EVALUATION OF PARENTAL LEAVE WITHIN CANADIAN ORTHOPAEDIC SURGERY: A NATIONAL SURVEY

Parental leave includes maternity, paternity, surrogacy, and adoption leaves. Parents taking leave after the birth or adoption of a child is associated with significant benefits for the child and parents alike. Although nearly 40% of residents have or plan to have children during residency, there is no standard parental leave policy for consultants or trainees. In Canada, standard parental benefits include 12 months or extended parental benefits include 18 months. However, many orthopaedic surgeons do not take the standard leave. Current policy among Canadian orthopaedic surgery programs regarding parental leave is not well described and is inconsistent between programs. Parental leave among Canadian orthopaedic surgeons is not widely understood and there is little reported in the literature. The objectives of this survey were to 1) collect information from Canadian Orthopaedic Association (COA) members about their experience with parental leave (including pregnancy leave), 2) determine a national average for parental leave among COA members, and 3) better understand parental leave support systems and models that are in place across the country for orthopaedic surgeons. All COA members were contacted by email and sent the secure survey link (Qualtrics). To participate in the study, the participant must have met the following criteria: (i) be an adult (aged ≥ 18 years) and (ii) be a COA member (practicing orthopaedic surgeon, fellow, resident, or medical student). Quantitative data was analyzed using Prism 9. Descriptive statistics were used to describe respondent frequencies calculated for responses to the closed-ended questions. n=138 participants (mean age of 43.8±11 years) completed the COA parental leave survey. There were n=71 male and n=64 female survey respondents, with n=1 that preferred not to answer. Of the survey participants, 78% were practicing orthopaedic surgeons, 5% were clinical fellows, 10% were residents, 1% were medical students, and 6% were retired practicing orthopaedic surgeons. Of the practicing orthopaedic surgeons, 43% were academic surgeons, 37% were community surgeons, 2% stated they did both academic and community, and one orthopaedic surgeon was in private practice. 64% of survey respondents had taken a parental leave in their career, while the remaining survey respondents had not. Most survey respondents took their parental leave while practicing as an orthopaedic surgeon (49%). The most common responses of why respondents did not take parental leave include: 1) “too busy during residency/fellowship”, 2) “busy work schedule”, 3) “partner took parental leave”, and 4) “fear of overburdening colleagues”. When asked if their department or training program having a formal written parental leave policy, 17% responded “yes”, 55% responded “no”, and 28% were “unsure”. Of those that took parental leave and were pregnant, 20% took less than 8 weeks of parental leave. Also, of those that took parental leave, only 3% of survey respondents took 12 or more months of leave. The most common factors that played a role in deciding how much time the COA member took off included: 1) loss of income, 2) concern for practice coverage by colleagues, 3) impact on surgical skills, 4) level of support from colleagues, and 5) partner's/spouse's ability to take parental leave. Further, of those respondents that were pregnant, 46% took call when they were >36 weeks pregnant. Also, 18% of survey respondents took extra call before their parental leave to compensate for their leave. Lastly, 78% of the survey respondents that took a parental leave felt supported by their centre/colleagues/training program through the preparation, duration, and return of their parental leave. Parental leave positively impacts family engagement, bonding, stress, and happiness. Understanding parental leave practices in orthopaedic surgery is critical to promote equity within the profession and supporting balance in work and family life. There are significant challenges for trainees and faculty to take parental leave. Key stressors around parental leave include poorly defined leave policies, historic paradigms of prioritizing professional duties over personal ones, the stigma attached to taking time off, and the guilt related to imposing extra work on colleagues. Pregnancy and parenting leave policies should be consistent nationwide and readily available for all surgeons and further efforts must be made to ensure support is available for parental leave.

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