Avani Desai on why residency needs program-specific parental leave policies

In this interview, Avani Desai, an MD candidate at the University of North Carolina in Chapel Hill, discusses her research examining the availability and transparency of parental leave policies across residency programs.¹ She highlights a notable gap between institutional-level policies, which were relatively common, and program-specific policies, which were far less frequently available. Although institutional policies establish a baseline framework, Desai emphasizes that they often fail to address the specialty-specific and practical realities of residency training, such as call responsibilities, operative duties, or the impact on board eligibility. This lack of detail can leave both residents and applicants uncertain about how leave will actually function in practice.

Desai points to urology as a relative outlier, with the highest rate of program-specific policy availability, though still not widespread. She attributes this to proactive efforts within the field, including initiatives by the American Urological Association and the Society of Women in Urology, as well as advocacy to support diverse trainees, particularly women and those starting families. These efforts, she suggests, have fostered a culture that encourages greater policy clarity. Other specialties, she argues, could learn from this example by engaging national organizations to set expectations for transparency and provide frameworks for programs to follow.

Looking ahead, Desai stresses that simply posting policies online is insufficient. For policies to be truly useful, they must include actionable details: the duration and nature of leave (paid or unpaid), how clinical responsibilities such as call or operative duties are covered, the impact on training timelines and board eligibility, and clear procedures for requesting leave and accessing support. By providing this level of specificity, programs can empower residents to make informed decisions, promote equity, and normalize parental leave as a natural part of surgical training. Ultimately, Desai argues, increasing transparency in policies is not only about compliance but about fostering resident well-being and inclusivity.

REFERENCE

1. Desai A, Stivali T, Muir, C, Bethel E, Michel K, Smith, A. Variability in accessibility of residency parental leave policies across surgical specialties. Urology. 2025 Jul 15:S0090-4295(25)00695-8. doi:10.1016/j.urology.2025.07.015