ABIM Clarifies Leave Policies Intended to Support Resident Physicians

January 08, 2020 (PRLEAP.COM) Health News
PHILADELPHIA, January 8, 2020 A misinterpretation of ABIM leave policies for graduate medical education prompted a new article in the Annals of Internal Medicine. ABIM wants to prevent confusion that could lead to extending training for residents and fellows unnecessarily.

Experts say that graduate medical education is strenuous and can contribute to work/life balance issues. ABIM continually examines its policies to align with the current health care environment, and after finding that its leave policies were being misinterpreted by program directors, updated its website to provide greater clarity. Based on the research reported in the article, a follow-up survey of all internal medicine and subspecialty program directors indicated that the clarifications make leave requirements clearer and more accessible.

ABIM has two leave policies: (1) the Leave of Absence and Vacation Policy and (2) the Deficits in Required Training Time Policy that permit residents and fellows to take time away from training for any reason including vacation, illness, family leave and all parental leave. The policies previously allowed for one month per year of training away, but were often being interpreted more restrictively as four weeks instead of five weeks as intended. ABIM allows five weeks (or 35 days) per academic year for leave and leave not used in one year can "accumulate" to be used in future years of training in the same program.

"As one example, my program director and I thought it unfair to ask women to extend training after having a baby. I had heard about all the clever rotations residency programs directors employed to get around the one month limitation," said Kathleen Finn, MD, Assistant Professor of Medicine at Harvard Medical School and lead author of the article. "In talking with colleagues from ABIM, they reassured me an extension was not necessary and we did the math together. I would have never defined "one month" as five weeks, so we decided it was important to ask program directors for their understanding."

Prompted by the misinterpretation, ABIM collaborated with the Association of Program Directors in Internal Medicine (APDIM) Survey Committee to better assess program directors' understanding of these policies. Program directors were asked to apply these policies to six case based scenarios of residents requesting leave, including parental and medical leave.

While the program directors surveyed reported understanding the ABIM leave policies, the vast majority did not correctly identify ABIM's definition of one month or correctly apply the two policies to hypothetical scenarios, including maternity leave. In many cases, program directors indicated they would require extension of training when ABIM's policies would not require it.

"ABIM is committed to working with APDIM and Internal Medicine Program Directors to make sure our policies are written in a clear and understandable way," said Furman S. McDonald, MD, MPH, Senior Vice President for Academic and Medical Affairs at ABIM and co-author of the article. "Life events can happen anytime. ABIM has policies in place that can help support residents through these times and ensure their training can continue as planned."

"It was wonderful to see the Alliance for Internal Academic Medicine (AAIM) and ABIM partner in this important area through the APDIM survey. This collaborative effort quickly led to improved clarity surrounding policies related to leave and extended training. Hopefully, because of this effort, trainees will have the flexibility they need to balance their family planning within their time of residency training," said Lisa L. Willett, MD, Tinsley Harrison Internal Medicine Residency Director and Vice Chair of Education, Department of Medicine at the University of Alabama at Birmingham and a co-author of the article.


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