Parenting in Residency

Medicine and Fertility - Family Planning for Docs 

Fertility and Childbearing Among American Female Physicians - PubMed (nih.gov)

Podcast - Family Planning For Docs

Starting a Family at Different Stages of Training

Royal College Exams

• Taking the royal college certification exams with your residency cohort was a concern of the past that sometimes led to residents limiting the length of their leave (i.e. to 6 months) so that they could take the exam at the same time. As of 2022, there is no timeline for completion of residency in relation to the exam, which allows residents to take leaves of any length and take the exam during the same time as their residency cohort if they so choose.

Fellowship Applications

• Timing of leave during residency may impact whether or when you are able to apply to fellowship programs of your choice. Reach out to other fellows in the program, upper year residents, staff mentors and/or fellowship program administrators to discuss terms of a leave.

Rotation Planning

• Some rotations are mandatory in certain year, while others are optional. It may be preferable to be on less physically strenuous rotations in the first trimester of pregnancy or in the last trimester. Similarly, returning to work for any parent can be challenging and lighter rotations which allow for an earlier return home and possible missed work days may be preferable. 

• Inform your Program Director about your pregnancy first.
• Enroll in childcare waitlists early, ideally during pregnancy.
• Familiarize yourself with the PARA Agreement and PGME Policies. 
• Consider reaching out to the Office of Resident Affairs and Physician Wellness for additional resources and support.  
• Plan for patient continuity during your upcoming leave - 
  • Scale back on using secure chat for patient concerns
  • Use Notes in the patient chart rather than staff messages
  • Use the “Attach” function in your Connect Care In-Basket to forward results to covering physician

3 months before due date 

• Ensure your PD knows that you are expecting by this point. 
• Complete the Resident Leave of Absence Request Form and submit it to your Program Administrator through e-people. 
  • Once PGME receives your signed LOA form, they will start the process with AHS. If you have any questions please email - pgme@ucalgary.ca
• Choose how much time you would like to take and how you would like to distribute your Government of Canada EI benefits Find out how here. Calculate your potential benefits here. 
• CIP Program: If you will be absent from any of your CIP seminars, ask someone else to host them

5 - 3 weeks before due date

• Check your mail for your Maternity Benefit Package from AHS
  • You will lose your resident Blue Cross benefits while on leave, consider “opting in” to keep them.
  • If you haven’t received a maternity benefits package from AHS, please inform MEO at CAL.MedicalEducationOffice@albertahealthservices.ca or (403) 943-1253.
• Apply for Employment Insurance (EI) through Service Canada
  • Gather required information: 
  • Check snail mail for your EI benefit statement, on this statement will be your EI access code. This code is critical. 
• Cancel your CMPA membership for the period of time you are not working
  • Call 1 (800) 267-6522 between 8:30 a.m. and 4:30 p.m. EST or check out www.cmpa-acpm.ca.
• Your Record of Employment (ROE) 
  • will be issued by the AHS Payroll department following the payment of your final earnings. Your ROE will be sent electronically to Service Canada. Once ROE is uploaded to Service Canada Web page, you should be able to log into your Service Canada account and download the copy for your records.

Baby Arrives

• Provide a birth announcement to the HR Contact Centre (1-877-511-4455) or online through the HRCC Portal as soon as possible. You will need to provide your employee details such as your employee ID number. 
• If you have not done so already, turn off push notifications on the Connect Care (EPIC/Haiku) application on your phone
• Set an “Out of Contact” message on your Connect Care in-basket.
• Take pleasure in the time with your new little one. Remember, even while on leave, you can still access the counselling services offered by the Office of Resident Affairs and Physician Wellness.

6 Weeks Postpartum

• Complete your Supplementary Unemployment Benefit (SUB) form at your 6-week postpartum checkup. (Received in your maternity benefits package - details are on the form) 

The decision to inform your Program Director (PD) about your pregnancy or plans for maternity and/or parental leave is yours. We advise that you notify your PD before others, as it is preferable for your program to learn of it directly from you. The sooner you communicate this, the earlier they can assist with arranging rotations, modifying call schedules, and planning medical leaves if needed.

Speaking to Your Program Director - Deciding when/how to discuss this important topic with your program director can be challenging. Here are some tips and considerations

Unless a pregnant Resident Physician otherwise chooses, they will not be required to perform on-call duties over twelve (12) hours or between 2400 and 0600 hours, nor be scheduled for standard or shift-based duty hours over twelve (12) hours or between 2400 and 0600 once they have completed twenty-four (24) weeks of gestation, or earlier if a valid medical reason is provided. AHS may require a medical certificate confirming any medical restrictions related to the provision of services by the Resident Physician during pregnancy. (PARA Agreement Article 19.02)

In Simple Terms  

• After 24 Weeks of Pregnancy: 
  • A resident is not required to work more than 12 hours per day. 
  • A resident are not required to work from 12 – 6 AM. 
  • A resident is not required to work more than 4 in-house call shifts in 10 days (PARA Agreement Article 23.05e).
    • These call shifts should not be front-loaded. Please contact para@para-ab.ca if you have any concerns with this.

ARTICLE 17: PARA Agreement 

17.01 Resident Physicians shall be provided paid leave and health benefits, as defined in Article 32: Health Benefits, for illness or non-occupational injury for a total of up to ninety (90) days for each Appointment Year. Coverage under this Article shall commence on the first day the Resident Physician carries out the duties of their appointment. In the event that the leave for illness or non-occupational injury occurs in the last ninety (90) days of the final Appointment Year, that Appointment Year shall be extended to ensure coverage for up to ninety (90) days of sick leave benefits at which time the Resident Physician may become eligible to receive long term disability benefits. 

17.02 In the event the educational requirements are not met, the Resident Physician may be required by the Program Director to make up the period of appointment missed due to the illness or non-occupational injury. 

17.03 The Resident Physician may be required by the Program Director to submit a medical certificate in support of any illness or non-occupational injury.

In Simple Terms  

• A Resident that has a valid reason for being absent from work prior to their estimated delivery date or following their maternity leave is eligible for 90 days of paid sick leave. 
• Residents can apply for accommodations for any medical limitations experienced during pregnancy. 

Pregnancy Loss Resource - Family Planning for Docs

Me or my partner's pregnancy unexpectedly ends (before 24 weeks pregnant) 

• If a resident’s pregnancy ends:
  • If you're reading this following a loss, please accept our condolences. There are two possible avenues for taking the time you need to heal and grieve.
  • Sick leave: Resident Physicians shall be provided paid leave and health benefits, as defined in Article 32: Health Benefits, for illness or non-occupational injury for a total of up to ninety (90) days for each Appointment Year. The Resident Physician may be required by the Program Director to submit a medical certificate in support of any illness or non-occupational injury. (PARA Agreement Article 17)
  • Bereavement leave: Upon request, a Resident Physician shall be granted leave of absence in the event of the death of a relative of the Resident Physician. For the first five (5) days of such leave of absence, the Resident Physician shall suffer no loss of pay or health benefits, as defined in Article 32: Health Benefits. In extenuating circumstances, paid bereavement leave may be extended by up to a maximum of five (5) additional days subject to approval of the Associate Dean. Such extension shall not be unreasonably requested or denied. If further time off is required, such additional leave shall be subject to the approval of the Associate Dean and shall be unpaid. (PARA Agreement Article 16)
• If your partner's pregnancy ends: 
  • If you're reading this following a loss, please accept our condolences. Bereavement leave - Upon request, a Resident Physician shall be granted leave of absence in the event of the death of a relative of the Resident Physician. For the first five (5) days of such leave of absence, the Resident Physician shall suffer no loss of pay or health benefits, as defined in Article 32 of the PARA agreement. In extenuating circumstances, paid bereavement leave may be extended by up to a maximum of five (5) additional days subject to the approval of the Associate Dean. Such extension shall not be unreasonably requested or denied. If further time off is required, such additional leave shall be subject to the approval of the Associate Dean and shall be unpaid. (PARA Agreement Article 16).

Note: If your pregnancy ends in week 20 or later, you can receive maternity benefits through the Government of Canada. Maternity benefits through PARA begin at 24 weeks pregnant. 

My or my partner's pregnancy unexpectedly ends (after 24 weeks pregnant)

• If a resident’s pregnancy ends:
  • If you're reading this following a loss, please accept our condolences. A Resident Physician whose pregnancy ends other than as a result of a live birth within sixteen (16) weeks of the estimated due date is entitled to 17 weeks of paid maternity leave. If maternity leave has not already commenced per Article 11.03(b) such maternity leave shall commence on the date that the pregnancy ends. Such maternity leave shall end sixteen (16) weeks after the commencement of the leave (PARA Agreement Article 11.03g).
• If your partner's pregnancy ends: 
  • If you're reading this following a loss, please accept our condolences. Bereavement leave - Upon request, a Resident Physician shall be granted leave of absence in the event of the death of a relative of the Resident Physician. For the first five (5) days of such leave of absence, the Resident Physician shall suffer no loss of pay or health benefits, as defined in Article 32 of the PARA agreement. In extenuating circumstances, paid bereavement leave may be extended by up to a maximum of five (5) additional days subject to the approval of the Associate Dean. Such extension shall not be unreasonably requested or denied. If further time off is required, such additional leave shall be subject to the approval of the Associate Dean and shall be unpaid. (PARA Agreement Article 16).

Registering early for child care waitlists can help secure a spot for your child. Families can find information about licensed child care programs and family day home agencies with the:

• University Child Care Centre Society 
  • In accordance with the University of Calgary Registrar’s Office policy, medical residents are considered in the “student” category and post-doctoral fellows in the “faculty/staff” category.
•  Child Care Lookup tool.
•  Call Child Care Connect toll free at 1-844-644-5165 for help finding child care or any questions you might have about child care in Alberta.
•  Choosing Child Care: a Guide to Licensed and Approved Child Care in Alberta
•  Care Find is an easy to use website that helps you find daycares, preschools, out of school cares and approved day homes.

Maternity Leave 

• Lasts 17 weeks
• You will receive 90% of your salary if you are eligible for EI 
• The 17 weeks of top-up pay is paid in a lump sum at the end of the leave
• Begins no later than the date of delivery.
• Can begin 8 weeks before estimated due date. 

Parental Leave

• After the 17 weeks of paid maternity leave, unpaid (other than EI payments) Parental Leave can begin
• You can choose to take a standard parental leave or an extended parental leave.
  • Standard: up to 40 weeks if shared between parents. One parent cannot receive more than 35 weeks of standard benefits (at 55% of your wage up to $668 weekly)
  • Extended: up to 69 weeks if shared between parents. One parent cannot receive more than 61 weeks of extended benefits (at 33% of your wage or up to $401 weekly)
  • Calculate your benefits here 
• Residents must opt-in to maintain their benefits while on maternity and unpaid parental leave.
• The non-birthing partner gets 2 paid weeks off within the first year
• You do not have to pay tuition during maternity or parental leave.

• The Resident Physician shall receive up to seventeen (17) weeks of sufficient pay inclusive of the Employment Insurance one (1) week waiting period to match ninety percent (90%) of her salary when combined with Employment Insurance benefits for maternity leave.(PARA Agreement Article 11.03c)(Government of Canada - Maternity Benefits) 
• The pregnant resident can start their Maternity Leave up to eight (12) weeks prior to the predicted date of birth. Maternity leave must start no later than the estimated date of delivery (PARA Agreement Article 11.03b)  
• Maternity benefits are only available to the person who is away from work because they’re pregnant or have recently given birth. They cannot be shared between parents.
• If a resident physician goes on sick leave prior to the birth of the child, the sick leave ends and the maternity leave starts the day the child is born.

• In the event of the birth or adoption of a child, where a Resident Physician has not been granted maternity leave, a Resident Physician shall be granted a maximum of two (2) weeks leave of absence with full pay and benefits to be taken within the first fifty-two (52) weeks following the birth or adoption of a child (PARA Agreement Article 11.04a).
  • Note: This time does not need to be taken all at the same time (ie. two one-week periods are acceptable under the Agreement).
• A Resident Physician shall receive at their request additional leave without pay or benefits as follows (PARA Agreement Article 11.04b): 
  • i. Maternity Leave granted – total leave of up to seventy-eight (78) weeks inclusive of any leave taken under Article 11.03(b), or 
  • ii. No Maternity Leave granted – total leave of up to sixty-two (62) weeks inclusive of any leave taken under Article 11.04(a).
  • Note: EI can be collected during this leave (see below)
• According to the Government of Canada: 
  • Standard Parental Leave: up to 40 weeks can be shared between parents, but one parent cannot receive more than 35 weeks of standard benefits. 55% of wage at a maximum of $668
  • Extended Parental Leave: up to 69 weeks can be shared between parents, but one parent cannot receive more than 61 weeks of extended benefits. 33% of wage at a maximum of $401

Resident physicians automatically lose their Blue Cross benefits while on maternity and unpaid parental leave. A resident may choose to “opt-in” by paying 100% of the premiums for these benefits by submitting the “Benefits Coverage During Leaves of Absence” form that is included in the Maternity Package you receive from AHS Benefits three months before your expected due date. 

• In either case, residents continue to have access to their Flexible Spending Account, and PARA will continue to pay their premiums for Long Term Disability Insurance and Life Insurance.

Government of Canada EI Maternity and Parental Benefits

• Are you pregnant or recently given birth? 
• Are you or will you be a parent caring for your newborn or newly adopted child?
• Have or will your regular weekly earnings from work decreased by more than 40% for at least 1 week? 
• Have you accumulated 600 insured hours of work in the 52 weeks before the start of your claim or since the start of your last claim, whichever is shorter. (AHS records resident physician's hours at 40 hours per week.)
  • Note: you may still be eligible if you have insured working hours from another source/employer. Check with Service Canada to see if you are eligible.

AHS Maternity and Parental Benefits

• Has it been at least 8 weeks since the first day of your residency?  (PARA Agreement Article 11.03a)

In Simple Terms  

• You must have worked 600 hours in the last year and been in your residency for at least 8 weeks to receive full benefits and leave.

I haven’t been in my residency for 8 weeks yet

• Eligibility for maternity leave pay and benefits commences eight (8) weeks following the first day that the Resident Physician commences the duties of their appointment. If leave is required prior to completing eight (8) weeks of service, the Resident Physician may be eligible for sick leave and/or an unpaid general leave of absence in accordance with Articles 17 and 18 of the PARA Agreement.

I am in my last year of residency

• When a maternity leave commences in the final year of training, maternity pay and benefits will conclude at the end of the final Appointment Year, unless the Resident Physician’s appointment is extended and the Resident Physician is required to return at the conclusion of the maternity leave (PARA Agreement Article 11.03f).

I don't want to take a leave

• The Alberta government website states: Birth mothers (parent) must take at least 6 weeks after birth for health reasons, unless:
  • the employer agrees to an early return to duties, and
  • the employee provides a medical certificate stating the return will not endanger their health

Connect Care access is deactivated if you do not login for 180 consecutive days (about 6 months). Typically, you would receive a reminder about the need to login to preserve your access at 150 consecutive days without logging in. Logging into Connect Care at least once every 180 days will avoid unintended deactivation of your Connect Care access.

Please email connectcare@ahs.ca if your Connect Care access is deactivated. 

• If you return to work earlier than the date on your original Leave of Absence Request Form (LOA) you must: 
  • Inform the MEO by sending an email to CAL.MedicalEducationOffice@albertahealthservices.ca with your new return date 
  • Complete a new LOA form and submit it to your Program Admin.
  • Email PGME to update them on your new return date at pgme@ucalgary.ca.
• If you choose to extend your leave, you must inform your program administrator, PGME and the MEO as well as re-apply for EI to extend your benefits if applicable.
• In the month before returning: 
  • Please send an email to your Program Administrator (PA) to inform them of your return to work. NOTE: your PAs and Program Directors (PDs) may have changed during your leave. The most up-to-date program information can be found here.
    • You will get an email from your MEO a month before returning. If you have not heard from your MEO two weeks before your return, please contact the Postgraduate Medical Education (PGME) office, and the Medical Education Office (MEO) to inform them of your return to work. 
  • Contact the Parking office to get your ID reactivated.
  • Should your CPSA license or CMPA Malpractice Insurance require renewal while on your leave and it lapses, you might be required to submit new police checks from each jurisdiction where you have held a practice permit upon renewal.
  • Ensure any expired certifications, such as BLS or ACLS, are renewed before returning.
  • Ensure you still have access to Connect Care. 

• It is AHS’ responsibility to provide a private space for you to chestfeed/pump; however, you may need to contact AHS prior to returning to work to request that they locate a space for you.
• You will need to fill out a ‘Request for Accommodations’ form, which can be found on the AHS website. Once there, search for “Employee Request for Accommodation”, and it will be the first available option.
• Lactation room locations at the 5 Calgary hospitals

To add tips to this list please click here. 

• Use your 5 special leave days when your children are sick 
• Being a parent, a leader and an excellent physician are all achievable 
• Don’t have your work email on your phone. Do work after the kids go to sleep 
• Its worth it to spend time with your kids. The hospital will always be there
• The knowledge comes back after leave. But be kind to yourself during this process
• Block time in your calendar. Know when deadlines are and what you're being evaluated on. Scheduling time is so important.
• Sometimes you won't meet your own expectations. That’s okay. 
• Listen to podcasts in the car and use that time efficiently. 
• You will have to be more thoughtful and creative with your time. Kids are great at keeping your priorities straight.
• Approach your PD first with a request. If things go poorly, there are a lot of supports. If it goes well, follow up with an email so that it is in writing. 
• If you can handle call, you can handle a baby through the night
• Get on daycare lists early and utilize the available subsidies. 
• UCalgary Childcare Centre is excellent and reliable as well as quite subsidized (affordable) currently - apply early (around 18 months from start date minimum). It is worth paying for a few months before you need it.
• Try to leave work at work as much as possible, so that when you get home you can just focus on being a parent (until they go to bed at least).

In Simple Terms: 

• Residents have access to 5 days of special pay that they can use when a family member is sick. Communicate with your clinical supervisor and PD when you need to take one of these days.
• You are not expected to make these days up.
• If you find that you are in need of regular protected time off due to health challenges, you can request a formal accommodation.

Specifics:

• Resident Physicians shall be granted up to a maximum of five (5) days in each Appointment Year of Special Leave, without loss of pay and health benefits, as defined in Article 32: Health Benefits. Special Leave includes reasonable circumstances where the Resident Physician is unable to report to service due to an unanticipated circumstance which requires the Resident Physician’s personal attention and which may include illness in the Resident Physician’s immediate family. A Resident Physician may be required to submit satisfactory proof demonstrating the need for Special Leave. Resident Physicians will communicate their need for Special leave to their clinical supervisor and Program Director as soon as possible. (PARA Agreement Article 14)