A Call for Changes After Study Finds Internal Medicine Residency Program Directors Misinterpret Leave Policies

Parental leave policies are a frequent topic in the news, including in the field of internal medicine. Kirti Magudia, MD, PhD, a T32 scholar and clinical fellow in the Abdominal Imaging section at the UC San Francisco Department of Radiology and Biomedical Imaging, recently reviewed a study that found that most internal medicine program directors (PDs) misinterpret American Board of Internal Medicine (ABIM) leave policies for resident physicians. Many PDs mistakenly believe they must extend training to follow ABIM policies, resulting in unnecessary extension of residency for many trainees. She corresponded with Reuters Health's Anne Harding on the findings.

The report itself was published in the Annals of Internal Medicine in December 2019. A total of 279 PDs responded to the survey conducted by the ABIM and the Association of Program Directors in Internal Medicine (APDIM). They were asked to apply current leave policies to six hypothetical scenarios involving residents' requests for leave and the percentage of correct responses ranged from 1.5 – 52%.  Much of this comes from the ambiguity surrounding the ABIM's definition of "one month" as it relates to both the Leave of Absence and Vacation policy and Deficits in Required Training Time policy. 

Overall, most PDs do not realize that they have more flexibility to allow for leave. This means that many trainees unnecessarily have their training extended, therefore delaying the start of their fellowship or their first job. The ABIM is trying to be generous and fair to trainees, says Dr. Magudia, however it's been found that internal medicine program directors did not understand how to apply existing ABIM policy. 

Back in 2017, Dr. Magudia and former colleagues at Brigham and Women's Hospital and Massachusetts' General Hospital performed a study, accepted for publication in the Journal of Graduate Medical Education, that found only 1/3 of graduate medical education (GME) trainee respondents knew or knew where to find their institution's or program's parental leave policy at the time of being surveyed. Findings from the ABIM/APDIM study reinforce these findings while also showing how difficult policies are to write clearly and interpret as intended, she says.  

So, what happens from here? "I believe that all boards should establish formal parental leave policies for this relatively common occurrence in GME training," says Dr. Magudia. "Given the misinterpretation of board policies that is known to occur, a specific parental leave policy would only help GME trainees and program directors access the information they need."

For more information see Internal Medicine Residency Program Directors Misinterpret Leave Policies - Medscape - December 24, 2019.

Related Content