Parenting

Before Going On Leave

Planning

When and how to start your family are very personal choices. There are 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. Some provinces are now offering maternity/parental leave benefits programs; Doctors of BC’s program provides pregnancy benefits as well as parental benefits for physicians and adoptive parents.

To be eligible for EI, you must have worked 600 insurable hours in the last 52 weeks, or since your last claim.

If you are going on leave, unless you choose to continue working, you will need to pause your CMPA. CMPA while leave will not be reimbursed.

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 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.

Once you are ready to start planning your maternity leave, we recommend the following steps:

1. You can apply for EI as soon as you stop working. You can start the application without your Record of Employment, but you will need it to complete the application. To obtain your Record of Employment, you will need to contact Employee Records and Benefits (employeeRBsupport@phsa.ca). We recommend you do this as soon as your program approves your leave, to ensure you give yourself enough time before going on leave to receive your ROE. For any questions about your EI application, you can contact Service Canada.

2. Your program must classify your leave as Maternity Leave, which will allow you to qualify for the Supplemental Employment Benefit (SEB) Plan.

3. Birthing parents qualify for the SEB top-up as long as they apply for EI. The SEB top-up does not require the EI application to be approved, as long as the circumstances laid out in the Collective Agreement are met (Maternity/Parental/Adoption Leave, 9.06 D.iii).

4. If your EI application has been approved, you can send your “My Latest Claim” page screenshot with your name visible within the screenshot to Employee Records and Benefits who will process the top-up accordingly. The screenshot must confirm the following information:
   1. Your full name
   2. Type of claim
   3. Claim Start Date
   4. Waiting Period
   5. Benefit Rate
   6. Claim End Date

If your EI application has not been approved, you can reach out to Employee Records and Benefits regarding what process you should follow to apply for the SEB top-up.

Finances

Can I afford a child on leave?

Yes! If you managed to budget your way through your undergraduate degree(s) and medical school, you can budget for a child. There are many ways to prepare for parenting. You can buy every baby item new and from top end boutiques but you don’t have to go this route. Babies are big business and there is a lot of marketing to suggest that every baby accessory, clothing item and toy is essential to rearing a happy, healthy and brilliant child. Instead of buying the majority of baby stuff before the arrival of your child, stock up on some simple essentials and then see what you and your child need as they grow. You will not be trapped in your home once the baby arrives. You can make it out to the shops to pick up items as you need them. The advantage to buying as you go is also that you will not have to store loads of bulky stuff, waiting to use them. I also believe you do not need as many things as you think. The items you can forgo may be different than mine but keep in mind that lots of things are not essential. One wonderful (free!) resource is “Baby’s Best Chance,” a book published by the province of BC.

Friends and family are great resources for preparing for your baby. It is inevitable that you will receive gifts for your newborn. Many parents find they hardly need to purchase any clothes for the first six months! People cannot resist buying adorable outfits in those tiny sizes; you will likely receive more than you need. If people ask what you need, it is often helpful to suggest clothing in sizes over six months to avoid the upfront oversupply. Friends and family are also a good resource for gently used hand-me-downs. People are often eager to lend out their baby things and babies grow so quickly that most items get minimal wear. If you are contemplating a big-ticket item it is useful to ask a friend who already has that item if you can come over and try it out. If you or your child does not like the item in the trial you may have saved yourself a large amount of money.

Thrift stores and child consignment shops are a good place to get clothing and accessories at affordable prices. Craigslist is a good resource for baby things and you can often get great deals on strollers and cribs. The one item you may want to appraise carefully is an infant car seat, due to frequently changing safety concerns. Models out date within 5 to 8 years. If you want to check on whether used items have any safety concerns or have been recalled, go to the Health Canada website; it lists recalled items and is a good information source. Health Canada also has a section on child safety.

What can I expect to earn while on 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.

The basic benefit rate is 55% of your salary up to a maximum amount of $695 per week as of 2025. This amount is “topped up” to 90% of your salary for birthing parents for weeks 2 – 17, depending on employer policies (as some employers offer top-ups). If you opt for the Extended Parental Leave, the benefit rate is 33% of your salary up to a maximum amount of $417 per week as of 2025.

Maternity Leave

Maternity leave is 17 weeks of unpaid leave for birthing parents; the remainder of the available 78 weeks of leave are parental leave.

Residents on maternity leave will receive 16 weeks of EI top up where the employer pays 90% of the salary rate, less EI earnings.

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 17 weeks of your maternity leave, the employer will provide 90% of your salary for 16 weeks as part of the SEB Plan.

A combination of maternity and parental leave can make up to a maximum of 55 weeks or 84 weeks if on Extended Parental leave of EI benefits.

The basic benefit rate for EI 55% of your average insured earnings up to a yearly maximum insurable amount. For 2025, this means you can receive a maximum payment of $695 per week. For extended parental benefits, this rate is 33% of average insurable weekly earnings, up to a maximum amount. In 2025, the maximum amount if $417 per week.

If you work while on maternity leave, you will be able to keep 50 cents of your EI benefits for every dollar you earn, up to 90% of the weekly insurable earnings used to calculate your EI benefit amount.

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 (standard maternity leave):

• Week 1: $0

• Weeks 2-17: EI $695 + SEB $431.42 = $1126.42/week (90% of salary)

Parental/Adoption Leave

Parental EI Benefits are a maximum of combined 40 weeks, shared with the other parent (one parent cannot receive more than 35 weeks of benefits). If your child is born or adopted after March 17, 2020, and you share EI parental benefits with another parent, you may be eligible for 5 extra weeks of standard parental benefits, or 8 extra weeks of extended parental benefits.

If sharing, you must each choose the same option when applying and submit your own applications.

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. In 2025, this means you can receive a maximum payment of $695 per week or a maximum of $417 per week if on the Extended Parental leave.

If you work while on parental leave you can earn up to 90% of your weekly earning, and keep $.50 of EI for every dollar you make, above that amount your EI is deducted dollar for dollar.

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

Pregnancy During Residency

Workload

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 Collective Agreement includes a Memorandum of Understanding on Workload during pregnancy, that ensures if the resident’s physician notes a reduction in work is warranted then the workload shall be reduced to the extent prescribed, including the elimination of call if necessary. If your workload is reduced, including call, this call is not made up at another date.

UBC also has a policy regarding Pregnancy in 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 Program 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 feel quite well during the second trimester, and the third trimester is marked by fatigue, leg swelling and difficulty bending. Consider tailoring your rotations to make your heavier rotations during the second trimester.

It is worth thinking about the exposures you 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 pediatrics 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. 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.

Sick Leave

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, 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.

Collective Agreement sick leave is five (5) months per academic year. If necessary, disability insurance coverage is available after 5 months. If you have concerns about the extension of your residency consider arranging a research elective if you need to go on bed rest or reduced activities to minimize time missed from your residency.

EI Sickness Benefits

If you have exhausted your sick leave and you have not completed the waiting period for LTD (5 months) you may be eligible for EI sickness benefits instead of using maternity benefits prior to the baby’s arrival.

Sickness benefits may be paid up to 26 weeks to a person who is unable to work because of sickness, injury or quarantine. As with maternity leave you are required to have worked 600 hours in the last 52 weeks or since your last claim to be eligible. You will also need a medical certificate from your physician to confirm the duration of your inability to work. The fees for the certificate are your responsibility. A person who makes a claim for sickness benefits is not only required to prove to be unable to work but also that he or she would be otherwise available for work.

If you work while on sick leave your earnings are deducted dollar for dollar from your benefit amount. For more information on Sickness Benefits visit: http://www.servicecanada.gc.ca/eng/sc/ei/benefits/sickness.shtml

Loss

If you experience a loss within 13 weeks of your expected due date, you are entitled to maternity leave under the Collective Agreement. This includes the maternity leave top-up and the option to apply for EI maternity benefits, provided you meet the eligibility requirements.

You are also guaranteed a minimum of 6 weeks of unpaid leave following a loss, with an additional 6 weeks if a medical practitioner certifies that you are unable to return to work for medical reasons.

In the case of a loss before you are eligible for maternity leave under the Collective Agreement, you can still take a leave and apply for EI maternity benefits, as long as the loss occurs after the 20th week of gestation.

If the loss happens before the 20th week of pregnancy, it is considered sick leave. You may use employer-paid sick leave, Long Term Disability, or EI sickness benefits, depending on your situation.

For your spouse's pregnancy loss, residents are eligible for three (3) days of compassionate leave, plus an additional two (2) days of travel if needed. You may also qualify for sick leave or long term disability under the Collective Agreement.

This is a traumatic experience, and we encourage residents to use wellness resources available to them. The Employee Wellness and the Physicians Health Program (PHP) both offer services to support residents dealing with grief and loss. Both offer confidential 24- hour help lines and referrals.

Day-to-Day Advice

On the more day-to-day side of being an expectant resident, it is important to follow the same advice you would give a pregnant patient. Biologically, you are the same as regular mortals despite your superhuman schedule. Remember to eat frequently and take bathroom breaks. If you have not tried them before, compression stockings, especially on call, can make a big difference to leg swelling and fatigue. Prescription stockings are covered by the resident health plan, but for $15 to $20 you can pick up a pair from a medical supply drugstore to try them out.

Pregnancy is tiring and you will require more sleep. Take naps in the evening if you need them and get into the habit of sleeping post call. You will have regular medical appointments throughout your pregnancy and the frequency will increase to once a week by the end of your third trimester. Talk to your program director about the best times to book your appointments. Some people find appointments right after half day, on post call days, or at the end of the workday are the least inconvenient.

Find A Physician

If you’re a resident without your own family physician, you’re not alone. However, starting a family should give you the push to put this at the top of your list. The Physician Health Program of BC, through Doctors For Doctors will seek family physicians in your area will to accept a new physician-patient. Contact the Physician Health Program at 604-742-0747 or info@physicianhealth.com for more information.

Adoption

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

• Inter-country

• Custom (Aboriginal)

• By relatives

• Stepparent

• Direct

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

The Belonging Network also provides education support and resources on adoption for those considering adoption, waiting for a child, considering placing their child and adoptees.

Adoption Leave is the same as Parental Leave and is eligible for the same benefits.

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. Birthing parents are entitled to 78 weeks consecutive leave (the first 17 weeks of which are paid at 90%), whereas non-birthing parents are entitled 62 weeks of unpaid leave.

Keep in mind that your residency will be paused during maternity or parental leave, and you will resume from where you left off when you return to work.

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: meetup.com – local parent groups are searchable here

• Locum – If you have a general license, you could look into doing a locum

• 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.

Income and Benefits

With the exception of maternity, leave is unpaid. However, residents may quality 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 or have other income sources. The basic benefit rate is 55% of your salary with a maximum payment of $695 per week on Standard Parental leave and maximum payment of $417 per week on Extended Parental leave from EI. This amount is ''topped up'' to 90% of your salary for birthing parents for weeks 2-17.

Maternity Leave

EI Maternity Benefits

Maternity EI benefits are payable to the birthing parent for a maximum of fifteen (15) weeks.

To receive maternity benefits you are required to have worked for 600 hours in the last fifty- two (52) weeks or since your last claim. You need to prove your pregnancy by signing a statement declaring the expected or actual birth date. The basic benefit rate is 55% of your salary to a maximum of $695 per week from EI.

Birthing parents can start collecting EI maternity benefits up to twelve (12) weeks before the expected due date, but must apply for EI no later than the week of the birth. Maternity benefits cannot be collected past seventeen (17) weeks following the actual or expected birth (whichever is later). Please note that the date you file your claim is very important in order for you to receive the maximum maternity benefits to which you are entitled. If the actual date of birth is different from the expected date, it is very important that you inform EI as soon as possible after your child’s birth. Contact Service Canada at 1-800-206-7218, or you can go in person to your local Service Canada Centre.

If your baby is hospitalized, then the seventeen (17) week limit to collect benefits can be extended for every week your child is in the hospital, up to a maximum of 52/78 (depending on your type of parental leave) weeks following the week of the child’s birth. You will still only receive benefits for a maximum of 15 weeks, but payments can be delayed until your child comes home. However, if you received maternity benefits prior to the birth and wanted to receive the remaining benefits when your child comes home, contact Service Canada to have the necessary adjustment done to your claim.

The weekly EI payment and the number of weeks to be paid remain the same even if you give birth to more than one child at the same time.

Collective Agreement Benefits: Maternity Leave

Resident birthing parents are entitled to a total of seventy-eight (78) consecutive weeks (17 weeks maternity plus 61 weeks parental) leave of absence without pay. Through the Supplement Employment Benefits (SEB) Plan, the Employer will pay 90% of your salary during the the one-week EI waiting period, and then top up the amount you receive from EI, or any other earnings, to a maximum of 90% of your salary.

Residents may start maternity leave up to thirteen (13) weeks prior to the week of expected delivery, but no later than the actual birth date, and must make every effort to give four (4) weeks notice prior to the start of leave. For the duration of maternity leave, all extended medical and dental benefits continue as if the resident were not absent.

Child Born/Adopted the Year Before Starting Residency

Maternity leave must commence no later than actual birth date of the baby; therefore, if you had a baby before the start of residency, you would not be eligible for maternity leave. However, you may be eligible for up to 62 weeks of unpaid parental leave, if the baby was born/adopted within the last 52 weeks.

Vacation Entitlement

Your vacation is prorated in years that are shorter than the full appointment. This means if you take a leave in a year and your residency term for that year is shorter than a full year, your vacation days may be adjusted.

In other words, if you're away on leave but you're not in the final year, you would still receive your full 20 vacation days for the year, assuming your term is full.

Parental and Adoptive Leave

EI Parental Benefits

Parental EI benefits are payable to the parents for a maximum of forty (40) weeks with one parent not exceeding 35 weeks, or 69 weeks with the same clause under the Extended parental leave. These weeks are shared, i.e. one parent takes 15 weeks, the other takes 25 weeks for a total of 40 weeks, or can be taken at the same time. There is a one week waiting period, and each parent must apply with their own applications. If applying for maternity benefits, you can apply for parental benefits at the same time.

For adoptive parents, one parent will need to complete one week waiting period, but not both.

To receive parental benefits you are required to have worked for 600 hours in the last fifty-two (52) weeks or since your last claim. You need sign a statement declaring the date of birth or adoption. Benefit payments must be completed with fifty-two (52) weeks of the child’s birth or adoption placement.

The basic benefit rate is 55% of your salary for a maximum of $695 or $417 per week depending on your benefits plan from EI. The weekly EI benefit remains the same even if you have or adopt more than one child at the same time.

If your child is hospitalized, then the fifty-two (52) week limit to collect benefits can be extended for every week your child is in the hospital, up to 52 weeks following the birth date. You will still receive benefits for a maximum of forty (40) weeks, but payments can be delayed until your child comes home.

Collective Agreement Benefits: Birth Parent

Parental leave for birthing parents in the Collective Agreement is sixty-one (61) weeks (this is in addition to seventeen (17) weeks maternity leave). During this time extended medical and dental benefits continue as if the resident is not absent.

Birthing parents are entitled to up to six (6) additional consecutive weeks of leave if a medical practitioner certifies that she is unable to return to work when her leave ends due to reasons related to birth or termination of pregnancy.

If there are special circumstances, an additional five (5) consecutive weeks of leave without pay is available if a medical practitioner certifies that an additional period of parental care is required because the child suffers from a physical, psychological or emotional condition. This leave must begin immediately following the seventy-eight (78) weeks (combined maternity and paternity) leave.

The maximum combined entitlement to leave for birth mothers is seventy-eight (78) weeks.

Collective Agreement Benefits: Non-Birthing Parents

Parental leave for non-birthing parents in the Collective Agreement is sixty-two (62) weeks. During this time extended medical and dental benefits continue as if the resident is not absent.

Residents also receive two (2) paid days off to attend the birth of their child. To increase the amount of time you can take off to attend the birth, you can also use your two (2) paid flex days, or take vacation.

If there are special circumstances, an additional five (5) consecutive weeks of leave without pay is available if a medical practitioner certifies that an additional period of parental care is required because the child suffers from a physical, psychological or emotional condition. This leave must begin immediately following the sixty-two (62) weeks leave. Any additional leave beyond this will be without pay or benefits.

Child Born/Adopted the Year Before Starting Residency

You may be eligible for up to 62 weeks of unpaid parental leave, if the baby was born within the last 52 weeks.

Working While On Parental Leave

Default rule: Under the default rule you can earn up to 90% of your weekly earning, and keep $.50 of EI for every dollar you make, above that amount your EI is deducted dollar for dollar.

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

Vacation Entitlement

Your vacation is prorated in years that are shorter than the full appointment. This means if you take a leave in a year and your residency term for that year is shorter than a full year, your vacation days may be adjusted.

In other words, if you're away on leave but you're not in the final year, you would still receive your full 20 vacation days for the year, assuming your term is full.

Summary

Paperwork

Getting your paperwork in order for Leave, Employment Insurance, and your SEB top-up (if applicable) can take a lot of time and organization. Here is a summary:

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). 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 leave 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 twelve (12) 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.
   
   The application will take approximately 60 minutes to complete, and you will need the following personal information:

   1. Social Insurance Number (SIN) – If your SIN begins with a 9 you will need to provide proof of your immigration status and work permit

   2. The SIN and name of the other parent

   3. Your mother’s maiden name

   4. The expected or actual date of birth

   5. Your mailing and residential addresses, including postal codes

   6. Your complete banking information, including your branch number, institutional name and number, and your account number (as shown on your cheques or bank statements) if you want to have your payments directly deposited

   
   You will also need the following employment information:

   1. The names, addresses and telephone numbers of all employers you have worked for in the last 52 weeks, as well as the dates of employment and the reasons for separating from these employers

   2. Your detailed version of the facts if you quit or were dismissed from any job in the last 52 weeks

   3. If your earnings varied over the last year, you will need to provide dates (Sunday – Saturday) and earnings for each of your highest paid weeks of insurable earnings in the last 52 weeks or since the start of your last EI claim, whichever is the shorter period. This information will be used, along with your Record(s) of Employment, to calculate your weekly EI benefit rate

   4. Record(s) of Employment from the last fifty-two (52) weeks
      
      

3. File newborn paperwork (when your child arrives):

   • In BC we can use the Newborn Registration Service to take care of several things at once:

     1. Complete the registration of your baby’s birth with Vital Statistics

     2. Apply for their birth certificate

     3. Apply for a SIN for your baby

     4. Register them for MSP coverage

   • You will also need to let PHSA know of your new baby so they can add your new dependent to your coverage. This can come in handy early on if your child is admitted for neonatal jaundice or other health concerns. You can contact them by email at employeeRBsupport@phsa.ca or by phone at 604-297-8683 (option 1) or 1-866-875-5306 (option 1).

   • The Canada Child Benefit (CCB) is a tax-free monthly payment made to eligible families to help with the cost of raising children under age 18. You should apply for the CCB as soon as possible after your child is born.

Finally, there are financial savings plans to register for as well. Don’t put this off as the government will match or top up your contributions, depending on your income level, in some of the programs:

• The Canada Learning Bond (CLB) program contributes a $500 bond to the Registered Education Savings Plan

• The Registered Education Savings Plan (RESP) allows savings for education to grow tax free in a special savings plan registered by the Government of Canada until a child named in the RESP enrolls in a post-secondary education program.

• The Canada Education Savings Grant (CESG) provides grants to Registered Education Savings Plan (RESP) contributors until the beneficiaries reach the age of 17

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.

Birthing parents 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 and intends to return in the new appointment period. Their vacation for the current term of appointment (July 1 – June 30) 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.

First Rotations

When planning your return to work, select rotations that will help make your transition back to work as smoothly as possible. If you are still breastfeeding, you might choose rotations that have no or very little call so you can physically be present to breastfeed more easily. Other people find they just want to “get the worst of the call over with.”

Your schedule will already have been disrupted if you have taken any parental leave, so it is generally not much more trouble to amend your schedule with your Program Director. Plan out your return-to-work rotations when you are arranging your parental leave. It will save you time, hassle and worry about returning to a demanding schedule. Even if you have not taken any time off, your program may be able to rearrange your schedule so that you are on a lighter schedule when your child is a newborn. Given the distributed model of medical education in BC, you might want to consider requesting rotations closer to home in advance.

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.

RCH Breast Pump Location

Royal Columbian Hospital has a Staff Pumping Room located on the Maternity Ward (3E) in the Health Care Centre Tower. Ask at the nursing desk for directions. The room is down the hall to your right as you walk in to ward, in a corridor on the left (next to the patient pumping room). Not all nurses know that there is a staff pumping room so if the first person you talk to is unsure, be persistent. The room is equipped with a Medela institutional breast pump. Nursing staff are very helpful and will happily show you how to use the institutional pump. Sterilized attachment parts are available for your use. The attachment parts are stored in the patient pump room next door. Once you are done, rinse the milk off the attachment parts and place them in the “dirty” bin in the patient pumping room. There is a logbook in the room. Try to remember to sign it, as it shows how much use the room gets and how important it is to breastfeeding staff.

BCWH/BCCH Breast Pump Location

A Medela institutional breast pump is located on Arbutus Ward at BCWH. The key to the room is at the nursing desk. Pump attachment parts are located in the back room behind the nursing desk. Nursing staff are very helpful and will happily show you how to use the institutional Medela pump.

VCH Breast Pump Location

Dedicated lactation spaces have been installed at the following sites:

• Lions Gate Hospital (northern expansion 3rd floor, Room 3.50.45)

• Three Bridges Community Health Centre (2nd floor, Room 202)

• Vancouver General Hospital (Leon Blackmore Pavilion, Room G910)

To learn more, click here.

Locations without Pump Facilities

• Queen’s Park Care Centre

• Eagle Ridge Hospital

A list of the Lactation Rooms across BC can be found here.

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.

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

Family Care

Your spouse may be interested in being a stay at home parent either part-time or full-time. Grandparents or other relatives may also be interested in providing childcare either part or full-time as well.

Day Homes

These may be licensed or unlicensed. Usually, an individual offers childcare within their own home to others; they often have children themselves. Whether they are licensed or unlicensed depends on the number of children in their care, the goals of the program (tutoring vs. childcare), and how long the care is offered for (occasional vs. regular care).

Daycares

Daycares can be hard to come by. Some health regions or hospitals have daycares associated with them. In the lower mainland, Vancouver Coastal Health has contracted the YMCA to provide daycare sites at VGH (Kids at Heather), and BCCH/WHC/GF Strong (Kids at GF Strong).

The Advantages of Daycare

With so many toys, activities, and other children, daycare can be highly stimulating. Good daycares have educated and experienced teachers, who can give you lots of advice and can assist in your child's development. Daycares are registered and regulated by the government, and you don’t have to open your home to anyone. Daycares are great places to meet other families and form lasting friendships. Your child will develop social skills and some daycares have extensive education programs to teach your child everything from mathematics to languages. Conveniently, certain health regions and hospitals have daycares associated with them: In the Lower Mainland, Vancouver Coastal Health has contracted the YMCA to provide daycare sites at VGH (Kids at Heather), BCCH/WHC/GF Strong (Kids at GF Strong).

The Disadvantages of Daycare

With so many other children, germs are unavoidable, which means you will have to deal with finding alternative care if your child is too sick to go to daycare. Having to pack up your child every morning may be stressful and time-consuming, and if your work schedule doesn’t coincide with the daycare’s hours you may have to pay more for extended care or arrange for someone else to pick-up/drop-off your child. Some daycares may dictate when your child has to be off the bottle, take naps, etc. Turnover can be high, so if caregiver consistency is important to you this may be an issue.

Nannies

Nannies can be Live-in, Live-out, or On-call.

Live-in nannies live in your home and provide childcare. The Live-In Caregiver Program is a federal program that “helps Canadians hire foreign workers to live and work in their homes to care for children.” This link summarizes the obligations in BC to hired domestic employees.

Live-out nannies live outside your home, but provide childcare in your home. They may be permanent full-time, part-time, occasional or temporary.

Nannies on Call are able to assist with permanent placements, and also provide on-call and temporary nannies.

If you don’t have a stay-at-home spouse and family assistance is unavailable, you will likely find yourself looking at the big question of “nanny versus daycare.” So how do you decide? Ultimately, the decision will be entirely personal and depend on convenience, finances, and the needs of your child. You may decide to use both, starting with one and switching to the other later on, or having a part-time nanny to fill in the times daycare is unavailable.

The Advantages of Nannies

Nannies provide one-on-one care, and can cater to your child’s individual needs and schedule. They works out of your home, so all you have to worry about in the morning is getting yourself ready since the nanny will take care of dressing and feeding your child. In addition, your child is being cared for in a familiar and comfortable environment. If you child is sick, you don’t have to worry about staying home from work or finding back up childcare. Nannies can be either “live-in” or “live-out,” and the services they provide range from basic childcare to full-fledged housekeeper. With a nanny, you have more control over what values and rules are taught. A good nanny can be almost like another family member, a true Mary Poppins, taking care of the children and helping you keep your family life in order.

The Disadvantages of Nannies

The most obvious disadvantage is cost. Nannies can be quite expensive, as you are essentially paying someone’s salary. (On the other hand, with multiple children the cost can actually work out to be more economical.) Other concerns include privacy, as she will be in your home, and security, as there is no formal registration process for nannies and you don’t know what they are doing all day. If your nanny is sick or takes vacation, you will need to find alternative childcare. And don’t forget about the paperwork involved in paying someone’s salary; unless your nanny is self-employed, you will have to deduct EI, CPP and income tax from their wage. Finally, finding the right nanny to fit with your family can take a long time, and you may have to go through a few people to find the right person.