When my daughter was born, I was just a year out of fellowship training, working hard within my hospital’s medical hierarchy. Fearful of burdening my colleagues with extra work, I did not use the Family and Medical Leave Act (FMLA), a national law requiring employers to provide job-protected, unpaid leave for personal reasons. Instead, I took three weeks of unpaid vacation time masquerading as my paternity leave.
To be honest, I was eager to get back to work when the vacation time had run out. Still on the probationary partner track, I hoped to show my colleagues I was worthy of joining their ranks. Yet looking back five years later, I see a largely absent father for the first few months of my daughter’s life and wish I had been home more, physically and emotionally, during her first year.
I hope it’s a mistake other fathers won’t make.
In a poll of my medical school and residency friends, no dads I knew took more than a few weeks off after their children were born. Some were home just a few days, while one, a cardiologist, was placing an implantable cardioverter-defibrillator into a patient when his wife, who was in the maternity ward in the same building, went into labor. In contrast, my wife, in her last year of her training as a medical resident, took three months off — in the United States, an unusually good chunk of time for maternity leave — plus an additional six months off after finishing her residency before starting her new job.
A pervasive narrative within medicine, one which then I adhered to, is that male physicians in a family unit are viewed as breadwinners, rather than as caregivers or nurturers. A decade of medical training recapitulated traditional notions of masculinity, where pushing myself to my physical and mental limits and being able to stoically endure were celebrated traits. As I began my career as an attending physician, I pressured myself to skip lunch, cover more weekends and holidays, and add extra non-emergency patients at the end of the day. My identity as a medical professional superseded my identity as a husband and father, and I didn’t let the birth of my daughter distract me from my calling.
There were other reasons why I hesitated taking an extended paternity leave. The beginning of my career coincided with the financial pressure of taking on a mortgage. And I worried that my being unavailable could harm my reputation with patients: If they couldn’t reach me, would they want to see me in the future?
Yet the benefits of fathers staying home longer during the first few months of a baby’s life are myriad. The bond between father and child deepens, and the relationship between partners can be strengthened enough that they are less likely to get divorced. Even though I was mentally tethered to the office, I still recall moments my wife and I marveled at our daughter’s first peals of laughter, and commiserated at her uncanny ability for relieving herself the moment we took off her diaper.
Multiple studies show extended paternity leaves also benefit partners, with more robust professional advancement, increased income, reduced postpartum health complications, and better mental health. My wife bristles at the societal assumption that fathers merely “help” mothers, instead of being equal partners in caring for their children.
It took a while for me not to feel estranged from my daughter. Over time, as she communicated more and I grew to appreciate the intangible values of reading “The Cat in the Hat” for the hundredth time, our relationship grew deeper. Especially during the pandemic years, as medical professionals experience a tremendous amount of strain, I realize now, as never before, the primacy of family.
I was determined not to make the same mistake twice. After my wife finished her second maternity leave, I arranged to take 10 weeks off under the FMLA (I was still too sheepish to ask for the full 12 weeks allotted) to care full-time for our infant son and then 3-year-old daughter. While their mother was at work, the three of us posted up at parks, strode down sidewalks in a double stroller, and raided the children’s section of the local library. In the afternoons, we took naps on a gigantic bed, my daughter lightly snoring, my son curled up against my chest. In the silence of the room, I realized there was nowhere else I wanted to be.
That year the paycheck was quite a bit smaller, but the memories of mundane events now held sacred more than made up for it. That autumn I had unfettered time — the most irreplaceable thing in the world — with my kids. Being a more present dad has given me a newfound sense of fulfillment and a closer relationship with my wife and kids. Contrary to my initial fears, when my paternity leave ended and I went back to the clinic, my patients were waiting for me, full of congratulations for my growing family.
Taking the extended paternity leave has also made me a better physician. When new parents are running a few minutes late, I’m more empathetic. When a lone parent, his partner at work, brings all three kids to the clinic by himself, I’m impressed, and understand the chaos in the room. I comfortably hold the baby while the parent runs to the restroom with one of the kids, occasionally eliciting a giggle with a game of peek-a-boo.
Among the nearly 200 countries in the United Nations, the United States — along with Papua New Guinea, and a few island nations in the Pacific — don’t offer paid parental leave. The United Kingdom, by comparison, offers fathers two weeks, while Italy provides a generous 16 weeks.
Fortunately for U.S. doctors, the situation is improving: In July 2022, the organization that oversees educational standards for physicians in training, the Accreditation Council of Graduate Medical Education, required medical and surgical residency programs to offer six weeks of paid personal leave — whether for caregiver, parental, or medical purposes — to all physicians-in-training. Equally important, this time does not require them to extend their training. This policy is a tectonic shift, with beneficial repercussions for current and future residents and fellows, and is official, long-overdue recognition that life events occur during medical training. It’s certainly something I, as a physician and new father, would’ve found useful.
This personal leave policy is starting within academic medicine, and I hope it will eventually trickle down to community health organizations and private practices. When an organization promotes a culture of taking family leave, collegial support is sometimes more important than written policy. Over time, as more fathers take paternity leaves, male physicians will learn this is not only OK, but actually encouraged.
My ability to juggle parental and physician responsibilities is still a work in progress, and my default state still skews toward my job. Yet I’m also cognizant that my children are only young once, and far sooner than I expect they’ll be teenagers who’d rather spend time with their friends.
Doctors are entrusted with the responsibility of caring for other people’s lives. They should also be allowed more time to tend to the lives they help create.
Charles Feng is an allergist/immunologist in the San Francisco Bay Area.
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