Women now make up almost half of all American medical school graduates. With the increasing number of women entering the medical workplace, more and more women will need to cope with juggling their medical training and starting their family life.

In a 2013 survey done by the Society of General Internal Medicine, almost one third of residents became pregnant during family medicine and pediatric residencies. For those residents surveyed, pregnant residents were most distressed by their limited leave time, the financial constraints of their leave and pressure from their colleagues.

While all accredited residency training programs are required to provide written policies on leave of absence, the range of allowed maternity leaves varies greatly depending on the institution and specialty. Across the specialties of Medicine, Emergency Medicine, Pediatrics, Surgery and OB/Gyn acceptable leave can range anywhere from 1 month to 8 weeks, after which time must be made up for training, often after the resident must file for an exception. Many residents feel pressured to utilize vacation or return to work early so as not to impact the program or be ineligible for their board exams. These policies and perceived outside stresses lead many residents to make a difficult choice and return to work quickly after childbirth, sometimes after just 4 weeks of being post-partum. Subsequently, after return to work many residents fear requesting time to express breast milk or have difficulty finding a place to do so, forcing them to terminate breastfeeding their infant sooner than they would prefer.

As physicians we have been taught, and go on to teach our patients, that the bonding in the first year of life is very important for a child. It can have long lasting effects on a child’s academic future and ability to form relationships. So why would we as physicians take that right away from our future physicians in training?

The Family and Medical Leave Act (FMLA) opportunes all employees at least 12 weeks of protected leave for family leave - and residents are indeed employees that pay taxes. We request that the ACGME and the IOM advocate for policy that applies to all residencies, such that residents:

1) are notified that they have the right to 12 weeks unpaid FMLA and have the option to use that amount or less at their discretion

2) they be permitted to take that leave without facing repercussions or pressures from their program to return sooner should they want to take the full amount of leave

3) a standard method to make up critical education time is implemented

4) the ACGME and IOM "encourage" the various board accreditation councils to eliminate penalties in terms of being allowed to sit for boards in in a particular specialty if 12 weeks FMLA is taken 

If placed as universal policy, new resident mothers would have a choice and not feel the pressure to return early if it were to become the new standard. While we understand education is of high importance, every resident who chooses to start a family should have the opportunity to take leave for 12 weeks and makeup necessary time later on without repercussion or shaming.

We also request all residency programs to provide a reasonable break time for new mothers to express breast milk for her child. This is in line with the Affordable Care Act and section 7 of the Fair Labor Standards Act for all American employees. As physicians we teach patients that breast milk provides the best nutrition for newborns in the first year of life, and as such training physicians have the right to provide that same nutrition to their children.

This petition was created by a group of female physicians who have united to create change in these processes. However we implore all people who understand the importance of maternity leave and breastfeeding to sign this petition and request the creation and enforcement of standardized maternity leave and make-up policies, and break times for nursing mothers for our resident physicians in training.