Chernoby Kimberly A, Pettit Katie E, Jansen Jaclyn H, Welch Julie L
Department of Emergency Medicine Indiana University School of Medicine Indianapolis IN USA.
AEM Educ Train. 2020 Aug 5;5(2):e10504. doi: 10.1002/aet2.10504. eCollection 2021 Apr.
Many physicians complete residency training during optimal childbearing years. The literature shows that working nights or on call can lead to pregnancy complications including miscarriage, preterm labor, and preeclampsia. In addition, infant-parent bonding in the postpartum period is crucial for breastfeeding, health, and well-being. No national standards exist for flexible scheduling options for pregnant or new parent residents. Our project objectives are 1) to describe a policy for scheduling pregnant and new parent residents in an emergency medicine (EM) residency and 2) to report pilot outcomes to assess feasibility of implementation, resident satisfaction, and pregnancy outcomes.
An EM residency task force developed a proposal of scheduling options for pregnant and new parent residents based on best practice recommendations and resident input. The policy included prenatal scheduling options for pregnant residents and postpartum scheduling options for all new resident parents. Resident support for the policy was evaluated via an anonymous survey. It was piloted for 2 months in an EM residency program.
Policy development resulted in 1) an opt-out prenatal pregnancy work hour option policy with no nights or call during the first and third trimesters, 2) a 6-week new parent flexible scheduling policy, and 3) clarified sick call options. A majority of residents approved the new policy. During the 2-month pilot period, four residents (of 73 total) utilized the policy. The chief residents reported no added burden in scheduling. Of the residents who utilized the policy, all reported high satisfaction. There were no reported pregnancy or postpartum complications.
We successfully adopted a new scheduling policy for pregnant residents and new parents in one of the largest EM residency training programs in the country. This policy can serve as a national model for other graduate medical education programs.
许多医生在最佳生育年龄完成住院医师培训。文献表明，值夜班或随叫随到可能导致妊娠并发症，包括流产、早产和先兆子痫。此外，产后母婴亲密关系对母乳喂养、健康和幸福至关重要。对于怀孕或新晋父母的住院医师，目前尚无灵活排班选项的国家标准。我们项目的目标是：1）描述一项针对急诊医学（EM）住院医师中怀孕和新晋父母的排班政策；2）报告试点结果，以评估实施的可行性、住院医师满意度和妊娠结局。
一个急诊医学住院医师特别工作组根据最佳实践建议和住院医师的意见，制定了一份针对怀孕和新晋父母住院医师的排班选项提案。该政策包括为怀孕住院医师提供产前排班选项，以及为所有新晋住院医师父母提供产后排班选项。通过匿名调查评估住院医师对该政策的支持度。该政策在一个急诊医学住院医师项目中进行了为期2个月的试点。
政策制定产生了以下结果：1）一项选择性退出的产前妊娠工作时间选项政策，在孕早期和孕晚期无需值夜班或随叫随到；2）一项为期6周的新晋父母灵活排班政策；3）明确了病假选项。大多数住院医师批准了新政策。在为期2个月的试点期间，73名住院医师中有4名使用了该政策。总住院医师报告称在排班方面没有增加负担。在使用该政策的住院医师中，所有人都表示高度满意。没有报告妊娠或产后并发症。
我们在该国最大的急诊医学住院医师培训项目之一中成功采用了一项针对怀孕住院医师和新晋父母的新排班政策。该政策可为其他毕业后医学教育项目提供全国性范例。
