Family Leave Policy
Prolonged Absences from the Program
This policy clarifies the PIH Health Family Practice Residency Whittier Program policy about absences from the training program, with guidance per the American Board of Family Medicine (ABFM) and ACGME guidelines and policies.
The guidelines according to the American Board of Family Medicine Requirements for Certification are:
Other Leave - Vacation, sick leave, PTO - Residents are scheduled to perform their duties as resident physicians for a period of forty-eight (48) weeks each calendar year. Absence from the program for Other Leave is limited to twenty-five (25) working days per academic year. Other leave taken in excess of this will be made up prior to the completion of the academic year.
I. Please note ABFM limits Other Leave to 4 weeks per academic year. 5 working days are offered in accordance with California State Law requirements for sick leave and cannot be used to increase scheduled vacation blocks.
Vacation periods may not accumulate from one year to another. Annual vacations must be taken in the year of the service for which the vacation is granted. No two vacation periods may be concurrent (e.g., last month of the PGY-2 year and first month of the PGY-3 year in sequence) and a resident does not have the option of reducing the total time required for residency (36 calendar months) by relinquishing vacation time.
Family Leave – Family Leave provided under this policy is intended to be provided in the same circumstances specified in the Federal Family and Medical Family Leave Act (FMLA), including:
- The birth and care of a newborn, adopted, or fostered child, including both birth-and non-birth parents of a newborn.
- The care of a family member* with a serious health condition, including end-of-life care.
- A resident’s own serious health condition requiring prolonged evaluation and treatment
*Decisions about what constitutes family member and what constitutes serious health conditions is best left to the Program Director and their institutional policies. ABFM intends to leave those decisions at the local level where they are best able to be individually made.
ABFM does not require approval of a resident’s Family Leave if it is taken as outlined, and as long as the resident is on schedule to meet other training requirements. However, ABFM still requests that residents report in RTM any Family Leave of other LOA, even when extension of training is not required, to allow for data tracking that supports ongoing evaluation of this policy change.
Time Allowed for Family Leave of Absence
Family Leave Within a Training Year: ABFM will allow up to (12) weeks away from the program in a given academic year without requiring an extension of training, as long as the Program Director and CC agree that the resident is ready to advancement, and ultimately for autonomous practice. This includes up to (8) weeks total attributable to Family Leave, with any remaining time up to (4) weeks for Other Leave as allowed by the program.
- ACGME requires that the sponsoring institution:
IV.H.1.a) provide residents/fellows with a minimum of six weeks of approved medical, parental, and caregiver leave(s) of absence for qualifying reasons that are consistent with applicable laws at least once and at any time during an ACGME-accredited program, starting the day the resident/fellow is required to report; (Core)
IV.H.1.b) provide residents/fellows with at least the equivalent of 100 percent of their salary for the first six weeks of the first approved medical, parental, or caregiver leave(s) of absence taken; (Core)
IV.H.1.c) provide residents/fellows with a minimum of one week of paid time off reserved for use outside of the first six weeks of the first approved medical, parental, or caregiver leave(s) of absence taken; (Core)
At a minimum, a resident must have at least 40 weeks of continuity clinic experience in the year in which they take Family Leave.
Total Time Away Across Training: A resident may take up to a maximum of 20 weeks of leave over the three years of residency without requiring an extension of training. Generally speaking, 12 weeks (4 weeks per year) of this leave will be from institutional allowances for time off for all residents; programs will continue to follow their own institutional or programmatic leave policies for this.
If a resident’s leave exceeds either 12 weeks away from the program in a given year, and/or a maximum of 20 weeks total, (e.g. second pregnancy, extended or recurrent persona, or family leave) extension of the resident’s training during the relevant academic year will be necessary to cover the excess duration of time that the individual was away from the program.
Residents must still achieve a minimum of 1000hours in the continuity clinic by the end of the residency.
The ABFM policy only provides guidance about the maximum time away from training allowable for a resident to be away from their program and remain board eligible. The Program Director and/or CCC retains disretion to determine when or whether a training extension is required for any reason, including but not limited to completion of required rotations or assessment that the resident is not ready for attestation of meeting ACGME requirements and enter autonomous practice.
Additional Considerations:
- ABFM will allow Family Leave to cross over two academic years. In this circumstance, the Program Directors and sponsoring institution will be the ones to decide when the resident is advanced from one PGY-year to the next.
- Other Leave time may be utilized as a part of approved Family Leave, or in addition to approved Family Leave. ACGME requires programs to preserve a minimum of one week of Other Leave in any year in which a resident takes Family Leave. Consideration should be given to the importance of preserving some time away from resident well-being outside of a period of Family Leave.
- Residents are expected to take allotted time away from the program for Other Leave according to local institutional policies. Foregoing this time by banking it to shorten the required 36 months of residency or to retroactively “make up” for time lost due to sickness or other absence not permitted.
- Time missed for educational conferences does not count toward the time away from training under the Family Leave time allowed in this policy.
Waiver of Continuity of Care Requirement for Hardship
While reaffirming the importance of continuity of care in Family Medicine residency training, the Board recognizes that hardships occur in the personal and professional lives of residents. Accordingly, a waiver of the continuity of care requirement or an extension of the leave of absence policy may be granted when a residency training program closes or when there is evidence of the presence of a hardship involving a resident. A hardship is defined as a debilitating illness or injury of an acute but temporary nature, or the existence of a threat to the integrity of the resident's family, which impedes or prohibits the resident from making satisfactory progress toward the completion of the requirements of the residency program.
A request for a waiver of the continuity of care requirement or an extension of the leave of absence policy on the basis of hardship must demonstrate:
- that the absence from the continuity of care does not exceed 12 months;
- the nature and extent of the hardship;
- that excused absence time (vacation/sick time) permissible by the ABFM and the program for the academic year has been reasonably exhausted by the resident;
- that a medical condition causing absence from training is within the Americans with Disabilities Act (ADA) definition of disability.
- For absences from the training of fewer than 12 months, the amount of the 24-month continuity of care requirement completed before the absence will be considered a significant factor in the consideration of the request. When the break in continuity exceeds 12 months, it is highly unlikely that waivers of the continuity of care requirement will be granted. In communicating with the Board, the Residency Program Director should indicate what criteria will be used to determine the point at which the resident is expected to re-enter. The resident may NOT be readmitted to the program at a level beyond that which was attained at the time of departure, but the resident may reenter the program pending a final decision by the Board on the amount of additional training, if any, to be required of the resident.
