超过 3 班。同样重要的是，在我们的整个试点期间，我们所有临床站点的急诊部排班都得到了充分的人员配置，我们的值班人员储备也没有受到影响。
我们的新住院医师父母返岗政策为培训要求和家庭休假政策提供了全面的指导，概述了可用资源，并制定了一个排班框架，以实现临床职责的顺利过渡。
