Quiet, Yet Enormous, Steps Toward Gender Equity During COVID-19.

To the Editor:

After publishing an article about parenting during graduate medical training, [1] we attended a landmark summit jointly sponsored by the American Board of Medical Specialties (ABMS) and Accreditation Council for Graduate Medical Education (ACGME) focused on paid family leave for physicians-in-training. Soon after, the COVID-19 pandemic hit, amplifying caregiving challenges and physician wellness—the very outcomes that paid leave policies are intended to improve.

Since then, 2 landmark policies have been approved. In July 2020, the ABMS released a policy requiring member boards with training programs to develop written policies stating the time required for board eligibility, further stipulating that eligibility requirements “must allow for a minimum of 6 weeks of time away from training for purposes of parental, caregiver and medical leave” (effective July 1, 2021). [2] This has enormous reach, impacting 24 ABMS member boards, and all specialty boards have complied. [3] The second is the ACGME’s September 2021 Institutional Requirements revisions that now mandate all programs provide trainees 6 weeks of paid parental, medical, and caregiver leave (IV.H.1.a, b, c.; effective July 1, 2022). [4]

These policies deserve greater attention: They reflect long-awaited change, and we see them as harbingers of further policy shifts yet to come. Although little change may be felt in some specialties, adoption of a guaranteed minimum 6-week paid leave for new parents is an important milestone in others. The ACGME’s additional step in asserting that at least some vacation time must be preserved apart from family leave is another critical stake in the ground, and a particularly important development in a time of high stress and rampant burnout. While we hope and expect that family leave policies for trainees and other health care professionals continue to evolve, we should celebrate this moment—academic medicine has taken a giant step forward.