Paid Parental Leave Available to Medical School Faculty but Not Trainees
MedicalResearch.com Interview with:
Kirti Magudia, MD, PhD
Diagnostic RadiologyResident, Brigham and Women’s Hospital
Clinical Fellow, Radiology, Harvard University
Debra F. Weinstein, M.D.
Vice President, Graduate Medical Education, Partners Health Care
Associate Professor of Medicine, Harvard Medical School
Christina Mangurian, MD,MAS
Professor and Vice Chair at the UCSF Department of Psychiatry
Weill Institute for Neurosciences
Core Faculty, UCSF Center for Vulnerable Populations
Affiliate Faculty, UCSFPhilip R. Lee Institute for Health Policy Studies
Reshma Jagsi, MD, DPhil
Professor and DeputyChair, Department of Radiation Oncology
Director, Center for Bioethics and Social Sciences in Medicine
University of Michigan
MedicalResearch.com: What is the background for this study?
What are the main findings?
Response: Training lengths for medical specialties are increasing and many people are starting training later. Hence, many more trainees are having children during training, an especially difficult time due to long and inflexible work hours. Given the match system, trainees may not have complete control over where they end up in training and thus may not have an optimal support system nearby. Many of the top training institutions are also in high cost of living areas. Since trainees are essentially temporary employees, changing policies to their benefit is challenging. For all of these reasons, prospective and current trainee parents are especially vulnerable.
Parental leave is important to both male and female trainees. We found that just over half of the 15 top graduate medical education (GME) sponsoring institutions associated with the top 12 medical schools did not have parental leave policies. Without these policies, trainees are at the mercy of their departments and program directors. Those institutions that do have parental leave policies for trainees offer significantly less leave to trainees than to faculty. Even then, trainees may not be encouraged to take leave afforded by policy as, depending on specialty board regulations, the leave may extend training time.
Dr. Gardner[/caption]
Rebekah L Gardner MD
Associate Professor of Medicine
Warren Alpert Medical School
Brown University
Providence, Rhode Island
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Burnout profoundly affects physicians, their patients, and the health care system.The role of technology in physician burnout, specifically health information technology (HIT), is not as well characterized as some of the other factors. We sought to understand how stress related to HIT use predicts burnout among physicians.
Our main findings are that 70% of electronic health record (EHR) users reported HIT-related stress, with the highest prevalence in primary care-oriented specialties. We found that experiencing HIT-related stress independently predicted burnout in these physicians, even accounting for other characteristics like age, gender, and practice type. In particular, those with time pressures for documentation or those doing excessive “work after work” on their EHR at home had approximately twice the odds of burnout compared to physicians without these challenges. We found that physicians in different specialties had different rates of stress and burnout.
Dr. Steen[/caption]
Dr. Lowell H. Steen, Jr., M.D.
Interventional Cardiologist
Loyola University Medical Center
Dr. Steen discusses how holiday treats & stress can increase the risk of heart attack.
MedicalResearch.com: What are the main factors that are linked to an increase in heart related adverse events during the Christmas holiday season? Who is most at risk?
Response: The increase in holiday season heart-related hospitalizations and deaths are due to a variety of behaviors such as putting off seeking medical help until after the holidays, overeating rich foods, strenuous travel, excessive alcohol consumption and stressful family interactions. These factors can all trigger heart issues.
Factors such as age, diabetes, high cholesterol and smoking all increase heart risk. Additionally, those with high blood pressure, which is a leading risk factor for heart disease and stroke, are exceptionally at risk and should celebrate the hectic holiday season with caution. 
Dr. Wadhera[/caption]
Dr. Rishi Wadhera, MD
Cardiology Fellow
Brigham and Women's Hospital
Harvard Medical School.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In the United States, an estimated half a million people are homeless on any given night. In recent years, policy efforts to improve the health of homeless individuals have intensified, but there is little large-scale, contemporary data on how these efforts have impacted patterns of acute illness in this vulnerable population.
In this study, we examined trends, causes, and outcomes of hospitalizations among homeless individuals in three states – Massachusetts, Florida, and California – from 2007 to 2013. We found that hospitalization rates among homeless adults increased over this period of time.
Strikingly, over one-half of these hospitalizations were for mental illness and substance use disorder. More broadly, homeless adults were hospitalized for a very different set of reasons compared with demographically similar non-homeless adults. In addition, homeless individuals had longer lengths of hospitalization but lower total costs per hospitalization.
Prof. VanderWeele[/caption]
Professor Tyler VanderWeele Ph.D
John L. Loeb and Frances Lehman Loeb Professor of Epidemiology
Harvard University
MedicalResearch.com: What is the background for this study? What are the key points of the paper?
Response: Several prior studies have suggested that religious service attendance is associated with lower rates of divorce. However, many of these studies have been with small samples and have not had rigorous study designs. In addition, most studies have focused on women earlier in life and there has been little research on the effects of religious service attendance on divorce later in life. While divorce rates in the United States in general has been falling, it has in fact been increasing for middle-aged groups, doubling between 1990 and 2010.
In our study we found that among women in mid- to late- life, regular religious service attendance was subsequently associated with 50% lower divorce rates over the following 14 years of the study.
We also found that among those who were widowed, religious service attendance was associated with a 49% increase in the likelihood of remarrying over the 14 years of the study.
Dr. Barrett[/caption]
Charles Barrett. Ph.D.
School Psychologist
Loudon County Virginia
Public Schools
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Numerous studies have shown that Black children are more likely to receive ratings that are more indicative of displaying externalizing behavior difficulties, including Attention Deficit Hyperactivity Disorder (ADHD). However, many of these studies included teachers as the informants. Consistent with most teachers in the United States, raters have typically been White females. For this reason, it is unclear if these outcomes would exist if the rater and child shared the same racial/ethnic background. Additionally, most research in the United States that involved cross-cultural comparisons has used White and Hispanic boys. Few empirical studies have examined differences between Black and White boys.
The present study sought to address several limitations in the field. Most notably, cross-cultural comparisons between Black and White boys were included instead of Hispanic and White children. Next, maternal figures, rather than teachers, were included as the informants.
The present study was developed using a similar methodology that examined Hispanic and White boys’ behavior from the perspective of Hispanic and White teachers (Dominguez de Ramirez & Shapiro, 2005). In sum, we sought to determine if there were differences in how Black and White maternal figures rated Black and White boys who were demonstrating the same level/type of behavior (i.e., sub-clinical levels of 
Dr. Scullin[/caption]
Michael K. Scullin, Ph.D.
Assistant Professor of Psychology and Neuroscience
Director, Sleep Neuroscience and Cognition Laboratory
Baylor University
Waco, TX 76798
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There is a gap between what health behaviors individuals know they should adopt, and what those individuals actually end up doing. For example, a growing literature shows that simply educating students on the importance of sleep does not change their sleep behaviors. Thus, we need to think outside of the box for solutions.
In three classes, we have now investigated a motivational solution: if students can earn extra credit on their final exam for sleeping better, will they do so even during finals week?
