Ophthalmology Residents Report Gender Disparities, Bias Around Parental Leave

Ophthalmology residents’ survey responses overwhelmingly show policies that indicated bias before and after taking parental leave.

Nearly 80% of parental leave policies in ophthalmology residency programs cover duration of leave time and compensation during leave, according to a survey reported in the Candian Journal of Ophthalmology. However, 46.20% of residency directors who responded expressed a belief that parental leave negatively affected co-residents. Additionally, fewer than half of the policies studied address flexibility of rotation schedules or protected time for breastfeeding, the report shows. The study was conducted across ophthalmology programs in the United States.

A greater number of the residency directors polled shared an opinion that female residents were negatively impacted by parental leave time than male residents clinically (19.2% vs 3.8%), surgically (30.8% vs 7.8%), in scholarly activities (30.8% vs 26.9%), and in decreased well-being (23.1% vs 15.4%).

The report called for a national discussion is necessary regarding the standardization of parental leave and breastfeeding policies throughout ophthalmology residency programs. 

The researcher team distributed 2 electronic surveys which assessed perceptions toward parental leave during residency and breastfeeding upon return to clinical duties. The surveys were distributed to ophthalmology residents and program directors by the Association of University Professors of Ophthalmology (AUPO), and responses were collected in a period spanning 4 weeks.

Medical residency programs are required to have parental leave policies as per the Accreditation Council for Graduate Medical Education (ACGME), but there is a lack of standardized requirements regarding leave and policies related to breastfeeding. 

Of the 70 survey respondents, 64.3% (n=45) completed all survey questions, and all responses were included in the data. Although 87% of participants (n=23) reported not having taken time off without pay, nearly 60% (n=26) responded that they received negative feedback or actions prior to or after their parental leave.

Additionally, although residents felt that 53.8% program directors and 48.1% coresidents were supportive, program directors reported more negative impacts on surgical training in female residents (P=.035). The most-reported effects of parental leave on residents were missed surgical training and impact on research.   

The researchers explain that, while the Family Medical Leave Act (FMLA) allows a specific amount of unpaid leave to those who have been employed for at least 12 months and have given birth or adopted a child, the ACGME mandates that residency programs have written policies that reflect local and federal laws regarding leave. 

“All but 1 of the ophthalmology program directors responding to our survey had an existing parental leave policy,” the study notes. “This is in stark contrast to recent studies in the surgical subspecialties of otolaryngology and plastic surgery, where 46% and 37% had existing parental leave policies, respectively.” 

However, the survey found that both residents and program directors reported that vacation time was the most commonly utilized method of accounting for parental leave time. The researchers note this could be either due to having insufficient time as a resident prior to taking leave, or because taking vacation time warrants monetary compensation.

Finally, only a small percentage of the survey’s respondents reported their programs as having policies that addressed flexible rotation scheduled or protected time for breastfeeding.

“Only approximately 15% of programs outlined expectations for on-call responsibilities and both surgical and clinical duties,” the study explains. “This lack of duty standards, while providing flexibility for residents, can also result in residents missing opportunities or overworking postparental leave to attain all core competencies.” 


Reilly G, Tipton C, Liberman P, Berkenstock M. Attitudes toward parental leave and breastfeeding during ophthalmology residency. Can J Ophthalmol. Published online March 8, 2021. doi:10.1016/j.jcjo.2021.02.039.