Parental Leave Policy in Neurosurgery: Problems and Solutions Required Across the World

Introduction: Protected personal parental leave (PL) time, especially at the time of childbirth, is critical in establishing a healthy work-life balance (WLB) for all genders across all professions. However, studies of parental leave time in neurosurgery (NS) have not explored the issue across different countries/cultures and across the life span. We provide the first description of NS PL internationally and identify the directions for change required to address this major challenge to contemporary neurosurgery.

Methods: International e-survey of neurosurgeons and trainees.

Results: Of the 402 respondents, 239 (60%) noted that their culture still expects women to take on the main responsibility of raising their children. Significant limitations of PL were a lack of: 1) financial support for childcare (77%), 2) subsidized accommodations (75%), 3) child care (65%), 4) lactation room integrated at work (64%), 5) extra training time (62.3%). Most of them relied on their spouse (50.2%), their parents/their spouse’s parents (19.1%) and sit-in babysitter (11.7%) to fill these gaps.
Only 60% of organization/programs provide paid PL. The most common PL was only for 3 months (38%). Fewer than half (48%) were satisfied with the PL policy of their program/organization and most of these were NS with >20 years’ experience (OR 2.67, 95%CI 1.04-7.44, p=0.02). No statistically significant differences exist in satisfaction of PL across genders, level of training, whether the respondent has a child, work environments, and country.

Directions for improvement were the same amongst all genders: 1) paid PL (62%), 2) minimum of 6 months PL (47%), 3) replacement of NS resident/staff to take on work (37%), 4) spousal financial support and time off work to allow them to continue to do Neurosurgery (35.4%).

Conclusion : To attract and retain the best medical graduates from a diversity of backgrounds, NS across all continents must immediately create PL policies that incorporate contemporary views on gender roles, and, equitable and fair financial and WLB that allow people to have healthy WLB and family lives.