Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Analysis of current maternity leave policies for doctors in training

Rebekah Hoffman A B , Judy Mullan https://orcid.org/0000-0003-3772-7986 A and Andrew Bonney A
+ Author Affiliations
- Author Affiliations

A School of Medicine, University of Wollongong, Northfields Avenue, Wollongong, NSW 2500, Australia. Email: jmullan@uow.edu.au, abonney@uow.edu.au

B Corresponding author. Email: rhoffman@uow.edu.au

Australian Health Review 46(1) 52-59 https://doi.org/10.1071/AH20322
Submitted: 12 November 2020  Accepted: 16 June 2021   Published: 14 September 2021

Abstract

Objective This study reviewed the maternity leave policies in Australian general practice speciality training and compared them to hospital-based speciality training policies.

Methods Nine general practice regional training organisations’ maternity leave policies were audited and compared to 11 Australian hospital speciality training maternity leave policies. Data pertaining to each component of Cheung’s health policy analysis tool were reviewed.

Results Across all specialities there was a lack of evidence-informed policy design and evidence-based goal setting. Compared with other specialities, general practice was the only speciality where trainees did not receive paid maternity leave.

Conclusions This study highlights the need to improve maternity leave policies in line with evidence and best practice for both general practice and hospital-based speciality registrars.

What is known about the topic? There is an increasing number of females graduating from medical degrees and planning parenting and speciality medical training simultaneously. The balance of these two roles is dependent on the policies and protocols of the training providers, who need to ensure that parenting and a medical career are compatible.

What does this paper add? This paper reports on the findings of an audit of the current maternity leave policies for general practice and hospital-based medical registrar trainees in Australia. It identifies key areas within the policies that need to be addressed.

What are the implications for practitioners? This paper identifies that all policies lack evidence of being evidence based in their design. This audit has demonstrated that most policies do not meet the World Health Organization’s recommendations for maternity leave. Specifically, general practice trainees are the only doctors who do not have a policy that requires paid maternity leave. However, as the training of general practice registrars moves towards being undertaken by the Royal Australian College of General Practitioners, there is an opportunity for a review of this policy so that it becomes aligned with other Australian medical registrar training policies.


References

[1]  World Health Organization. Maternity leave legislation in support of breastfeeding: case studies around the world. 2019. Available at: https://www.who.int/publications/i/item/WHO-NMH-NHD-19.25 [verified 22 August 2020]

[2]  Hoffman R, Mullan J, Ngyuen M, Bonney A. Motherhood and medicine: systematic review of the experiences of mothers who are doctors. Med J Aust 2020; 213 329–34.
Motherhood and medicine: systematic review of the experiences of mothers who are doctors.Crossref | GoogleScholarGoogle Scholar | 32865236PubMed |

[3]  Joyce CM, Scott A, Jeon S-H, Humphreys J, Kalb G, Witt J, et al. Medicine in Australia: Balancing Employment and Life (MABEL); longitudinal survey – Protocol and baseline data for a prospective cohort study of Australian doctors’ workforce participation. BMC Health Serv Res 2010; 10 50
Medicine in Australia: Balancing Employment and Life (MABEL); longitudinal survey – Protocol and baseline data for a prospective cohort study of Australian doctors’ workforce participation.Crossref | GoogleScholarGoogle Scholar | 20181288PubMed |

[4]  Jefferson L, Bloor K, Maynard A. Women in medicine: historical perspectives and recent trends. Br Med Bull 2015; 114 5–15.
Women in medicine: historical perspectives and recent trends.Crossref | GoogleScholarGoogle Scholar | 25755293PubMed |

[5]  Bering J, Pflibsen L, Eno C, Radhakrishnan P. Deferred Personal Life Decisions of Women Physicians. J Womens Health (Larchmt) 2018; 27 584–9.
Deferred Personal Life Decisions of Women Physicians.Crossref | GoogleScholarGoogle Scholar |

[6]  Estryn-Behar M, Fry C, Guetarni K, Aune I, Machet G, Doppia MA, et al. Work week duration, work-family balance and difficulties encountered by female and male physicians: Results from the French SESMAT study. Work 2011; 40 83–100.
Work week duration, work-family balance and difficulties encountered by female and male physicians: Results from the French SESMAT study.Crossref | GoogleScholarGoogle Scholar |

[7]  Lambert TW, Smith F, Goldacre MJ. Combining parenthood with a medical career: questionnaire survey of the UK medical graduates of 2002 covering some influences and experiences. BMJ Open 2017; 7 e016822
Combining parenthood with a medical career: questionnaire survey of the UK medical graduates of 2002 covering some influences and experiences.Crossref | GoogleScholarGoogle Scholar | 29089347PubMed |

[8]  Mattessich S, Shea K, Whitaker-Worth D. Parenting and female dermatologists’ perceptions of work-life balance. Int J Womens Dermatol 2017; 3 127–30.
Parenting and female dermatologists’ perceptions of work-life balance.Crossref | GoogleScholarGoogle Scholar | 28831421PubMed |

[9]  Farahat FM. Challenges facing female physicians in Egypt. Arch Environ Occup Health 2009; 64 121–8.
Challenges facing female physicians in Egypt.Crossref | GoogleScholarGoogle Scholar | 19395343PubMed |

[10]  Lachish S, Svirko E, Goldacre MJMJ, Lambert T. Factors associated with less-than-full-time working in medical practice: results of surveys of five cohorts of UK doctors, 10 years after graduation. Hum Resour Health 2016; 14 62
Factors associated with less-than-full-time working in medical practice: results of surveys of five cohorts of UK doctors, 10 years after graduation.Crossref | GoogleScholarGoogle Scholar | 27737659PubMed |

[11]  Le Floch B, Bastiaens H, Le Reste JY, Lingner H, Hoffman R, Czachowski S, et al. Which positive factors give general practitioners job satisfaction and make general practice a rewarding career? A European multicentric qualitative research by the European general practice research network. BMC Fam Pract 2019; 20 96
Which positive factors give general practitioners job satisfaction and make general practice a rewarding career? A European multicentric qualitative research by the European general practice research network.Crossref | GoogleScholarGoogle Scholar | 31395016PubMed |

[12]  Smith P. Junior doctors go cold on GP training. Australian Doctor Group. 2019. Available at: https://www.ausdoc.com.au/news/junior-doctors-go-cold-gp-training [verified 6 March 2020]

[13]  Applicant Guide RVTS. Remote Stream Remote Vocational Training Scheme Ltd (RVTS) 2021 Applicant Guide for Remote Stream Program Overview. Available at: https://www.racgp.org.au/education/registrars/fellowship-pathways/policy-framework/policies/fellowship-exam-attempts [verified 6 June 2021]

[14]  The Royal Australian College of General Practitioners. General Practice: Health of the Nation 2018. Melbourne; 2018. Available at: https://www.racgp.org.au/download/Documents/Publications/Health-of-the-Nation-2018-Report.pdf [verified 23 September 2020]

[15]  Deloitte Access Economics. General Practitioner workforce report 2019 Nov. Available at: https://www2.deloitte.com/content/dam/Deloitte/au/Documents/Economics/deloitte-au-economics-general-practitioners-workforce-2019-021219.pdf [verified 23 September 2020]

[16]  Berkowitz CD, Frintner MP, Cull WL. Pediatric resident perceptions of family-friendly benefits. Acad Pediatr 2010; 10 360–6.
Pediatric resident perceptions of family-friendly benefits.Crossref | GoogleScholarGoogle Scholar | 20692217PubMed |

[17]  Pas BR, Lagro-Janssen ALM, Doorewaard JACM, Eisinga RN, Peters CP. Gender differences in career motivation: Female doctors’ ambitions benefit from family friendly work environment Ned Tijdschr Geneeskd 2008; 152 2172–6.
| 18953779PubMed |

[18]  Dagher RK, McGovern PM, Dowd BE. Maternity Leave Duration and Postpartum Mental and Physical Health: Implications for leave policies. J Health Polit Policy Law 2014; 39 2

[19]  Earle A, Heymann J. Paid parental leave and family friendly policies; An evidence brief. 2019. Available at: https://ecdpeace.org/paid-parental-leave-and-family-friendly-policies-evidence-brief [verified 2 September 2021]

[20]  Hawkins SS, Griffiths LJ, Dezateux C, Law C, Peckham C, Butler N, et al. The impact of maternal employment on breast-feeding duration in the UK Millennium Cohort Study. Public Health Nutr 2007; 10 891–6.
The impact of maternal employment on breast-feeding duration in the UK Millennium Cohort Study.Crossref | GoogleScholarGoogle Scholar | 17381907PubMed |

[21]  Skafida V. Juggling work and motherhood: The impact of employment and maternity leave on breastfeeding duration: A survival analysis on growing up in Scotland data Matern Child Health J 2012; 16 519–27.
Juggling work and motherhood: The impact of employment and maternity leave on breastfeeding duration: A survival analysis on growing up in Scotland dataCrossref | GoogleScholarGoogle Scholar | 21274609PubMed |

[22]  Andres E, Baird S, Bingenheimer JB, Markus AR. Maternity Leave Access and Health: A Systematic Narrative Review and Conceptual Framework Development. Matern Child Health J 2016; 20 1178–92.
Maternity Leave Access and Health: A Systematic Narrative Review and Conceptual Framework Development.Crossref | GoogleScholarGoogle Scholar | 26676977PubMed |

[23]  Kornfeind KR, Sipsma HL. Exploring the Link between Maternity Leave and Postpartum Depression. Womens Health Issues 2018; 28 321–6.
Exploring the Link between Maternity Leave and Postpartum Depression.Crossref | GoogleScholarGoogle Scholar | 29729837PubMed |

[24]  Cheung K, Mirzaei M, Leeder S. Health policy analysis: a tool to evaluate in policy documents the alignment between policy statements and intended outcomes Feature. Aust Health Rev 2010; 34 405–13.
Health policy analysis: a tool to evaluate in policy documents the alignment between policy statements and intended outcomes Feature.Crossref | GoogleScholarGoogle Scholar | 21108900PubMed |

[25]  Department of Health. Health Workforce Data; Medical Education and Training (4th Ed.). 2019. Available at: https://hwd.health.gov.au/resources/publications/report-met4-2019.pdf [verified 29 August 2021].

[26]  AGPT. Program leave policy 2020 Supporting documents, procedures and forms: AGPT Application-Program Leave Audience: Registrars enrolled on the AGPT Program Regional Training Organisations Stakeholders Contents. 2020.

[27]  Khanom A, Hill RA, Morgan K, Rapport FL, Lyons RA, Brophy S. Parental recommendations for population level interventions to support infant and family dietary choices: a qualitative study from the Growing Up in Wales, Environments for Healthy Living (EHL) study. BMC Public Health 2015; 15 234
Parental recommendations for population level interventions to support infant and family dietary choices: a qualitative study from the Growing Up in Wales, Environments for Healthy Living (EHL) study.Crossref | GoogleScholarGoogle Scholar | 25881187PubMed |

[28]  Jou J, Kozhimannil K, Abraham J, Blewett L, McGovern P. Paid Maternity Leave in the United States: Associations with Maternal and Infant Health. Matern Child Health 2018; 22 216–25.
Paid Maternity Leave in the United States: Associations with Maternal and Infant Health.Crossref | GoogleScholarGoogle Scholar |

[29]  Fallon KM, Mazar A, Swiss L. The Development Benefits of Maternity Leave. World Dev 2017; 96 102–118.
The Development Benefits of Maternity Leave.Crossref | GoogleScholarGoogle Scholar |

[30]  Walsh DS, Gantt NL, Irish W, Sanfey HA, Stein SL. Policies and practice regarding pregnancy and maternity leave: An international survey. Am J Surg 2019; 218 798–802.
Policies and practice regarding pregnancy and maternity leave: An international survey.Crossref | GoogleScholarGoogle Scholar | 31395271PubMed |

[31]  Fair Work Australia. Parental leave and related entitlements – Fact sheets – Fair Work Ombudsman. Fairwork.gov.au. 2017. Available at: https://www.fairwork.gov.au/how-we-will-help/templates-and-guides/fact-sheets/minimum-workplace-entitlements/parental-leave-and-related-entitlements [verified 23 January 2018]

[32]  Victoria State Government; Enterprise Agreement Common Policies. Parental Leave. Melbourne; 2019. Available at: https://vpsc.vic.gov.au/vps-enterprise-agreement-common-policies/ [verified 22 August 2020]

[33]  Parental Leave Pay – Services Australia. Available at: https://www.servicesaustralia.gov.au/individuals/services/centrelink/parental-leave-pay [verified 22 August 2020]

[34]  Parker K, Menasce Horowitz J, Wang W, Brown A, Assistant R, Patten E. Women and Leadership; Public says women are equally qualified, but barriers persist. Washington, D.C.; 2015. Available at: www.pewresearch.org [verified 8 October 2019]