Parenting

Parenting while you are working full time is always a bit of a juggling act, but parenting while in residency can be particularly tricky because of call shifts and rotations to hospitals that may be quite far from home.

Resident Doctors of BC supports residents who choose to start a family by providing educational workshops and a variety of resources to help parents-to-be make the right decisions for their families.

Our Parenting Guide (updated annually) collects all of the information below into one convenient handbook. Hardcopies are available at the Resident Doctors of BC office, or download a PDF by clicking on the image to the right.

The workshop slides on finances for parenting from the 2016 Parenting Workshop are also available for members to review.

Or watch the webinar on the right for a snapshot of the available leaves and benefits available for residents. Full details on leave and benefits can be found in the applicable sections below.

Before going on Leave

  • Planning

    When and how to start your family are very personal choices, but many residents start their families during their residency. There are several advantages to having children during residency: For many physicians, residency may be only time in their career that they expect to have parental leave and employment insurance covering at least part of their leave. However, many provinces are now offering maternity/parental leave benefits programs; Doctors of BC’s program provides pregnancy benefits as well as parental benefits for male physicians and adoptive parents.

    Before you go on leave, make sure you have worked 600 insurable hours in the last 52 weeks, or since your last claim in order to qualify for EI.

    Though there are many compelling reasons to become a parent during residency, it is also very challenging. Residents are busy and often have very little control over their schedules. They routinely have heavy call schedules making pregnancy and balancing family time even more challenging. Residents are not yet at their peak income, so careful financial planning can be necessary to budget for additional members of your family.

    Read more about preparing for leave in the Before Leave section

  • Pregnancy during Residency

    Residents have a unique workload, including long hours, potentially violent or hazardous exposures and physically demanding procedures. Accommodating the demands of residency with the physical changes of pregnancy can be tricky but not impossible. The current Collective Agreement includes a Memorandum of Understanding on the Workload during pregnancy. This Memorandum ensures, that should your physician be of the opinion that a reduction in workload is warranted (including the elimination of call) then the workload will be reduced to the extent prescribed.

    UBC also has a policy on Pregnancy during Residency. This policy specifically denotes that after 24 weeks gestation residents will not be required to work more than 12 continuous hours, and may opt out of duties to comply with infectious disease prophylactic measures.

    You should meet with your Program Director as soon as you are comfortable doing so to discuss your training adjustments and expected Maternity Leave date. When you sit down with your director to discuss your upcoming maternity leave, it is also important to review the rotations you will complete while pregnant. Be realistic about how you will be feeling during your first, second and third trimesters and consider moving rotations to best suit your physical state. Fatigue and nausea are common in the first trimester, most women feel quite well during the second trimester, and fatigue, leg swelling and difficulty bending mark the third trimester. Consider tailoring your rotations to complete your heavier rotations during the second trimester. Talk to your Program Director about what the department policies are regarding pregnant residents.

    When you discuss your end of work date, set a date that you are comfortable with but remind your director (and yourself!) that everything will depend on how the pregnancy unfolds. You may have to stop work earlier than planned or have lighter duties if there are complications during your pregnancy.

    It is worth thinking about the exposures we deal with during the course of our training and how they will relate to your pregnancy. You may choose to defer a rotation, for example, in pediatric emergency during the peak of flu season to avoid excess infectious exposures. Think about rotations with increased infectious, radiation and toxic exposures and discuss these concerns with your Program Director and occupational health services at your local health region.

    Hopefully, your pregnancy will be problem free and you will transition gracefully into maternity leave; however complications do arise during pregnancy. Should you have to stop work early due to complications of your pregnancy you should be aware that, under the current Collective Agreement, this time should be considered sick leave, not maternity leave:
    9.01 (E) Sick Leave Provisions – Maternity leave medical complications of pregnancy shall be covered by sick leave provisions. Pregnancy shall not constitute cause for termination.

    Read more about pregnancy during residency in the Before Leave section

  • Medicine and Motherhood

    Medicine and Motherhood

    The Physician Health Program in 2010 wrote a consensus statement on Medicine and Motherhood, This paper provides a summary of the current evidence regarding the impact of work on maternal and fetal health, including the implications for women who delay pregnancy until later in life. It also highlights workplace conditions that may need to be modified for the pregnant physician. It is intended to serve as a guide to assist the pregnant physician and her colleagues with conversations about workplace accommodation as set out in the Human Rights Code of Canada.

    Blog

    You are not alone in the ups and downs of motherhood and residency. Stay up-to-date on how your peers are doing through this online blog: www.mothersinmedicine.com

  • Infertility

    Your physician will be able to provide you with many options and support mechanisms for infertility. One group that meets in Vancouver is VIPS:

    VIPS flyer

    Additionally EFAP and PHP may also be able to provide support.

  • Adoption

    Adopt BCThere are many forms of adoption and options when it comes to creating a family. Some forms of adoption include:

    For more information on adoption in BC and resources for parents (waiting and placing) please visit the Ministry of Children and Family Development

    The BC Adoptive Families Association of BC also provides education support and resources on adoption for those considering adoption, waiting for a child, considering placing their child and adoptees. This organization also provides profiles on some of the children in BC waiting for families.

During Leave

  • Leave

    With the exception of maternity, leave is unpaid. However, residents may qualify for EI during this time. What you can expect to earn while on leave will depend on your income (and thus PGY level) and whether you choose to work part-time (moonlight, etc) or have other income sources. Birth Mothers are entitled to 52 weeks consecutive leave (the first 17 weeks of which are paid at 85%), whereas fathers and adoptive parents are entitled 35 weeks of unpaid leave.

    Regardless of the amount of time you take, maternity or parental leave can be an enriching time. It may also include: getting peed on, spit-up on, pooped on (or even all three at once), nights more sleepless than the worst night on VGH CTU, and seemingly endless crying at 3am. You will, however, have time to get to know your child and fall madly in love with them. Parenting is much more than just taking care of basics, so take time to make connections with your community; you will likely meet other parents in your area that you wouldn’t otherwise cross paths with. Whether you are experiencing parenthood for the first or the umpteenth time, there are things in the community (much of it free!) to do:

    • Parent-baby weigh-ins and discussion groups – Run through the Public Health Units/ local community centres
    • Community centre classes – singsong, baby sign language, drop-in gym time, local library story & song times
    • Participate in research – Women’s Hospital often has studies ongoing for new parents; UBC has an infant cognition lab that studies infant development
    • Fitness activities – Postnatal fitness/yoga classes, parent hikes, swimming lessons, etc.
    • Social outings – “Stars & Strollers” or “Movies 4 Mommies.”
    • Connect online – There are many online parent networks that you can subscribe to:
      • yoyomama.ca sends a weekly email with family-friendly events for the upcoming week. It covers cities and towns within about a 5-hour radius of the lower mainland.
      • meetup.com – local parent groups are searchable here
    • Moonlighting – If you have a general license, you could look into moonlighting or working at a walk-in
    • Stay connected with your program – You may want to stay connected to your program while on leave by attending half-days, resident retreats, or conferences.
    • Professional development – Some residents use the time for professional development by working on research projects, or doing CPD
    • Enjoy your freedom from your pager – Volunteer, travel, or whatever suits your fancy. There are often access programs for low-income families. These provide discounted or free access to swimming, skating, and other events. Recent graduates from medical school may be eligible. Check out the Vancouver program.

    Read full details on leave in the During Leave section.

  • Income and Benefits

    With the exception of maternity, leave is unpaid. However, residents may qualify for EI during this time. What you can expect to earn while on leave will depend on your income (and thus PGY level) and whether you choose to work part-time (moonlight, etc) or have other income sources. The basic benefit rate is 55% of your salary (although the maximum salary is $50,800 and all full time residents will pass this cut off). In other words, you can receive a maximum payment of $537 per week from EI. This amount is “topped up” to 85% of your salary for biological mothers for weeks 1 – 17.

    Maternity Leave

    Maternity Leave is weeks 1 – 17 of leave, birth mothers may take up to 52 weeks of consecutive leave; weeks 18 – 52 are considered parental leave.

    If you qualify, there is a two-week waiting period for EI; during this two-week period, you will receive 85% of your salary from the employer as part of the Supplement Employment Benefits Plan (SEB Plan)

    You are required to have worked for 600 hours in the last 52 weeks or since your last claim, to be eligible for EI benefits. If you are not eligible for EI benefits, for the 15 weeks of your maternity leave, the employer will provide 85% of your salary as part of the SEB Plan

    Maternity EI benefits are a maximum of 15 weeks (exclusive of the 2 week waiting period). A combination of maternity and parental leave can make up to a maximum of 50 weeks of EI benefits

    The basic benefit rate is 55% of your average insured earnings up to a yearly maximum insurable amount, which for 2016 is $50,800. This means you can receive a maximum payment of $537 per week

    If you work while on maternity leave, your earnings will be deducted dollar for dollar from your benefits.

    Your EI payment is a taxable income, meaning federal and provincial or territorial taxes will be deducted if applicable

    Example:

    R1 who qualifies for EI

    Weeks 1-2 SEB: $832.25 (85% of base salary)

    Weeks 3-17 EI: $537 + SEB: 295.25

    Parental/Adoption Leave

    Parental EI Benefits are a maximum of 35 weeks, shared with your spouse (i.e. one takes 12 weeks the other 23; or any other configuration adding to 35 weeks)

    If you or your spouse completes the two-week waiting period for maternity benefits it does not need to be repeated for parental leave (not applicable for adoption leave)

    You are required to have worked for 600 hours in the last 52 weeks or since your last claim.

    The basic benefit rate is 55% of your average insured earnings up to a yearly maximum insurable amount of $50,800. This means you can receive a maximum payment of $537 per week (as of January 2016).

    If you work while receiving parental leave benefits, you can earn up to $50/week or 25% of your weekly benefit (137) whichever is greater. Under the Working While on Claim (WWC) pilot project, available until August 6, 2016, once you have served the waiting period, if your earnings are equal to or less than 90% of your weekly earnings that were used to calculate your benefit rate, your benefits will be reduced at a rate of 50% of your earnings each week. Any earnings that exceed this 90% threshold, will be deducted dollar for dollar from your benefits.

    EI payment is a taxable income, meaning federal and provincial or territorial taxes will be deducted if applicable

    Example:

    A PGY-3 resident on paternity leave who has met the criteria for EI and plans to work while receiving benefits.

    Base salary = $61,893.80

    Weeks 1-35 (This EI benefit can be split with a partner in any configuration totaling 35 weeks) EI: $537/week + up to $134.25/week in income, any earnings above this amount will be deducted dollar for dollar from the EI amount.

    Read more about leave in the During Leave section.

  • Paperwork

    There is a fair amount of paperwork during leave. Visit the During Leave section for full instructions. The three main steps are:

    1. Talk to your program administrator once you have announced your pregnancy, or know when you intend to take leave if adopting or have an expecting partner (four weeks notice is required for natural fathers). They should let you know what steps you need to take; many will do this on your behalf. In general, payroll services need to know your expected delivery date so they can plan for your maternity/parental benefits. You will want to update them once you officially start your leave as the expected delivery date is rarely the birth date.
    2. Apply for EI Benefits. Apply for EI as soon as you stop working, expectant mothers can start collecting EI up to eight (8) weeks before their expected delivery date. Delaying filing for your benefits past four (4) weeks from the start of your leave may cause a loss of benefits.
    3. File newborn paperwork (when your child arrives)

After Leave

  • Returning to Work
    Whether you return to work after a year or four months, do whatever works for your family - whatever that looks like.

    There is no right answer to the question, “When should I go back to work?” It is a personal decision that you should make with your family. It can be helpful to get input from colleagues and friends, who have been in the same situation before, but ultimately the decision is up to you. While becoming a parent is a life changing event, you are still you, and you know yourself best. Factors that you should consider when planning the length of your leave might include if you want to split your parental leave with a partner, your financial situation, child care availability and where you are in your residency training.

    While on parental leave you may decide that you need to shorten or lengthen your leave. Keep in mind, that until you meet your child you will not know how easy it will be to return to work. Some babies are easy going and good sleepers, while some, though still adorable, are not. Be willing to change your plan based on the temperament of your child, because sleep is important to your function at work.

    Natural Mothers are required, as per Article 9.01(F), to provide at least 14 days notice of their intention to return to work prior to the termination of the leave of absence.

    Returning to work can be a stressful and guilt-inducing time – or you may be dancing with excitement to return to your clinical work. Whatever your situation, remember the choices you make are right for you and your family. Talk to your colleagues who have also taken leave to find out what worked for them.

    Any time taken off residency must be made up, which will prolong your training time. Your vacation leave is also prorated based on the duration of your leave using the following formula:

    (days paid to June 30th inclusive/261)*20

    Example: A resident intends to start their leave on April 16th 2014 and intends to return in the new appointment period. Their vacation for the current term of appointment (July 1 2013 – June 30 2014) is prorated to 16 days. Their vacation entitlement in the new appointment period would also be prorated based on the number of days delayed from the July 1, start date.

    For more information on returning to work see the After Leave section.

  • Breast Feeding

    It is recommended that you invest in a breast pump since you never know when the hospital pump will be unavailable, or when you will be in clinics or at sites without breast pump facilities. Well known brands for breast pumps include Medela and Ameda. Ask friends who have breast pumps how they like their model.

    What you choose to buy will depend on how much you are pumping, the age of your child, and how long and often you are away from your child.

    • Manual hand pumps are generally small and portable. They do not require an electrical outlet and so where you pump is quite flexible. Manual pumps are best suited to occasional use, slower and only allow you to pump one breast at a time.
    • The other major type of pump is electric. There are electric single and double side pumps. Double side pumps tend to be more expensive, but allow you to pump both breasts at the same time, increasing the speed at which you can pump.
    Many residents recommend the double pump. It will save you a lot of time, especially if you need to sneak away for a brief period of time in order to pump.

    Some hospitals have a room especially for breastfeeding staff, others allow you to use patient facilities. Take advantage of hospitals that provide you with an institutional grade breast pump. Institutional pumps are very efficient to use and the hospital supplies the attachment parts (cleaned and sterilized), which saves you from having to clean attachment parts at work.

    In hospitals without pumping facilities, residents have found it is easiest to approach nursing staff and explain that you are breastfeeding and need a private room to use a breast pump. If you have an electric pump, be sure to specify that you also need an electrical outlet. Remember many hospital staff are parents and many women have had to deal with balancing breastfeeding and work.

    For a list of locations with pumps/rooms visit the After Leave section.

  • Childcare

    Returning to work, whether shortly after your child’s birth or at the end of a full year of leave, is a time of adjustment. There are many options for childcare and may include sharing care within your family (your partner, grandparents) or getting help outside the family (day homes, daycares, live-in nannies, live-out nannies, on-call nannies). Each has positives and negatives and many residents utilize a combination of the above. Trying to find available, quality and affordable childcare that can work with the busy schedules that residents keep can be difficult. If local daycare is an option for your family, apply for a position as soon as you have a positive pregnancy test or confirmation from your social worker, as spaces are often limited and there are long wait lists.

    The provincial government has several online references to help you understand your childcare options; these can be invaluable in the planning stages. They have a child care programs map to help you locate childcare in your area that meets your needs. You can also visit your local Child Care Resources and Referral Centre for more options.

    The Westcoast Child Care Resource Centre in Vancouver has a number of informative brochures on childcare available on their website.

    For more information on childcare visit the After Leave section.

  • A Parent's Guide to First Aid

    Click here to read David Patterson’s guide on how to keep your children safe!