Division of Pediatric Endocrinology, Department of Pediatrics (M Cree-Green), University of Colorado Anschutz Medical Campus, Aurora, Colo; Department of Family Medicine (M Cree-Green), Idaho State University, Pocatello, Idaho.
Department of Pediatrics (J Cree), University of Colorado Anschutz Medical Campus, Aurora, Colo.
Acad Pediatr. 2020 Jul;20(5):595-599. doi: 10.1016/j.acap.2020.02.008. Epub 2020 Feb 8.
Pregnancy is common during residency, yet the duration of allowed paid leave is inadequate and utilizing unpaid family medical leave act (FMLA) time has financial and professional consequences. We evaluated the effectiveness of a novel parenting elective, consistent with educational goals for pediatric residents, on resident parents' financial, academic, and family outcomes.
In 2010, a 2-4 week structured at-home elective of outpatient neonatal care with full pay was implemented. Data were collected from all new parents in a large academic pediatric residency from 2002 to 2018, including duration of leave, on-time graduation, choice to pursue postresidency training, and unpaid FMLA leave. Data were compared from before/after implementation and by parent type (mothers or resident partners of mothers).
Twenty-two pregnancies occurred prior to implementation and 42 afterward. In mothers, leave duration was similar (7.9 ± 3.5 weeks before, 8.0 ± 0.3 after, P = .50) but the minimum time increased from 2 to 6 weeks and those taking ≥7 weeks increased (54% vs 96%, P = .002). Mothers using unpaid FMLA time decreased (38% vs 7%, P = .04) although on-time graduation (69% vs 93%, P = .13) and postresidency training rates were similar. Among partners, leave duration increased (0.8 ± 0.4 weeks vs 4.0 ± 1.7, P < .001) and 79% took ≥4 weeks, compared to 0% pre-elective (P < .001). In partners, postresidency training, FMLA, or on-time graduation rates did not change.
Parenting a neonate provides learning opportunities for pediatric residents that can be encompassed in an elective consistent with training requirements. This elective improved outcomes for mothers and partners and is generalizable to any training program.
妊娠在住院医师培训期间很常见，但允许的带薪休假时间不足，而使用无薪家庭医疗休假法案（FMLA）时间会带来经济和职业方面的后果。我们评估了一项符合儿科住院医师教育目标的新型育儿选修课程对住院医师父母的经济、学术和家庭结果的有效性。
2010 年，实施了一项为期 2-4 周的在家中进行的全额支付门诊新生儿护理结构选修课程。从 2002 年到 2018 年，从一个大型学术儿科住院医师培训计划中的所有新父母那里收集数据，包括休假时间、按时毕业、选择进行住院后培训以及无薪 FMLA 休假。比较实施前后的数据以及父母类型（母亲或母亲的住院医师伴侣）的数据。
在实施之前有 22 例妊娠，之后有 42 例妊娠。在母亲中，休假时间相似（实施前为 7.9 ± 3.5 周，实施后为 8.0 ± 0.3 周，P=0.50），但最短休假时间从 2 周增加到 6 周，休假 7 周以上的人数增加（54%比 96%，P=0.002）。使用无薪 FMLA 休假的母亲人数减少（38%比 7%，P=0.04），尽管按时毕业（69%比 93%，P=0.13）和住院后培训率相似。在伴侣中，休假时间增加（0.8 ± 0.4 周比 4.0 ± 1.7 周，P<0.001），97%的人休假 4 周以上，而实施前选修课程中没有 0%的人休假（P<0.001）。在伴侣中，住院后培训、FMLA 或按时毕业率没有变化。
新生儿育儿为儿科住院医师提供了学习机会，这些机会可以包含在符合培训要求的选修课程中。该选修课程改善了母亲和伴侣的结果，并且可以推广到任何培训计划。
