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Residency Parental Support and Wellness Procedures

The Department of Surgery aims to provide a safe and supportive environment for each resident in their pursuit of family, whether as the birthing parent, non-birthing parent, adoptive parent, foster parent or surrogate. This document lays out procedures for safe and supportive pregnancy wellness during surgical training. Use of available time is allowed and encouraged; however, this may extend training time if the leave is greater than that allowed by the respective qualifying boards. The first point of contact for residents requiring time off, planning for leave or seeking other accommodations is KU Medical Center’s Office of Human Resources.

The GME Office also has a helpful document for individuals to work through with the program director to plan time off and evaluate the impact to training time. This can be found on MedHub, under Resources and Documents, Folder “GME Program Toolkit,” Folder “FMLA.”

Surgical training is long and often coincides with peak fertility and childbearing years. These procedures are intended to mitigate stress associated with family planning for surgical residents and compile applicable university policies and resources applicable to all residents in one place.

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This document identifies several different instances for which expectant parents or those pursuing fertility preservation or treatments may need time off for scheduled appointments or other accommodations. There are also unplanned instances in which residents may need additional time off for medical related reasons. Non-birthing parents may also request time off to be present with their partners. This coverage will be arranged by the program with the Admin Chief(s). Trainees are NOT expected to find their own ad hoc coverage for these events (planned or unplanned) in order to:

  • Eliminate the perception of trainees making additional work for their colleagues
  • Normalize the culture of asking for help and coverage to ensure a safe and supported pregnancy
  • Encourage trainees to attend all the necessary and recommended appointments to ensure a safe pregnancy

Preconception & Fertility Preservation

It is the policy of the university and the Department of Surgery’s residency programs that residents:

  • Have time off to attend necessary appointments for consultations, lab draws, imaging studies and procedures related to fertility preservations or Assisted Reproductive Fertility; and
  • Can pursue this treatment with the expectation of confidentiality.

Potential accommodations may be made include:

  • Coverage for rounding and first case starts for necessary appointments.
  • Days off/sick leave for relevant procedures.
  • Flexibility to leave the OR for medication administration as needed.
  • Option to avoid 24 hr. call/night float if anticipated to adversely affect cycle.

Read about requesting accommodations in the Disability and Accommodation Policy FAQs (sharepoint.com)

View the Employee Pregnancy Accommodation Policy (policystat.com)

Prenatal Care

  • Pregnant residents should disclose their pregnancy to Human Resources as soon as they are comfortable, but no later than 30 days prior to the anticipated delivery date. This will allow for discussion of the schedule and any needed modifications. Obtain the checklist from GME to help plan time off (MedHub, under Resources and Documents, Folder “GME Program Toolkit”, Folder “FMLA”)
  • Pregnant or non-birthing parents should attempt to schedule routine prenatal appointments in advance and notify their chief resident who will be responsible for finding coverage. If a resident needs to attend prenatal appointments, they should inform their team members and staff at least 24 hours in advance to allow for service management and coverage. If necessary, one or more of the three personal days allocated by the department to all residents may be used. 
  • If urgent/emergent prenatal care is necessary, the resident should notify Human Resources as soon possible.
  • A jeopardy call schedule or plan will be in place per APD/PD and admin chief resident for all parents during the month prior to planned delivery. 
  • If a pregnant resident needs additional modifications, this should be discussed with Human Resources.
  • Residents that have experienced miscarriage or a negative pregnancy outcome should feel empowered to make use of their three allotted personal days for recovery. Additional time away from work may be available. Residents should contact Human Resources to discuss.
  • The department is committed to supporting residents’ mental health. Residents experiencing impairment in mental health are encouraged to attend all appointments. Efforts should be made to arrange appropriate coverage as outlined above for prenatal appointments.
  • Free mental health resources and support for the individual as well as the couple can be accessed via the GME Wellness webpage and Counseling and Education Support Services. Residents may schedule appointments for themselves or as a couple through the online portal or (913)588-6580. Additionally, the The University of Kansas Health System offers offers comprehensive, compassionate inpatient and outpatient mental and behavioral health services. Learn more online or call the department to schedule: (913)588-1300.

Operating While Pregnant

  • Pregnant residents may have new physical needs to manage. They are encouraged to attend to any necessary physical needs. Planned breaks are available to residents and additional requests for modifications should be made to Human Resources.
  • Fluoroscopy and Radiation Exposure
    • Lead designed for pregnancy should be available in all cases where fluoroscopy or exposure to radiation is involved or may be involved. This includes trauma activations, where lead is a required component of PPE (personal protective equipment) for the trauma responders.
  • Radiation dosimeters are available to pregnant residents on disclosure of the pregnancy, with the option of routine checks for cumulative radiation exposure. A dosimeter may be worn over their lead as well as a second dosimeter worn under the lead at the level of the abdomen.
  • For rotations during which a higher amount of radiation may be expected (i.e., vascular surgery, trauma, etc.), pregnant residents may discuss any concerns in participating in procedures with higher risk for radiation exposure (e.g., endovascular cases) with Human Resources and request accommodation. This discussion should be had before or at the beginning of the rotation.
  • HIPEC (Hyperthermic intraperitoneal chemotherapy) Cases
    • Pregnancy: Residents may perform the cytoreductive portion of the procedure but may consider not participating in the infusion of chemotherapy or any portion of the case afterwards. An alternative resident on service can substitute to perform the second portion of the case and the pregnant resident can perform other clinical duties on service. 
    • Lactation: Resident may discuss with the attending what additional precautions need to be taken. The resident may be excused from chemotherapy infusion and closure if requested.

Work Hour Modifications for Pregnant Residents

Pregnant residents may request accommodations in the OR to manage nausea, maintain hydration, get consistent nutrition and use the restroom. Residents are directed to make such requests to Human Resources who will communicate with the program about such needs.

Postnatal Care

  • It is essential that post-partum residents receive adequate mental and physical health follow up. Time off for postnatal follow-up appointments should be scheduled in advance if possible and the chief resident and attending notified of the need for time off. 
  • Post-partum residents have access to mental health support services through KU Medical Center and will be provided time to attend appointments should they choose to use such services. Free mental health resources and support for the individual as well as the couple can be accessed via the GME Wellness webpage and Counseling and Education Support Services. Residents may schedule appointments for themselves or as a couple through the online portal or (913)588-6580. Additionally, the The University of Kansas Health System offers offers comprehensive, compassionate inpatient and outpatient mental and behavioral health services. Learn more online or call the department to schedule: (913)588-1300.

Lactation

  • Lactating residents will be provided adequate time and space to express milk in a clean, private, secure location that has refrigeration capacities, with proximity appropriate for safe patient care. The timing of breaks for lactation should be discussed with the chief resident and with the attending prior to scrubbing into a case.
    • A typical schedule is 15-30 minutes every 3-4 hours but should remain flexible. Consideration should be given to the time needed to travel to a lactation room or find a private space. Lactation breaks may be more frequent in the first six months of pregnancy to support exclusive breastfeeding/providing milk for best health outcomes for both parent and infant.
    • The GME Office has resources for the lactating parent, including Elvie breast pumps and mini fridges, to help reduce the time needed for lactation breaks and provide more autonomy to residents.
    • OSHA supported lactation rooms are available across campus. See: Parent and Family Resources. 
  • Accommodation during test taking.
    • ABSITE (ABS Inservice Training Exam) – lactating residents who wish for additional time during ABSITE will contact the program director to arrange for additional time no later than December 25th of the same academic year.
  • Read the University of Kansas Medical Center Lactation Support Policy
  • View University of Kansas Medical Center Lactation Support Resources

Parental Support

Appointments

  • Non-birthing parents who plan to take leave should disclose their partner’s pregnancy or adoption plans to Human Resources as soon as they are comfortable, but no later than 30 days before the anticipated need for leave.
  • Non-birthing residents are encouraged to attend prenatal appointments, delivery, hospitalization and other appointments. Residents should arrange for time off for routine appointments as soon as possible but no later than 1 week prior. For any urgent or emergent issues, the resident should notify their chief resident and Human Resources.

Parental Leave

  • All resident parents are encouraged to take parental leave per the University of Kansas Medical Center's FMLA Policy (up to 12 weeks), Parental Leave Policy (8 weeks primary caregiver; 4 weeks secondary caregiver), and/or ACGME Medical Leave Policy (6 weeks), which all run concurrently.
  • Leave available to residents under university policy encompasses the requirements of the American Board of Surgery policy, which dictates 6 weeks total for parental leave: including 2 weeks of vacation time and 4 weeks of medical leave, with an additional 2 weeks of vacation time allowed during the remainder of the year. This leave is allowed twice during residency, once in years 1-3 and again during years 4-5. ABS (American Board of Surgery) requires 48 weeks of clinical rotations each year. Time may be taken intermittently based on the needs of the family. The GME Office has a helpful form to plan time off based on all of these parameters.
  • Non-birthing parental time off is important to the department. This time allows the non-birthing parent time to bond with the infant and supporting the birthing parent. This time helps to build the family dynamics, caregiver responsibilities and build a sense of work-life balance for the parents.
  • Leave requests or inquiries should be directed to Human Resources. Leave provided may require extending training in consultation with the respective specialty board.
  • Residents will also be allowed and encouraged to take bereavement leave in the event of a miscarriage or death of a child, to be discussed on an individual basis with Human Resources at the discretion and comfort of the resident.

Additional Leave Considerations

  • No “Make-Up Call”: Residents taking protected leave time will not be required to “make-up” call missed during their scheduled leave. This applies particularly to scheduled calls in addition to regular clinical duties such as trauma call coverage by senior residents and consult call coverage by junior residents.
  • The program will communicate with affected residents the planned schedule changes.
  • Residents can choose when to start the leave (e.g., does not need to be immediately after delivery for parental leave or non-birthing parents), though time parameters may exist in connection with specific policies.
  • We suggest you review your leave considerations with Human Resources for assistance.
  • Residency training extensions need to be pre-approved by the ABS and ABPS.

Returning to Clinical Activity

How/When to Express Your Anticipated Return to Work Date

We suggest you discuss various options for parental leave and returning to work with Human Resources as early as you feel comfortable discussing this.

Requesting Changes to Anticipated Return to Work Date

The program understands that the birthing process and outcomes can be unpredictable. The program will work to be fluid and accommodating to each resident’s individual circumstances. If there is a change to your anticipated return to work date for any reason, please contact Human Resources who will aid in navigating that process.

Accommodations Upon Returning to Clinical Duties

As during pregnancy, it is anticipated that parents may require accommodation upon returning to clinical duties, and effort will be made to accommodate requests to start or not start on a particular rotation upon return to clinical duties. Any requests for accommodation should be directed to Human Resources.

Resources and Support for Parents

Related University and GME Policies

KU School of Medicine

University of Kansas Medical Center
Department of Surgery
Mail Stop 2005
3901 Rainbow Boulevard
Kansas City, KS 66160
Phone: 913-588-3117