The AMA House of Delegates adopted a policy aimed at addressing the cost of child care for cash and busy medical students, residents and fellows. Child care is a major household expense for most American families. Medical students, residents and fellows with young children are no exception.
The US Department of Health and Human Services considers child care affordable if it costs families no more than 7% of their income. The average salary for a first-year physician resident in 2021 was $58,650, while center-based pediatrics ranged from $5,700 to $16,000 per year.
That math puts significant pressure on medical students, residents, and fellows to solve a complex problem with limited resources, and the results can extend beyond financial stressors.
“There is a nationwide lack of options for affordable, accessible, quality child care for the American public in general, but in particular for individuals with lower incomes and with work schedules that are non-traditional, varied or inflexible,” says An AMA Council on Medical Education report whose recommendations were adopted by the House of Delegates at the 2022 AMA Annual Meeting in Chicago.
“Medical students and residents who are parents face childcare challenges that include low or even non-existent income, rigid academic schedules, and training and service requirements that extend the workday far beyond what can be easily accommodated by most childcare providers ,”
Citing data indicating that the struggle for child care and medical education further increases stress for individuals who are in an environment documented to increase levels of depression and burnout, the delegates adopted policies to address what a heavy burden for students and doctors across the spectrum of training.
“Many physicians-in-training may become parents during their medical training, a time when their pay is low or nonexistent and they work highly unconventional hours,” says AMA President-Elect Jesse M. Ehrenfeld, MD, MPH. “We believe providing on-site or subsidized childcare to medical students and residents during their training will help alleviate some of the financial burden they face and provide the best possible solution to their family’s childcare needs.”
With the new policy, the AMA will:
- Recognize the unique child care challenges faced by medical students, residents, and fellows, resulting from a combination of limited bargaining power (given the residency matching process), nontraditional work hours, extended or unpredictable shifts, and minimal autonomy in choosing their work schedules .
- Recognize the fiscal challenges medical schools and graduate medical education institutions face in providing on-site or subsidized child care to students and employees, including residents and fellows.
- Encourage the provision of on-site or subsidized child care for medical students, residents and fellows.
Delegates also directed the AMA to “collaborate with the Accreditation Council for Graduate Medical Education, Association of American Medical Colleges, and American Association of Colleges of Osteopathic Medicine to identify barriers to child care for medical students and innovative methods and best practices for the institution of off-site or subsidized child care that meets the unique needs of medical students, residents and fellows.”
Parental leave for medical students
In a separate action, delegates moved to address family planning resources and parental leave options for medical students.
About one in 10 medical students will be parents by the time they earn a medical degree, according to research cited in an Illinois delegation resolution.
Even so, resources that provide medical students with clear information about navigating the process of having or raising a child as they progress through medical school are lacking, creating an additional stressor during a chaotic time in the lives of these new caregivers and future doctors.
“It is essential that medical students are able to take parental leave during their medical training without fear of penalty or punishment. We call on all medical schools to offer at least six weeks of parental leave to their students,” said AMA Trustee Drayton Charles Harvey.
To correct the problem, deputies adopted new policies to:
- Encourage medical schools to create comprehensive informative resources that promote a culture supportive of their students who are parents, including information and policies on parental leave and relevant make-up, fertility preservation options, breastfeeding, accommodations during pregnancy, and child resources care that spans the institution and the surrounding area.
- Encourage medical schools to give students a minimum of six weeks of parental leave without academic or disciplinary penalties that would delay expected graduation based on time of matriculation.
- Work with key stakeholders to advocate that parties involved in medical education—including, but not limited to, residency programs, administration, fellowships, away rotations, physician evaluators, and research opportunities—do not discriminate against students taking family or parental leave.
Delegates also directed the AMA to “advocate that medical schools make resources and policies regarding family and parental leave transparently and openly accessible to prospective and current students.”
Read about the other highlights of the 2022 AMA Annual Meeting.