This is a very charged topic! I have varied opinions on this topic depending upon whether I am wearing my hat as a department chair and residency director or as a mother and grandmother to a daughter and granddaughter. To give some historical context, I must share with the readership that my first child was a stillborn during my chief residency year in dermatology. I took three days off after this devastating experience and buried my sorrow in work and study. A year later I gave birth to our son during my dermatopathology fellowship. My fellowship director, a male, told me that women who had children were of no use to him or academic medicine! He literally said to me: “How dare I get pregnant on him”. I notified him that I did not get pregnant on him. I took my allotted vacation and then returned to work.Women have a time clock regarding fertility that men do not share. The length of time for a medical education and the subsequent training makes planning a family challenging especially for women who do not immediately attend medical school after college. Layered on top of this time clock, is the desire women have to get the best education and training; most of us do not want to miss work or lectures. But biologic needs and demands cannot be denied.Maternity leave in the USA was federally mandated in 1993 by The Family and Medical Leave Act. Twelve weeks of unpaid leave to mothers was mandated but the act only applied to businesses with 50 or more employees and for employees who had been working at the business for 1, 250 hours over 12 months. Subsequently many states expanded upon this by reducing the required size of the business and allowing longer absences from work with a guarantee of the job upon return. More recently time off has been extended to father’s as paternity leave. The initial motivation for maternity leave was to allow a new mother time to heal from their pregnancy and delivery as well as to have time to bond to their new baby.US health care “businesses” (hospitals, residencies, universities, etc.), unlike the legal and financial industries, have usually been generous with time off after a woman has given birth to a child. For example, at UCONN women receive four weeks paid time off in addition to any accrued vacation time for a vaginal delivery and six weeks for a cesarean section. If medical complications occur post-delivery, paid sick leave will be granted as for any other medical illness. Additionally employees at UCONN Health center may request an extended maternity leave beyond the period of paid leave. This unpaid family leave, which is not allowed to exceed 24 weeks over a two year period, ensures women who desire more time at home with their new child a job at the end of this unpaid leave.There are many pros to maternity leave as mother-child bonding, physical recovery of the mother, establishing feeding and sleeping patterns, etc. However one must also consider the cons. What is the impact to other physicians in the group that depend upon each other to cover expenses of the practice and patient work load? What is the impact on the education of a resident or fellow who is out for an extended period of time during their training for one or more elective maternity leaves? In the USA there is a requirement that residents work for a minimum number of days at their residency to graduate; if they are out for any reason, these residents must remain beyond their anticipated date of graduation to fulfill this requirement. When that occurs, what is the impact on their junior residents?I agree with the authors of this article that maternity leave should be standardized for residents as well as attendings. This is a critical time in a woman’s life with huge emotional, marital, and physical/health implications. How much time a woman can take off from work during this vulnerable period should not be at the whim of administrators who might vary in their sensitivity to this issue but also must be balanced with their obligations to their partners and co-residents as well as their own education. I think that extending the residency beyond three years is not an unfair solution if a young mother wants to take more time off. Additionally unpaid leave beyond a certain amount of time would be a reasonable and equitable consideration as the practice cannot bear the overhead plus the salary of a physician who has electively chosen to stay home.And what about paternity leave?