Missing prescription: long-term parental leave for fathers in medicine

In medicine, we’re trained to spot subtle patterns: the tiny lab abnormality, the murmur that’s easy to miss, the patient who looks “just a bit off.” But there’s one glaring abnormality in the healthcare system that somehow remains invisible: long-term parental leave for fathers in medicine.

We talk a lot (and rightly so) about maternity leave for women physicians. Yet when it comes to physician dads, the conversation often fizzles out somewhere between “Congratulations!” and “So… when are you back on the schedule?” In many institutions, paternity leave is treated less like a legitimate benefit and more like an optional side quest for the daring and very well-organized.

That’s a problem. We now have strong evidence that when fathers take meaningful parental leave, it improves mental health, supports maternal recovery, and strengthens child development and family stability. Yet for physician fathers, long-term leave is still the missing prescription in an otherwise evidence-based profession.

Why fathers in medicine still struggle to take parental leave

In the United States, the basic legal framework is the Family and Medical Leave Act (FMLA), which offers up to 12 weeks of unpaid, job-protected leave for eligible employees, including for childbirth and adoption. That sounds decent on paperuntil you remember that medical training and early career practice often coincide with crushing student loans, delayed earnings, and high living costs. Unpaid leave is technically available, but financially unrealistic for many physician families.

Within academic medicine and training programs, parental leave policies are a patchwork quilt stitched together by each institution. A national review of U.S. medical schools found that median paid parental leave was about four weeks for birth parents and just three weeks for non-birth parents, with some schools offering zero paid leave at all. In many family medicine programs, more than a third reported no paid paternity leave for residents or faculty.

So while women physicians often fight for enough leave to physically recover and bond with their newborns, fathers may quietly negotiate a week or two off, sprinkled with “checking a few charts” or “logging into the EMR real quick.” It’s not exactly what child-development experts mean when they say “engaged fatherhood.”

Policies are improvingbut not fast enough for physician dads

There has been progress. In 2022, the Accreditation Council for Graduate Medical Education (ACGME) introduced a requirement that sponsoring institutions provide residents and fellows with at least six weeks of paid medical, parental, or caregiver leave at 100% salary once during training, in addition to vacation time. That’s a big step forward, especially for trainees who previously had to cobble together sick days and vacation just to hit a few weeks at home.

The American Medical Association (AMA) has also called for stronger, more standardized parental leave policies, recommending that medical practices and training programs strive to offer at least 12 weeks of paid parental, family, and medical leave within a 12-month period for attending and trainee physicians. Professional societies are increasingly acknowledging that parental leave is not a perk; it’s part of a sustainable workforce strategy. Yet, when researchers examined parental leave offerings at physician societies themselves, they found substantial variability and gaps between stated values and actual employee benefits.

Even outside medicine, U.S. paternity leave is underused and uneven. Recent data suggest that about seven in ten Americans support paternity leave and believe fathers should take around four to five weeks off, but actual access and uptake vary widely across income levels and jobs. If that’s the picture in the general workforce, it’s not hard to imagine the situation in the high-intensity world of clinical practice and training.

Why long-term parental leave for physician fathers matters

Here’s the part that should make medicine, a supposedly evidence-driven field, very uncomfortable: we have good data that paternity leave is beneficial, yet we don’t consistently prescribe it.

Better mental health for fathers

Studies show that paternity leave can reduce stress and work–family conflict, and may improve mental wellbeing for fathers, particularly in higher-income groups (which includes most physicians once they’re out of training). Having protected time at home lets new dads adjust to their caregiving role, build confidence, and establish routines without the constant pressure of the pager.

For physicians, that time away can also act as an early “burnout buffer.” Many new attending physicians hit their highest stress levels just as they’re also starting families. A short, token leave may not be enough to reset, whereas a longer, well-supported leave could reduce burnout and promote retention in the workforce.

Stronger support for partners and maternal mental health

Paternity leave doesn’t just help dadsit helps mothers too. A growing body of evidence links fathers’ leave to better maternal mental health, including lower rates of postpartum depressive symptoms and less psychological distress. When fathers are available to share nighttime care, attend pediatric visits, and absorb some of the daily load, the entire postpartum experience shifts from “heroic survival” to “shared project.”

For physician couples, this can be huge. Two-physician households are common, especially in academic centers. When only the mother takes extended leave, she often bears the brunt of the “motherhood penalty,” including slowed career progression, lost income, and fewer academic opportunities. When fathers also take meaningful leave, it signalsto the couple and the workplacethat child-rearing is a shared responsibility, not a one-person detour.

More equitable sharing of unpaid work at home

International research suggests that when fathers take longer parental leave, they’re more likely to continue doing more childcare and housework long after the leave ends. In other words, leave isn’t just time off; it’s identity formation. It helps move fatherhood from “backup childcare” to “co-pilot of the household.”

Even outside the U.S., we see massive gender gaps in parental leave. For example, one study in Japan found that male physicians took parental leave at rates around 0.05%, compared with 4.5% among female physicians. While that’s not U.S. data, it shows how deeply cultural expectations and professional norms can suppress fathers’ use of leave, even in highly educated professions.

Barriers beyond policy: culture, money, and masculinity in medicine

Here’s the uncomfortable truth: even when policies improve on paper, culture often lags behind.

“Real doctors don’t disappear for months”

Physician culture still rewards constant availability. There’s an unspoken rule that serious doctors don’t take long breaksunless they’re for research fellowships, in which case, please post about it on LinkedIn. Extended parental leave for fathers can be perceived as optional, indulgent, or “something the department can’t afford right now.”

In a widely discussed commentary, a physician described how taking paternity leave still feels foreign in medical culture and argued that physicians not only need but should be encouraged to take paternity leave to model healthy norms for trainees and colleagues. When senior male physicians never step away for caregiving, the message to younger generations is loud and clear: caregiving is not part of the “ideal doctor” identity.

Financial and structural constraints

Even with ACGME’s six-week paid leave standard in training, many physician fathers still rely on multiple leversvacation time, stored sick days, unpaid leaveto extend time at home. Attending physicians often face productivity-based compensation systems that penalize time away from clinical work. Missing a few weeks of patient care may mean lower bonuses, slowed partnership tracks, or delayed academic promotion.

On the department side, there’s the legitimate challenge of coverage. Clinics must be staffed, ORs must run, and call schedules must be filled. Without intentional staffing strategies and cross-coverage plans, extended parental leave can feel like a heavy burden on colleaguesanother cultural pressure that subtly discourages dads from taking full leave, even when it’s technically allowed.

Gender norms and the “motherhood penalty” spillover

Across many countries, including the U.S., the “motherhood penalty” means women pay a long-term earnings price for having children, while men’s careers often remain relatively uninterrupted or even benefit. When only mothers step away from work, we reinforce stereotypes that caregiving is women’s work and career is men’s business.

Medicine isn’t immune to this. When physician fathers don’t take substantial leave, it cements the expectation that their primary role is provider, not caregiver. That narrative is increasingly out of step with what many younger physicians actually want from their lives.

What better parental leave for fathers in medicine could look like

If we were to design parental leave for fathers in medicine the way we design treatment guidelinesbased on evidence, outcomes, and long-term sustainabilitythe plan might look very different from what many institutions currently offer.

Core components of a better model

• Meaningful duration: At least 8–12 weeks of parental leave available to fathers, not just one or two weeks. This aligns with AMA recommendations and international best practices.
• Paid, not just protected: Fully or largely paid leave, especially during training and in early career, when financial vulnerability is highest.
• Non-transferable portions for fathers: Some leave specifically designated for the father (or non-birthing parent) so it doesn’t feel like “taking away” time from the mother.
• Flexible structure: Options to take leave in continuous blocks, or to phase back with reduced hours, telehealth days, or non-clinical duties.
• Coverage plans built in: Departments plan proactively with cross-coverage pools, locum support, or schedule buffers to normalize parental leave as part of workforce planning.

Done right, long-term parental leave for physician fathers isn’t just a feel-good benefit. It’s a retention strategy, a gender-equity intervention, and a mental health promotion tool rolled into one.

What individual doctors and institutions can do now

For institutions and leaders

• Audit your policies: Compare your parental leave policies to current ACGME standards and AMA recommendations. Identify gaps for non-birthing parents specifically.
• Make policies easy to find and easy to use: Many physicians discover the details of leave only after announcing a pregnancy. Clear, accessible policies reduce uncertainty and shame.
• Train program directors and chairs: Leaders should know how to support parental leave without subtle punishment (like bad rotations after return, missed opportunities, or unspoken stigma).
• Collect data: Track who takes leave, for how long, and in what roles. If fathers almost never use parental leave, that’s a sign something structuralor culturalis broken.

For physician fathers (and future fathers)

• Read the fine print early: Before you’re in the sleep-deprived fog of new parenthood, review your institution’s policy and talk to HR or GME.
• Ask colleagues who’ve done it: If you know a physician dad who took more than a token week off, ask what worked, what pushback they got, and how they navigated it.
• Frame leave as part of professionalism: Caring for your family isn’t a betrayal of your patients. It’s part of sustaining yourself as a physician long term.
• Be visible: If you take long-term parental leave, talk openly (when you’re comfortable) about it. Visibility changes culture faster than policy memos.

Experiences from the front lines: what long-term leave means for physician dads

Policies and data are important, but lived experience is what really shifts hearts and habits. Here are some composite, anonymized stories inspired by real scenarios reported by physician fathers and their colleagues.

Dr. A: The resident who took “too long” offand changed the culture anyway

Dr. A was a third-year internal medicine resident when his first child was born. Under his institution’s updated ACGME-compliant policy, he could take six weeks of fully paid leave, plus a week of vacation he’d saved. He hesitated. No man in his program had taken the full six weeks; most squeezed in two weeks and returned with dark circles and a permanent coffee mug.

With encouragement from his partner and his program director, he took all seven weeks.

The first few days, he admits, he checked his email constantly. But as the weeks went on, he shifted from “resident who is away” to “parent who is here.” He took the baby to pediatric visits, learned to soothe colic, and became the unofficial king of 2 a.m. diaper changes.

When he returned, two things surprised him. First, his clinical skills hadn’t evaporated; his first day back on wards felt rusty for about 20 minutes and then… muscle memory. Second, several interns quietly pulled him aside and said, “I didn’t know we were actually allowed to do that.” The next year, two residentsone male, one femalestructured longer parental leaves using the same policy he’d normalized.

Dr. B: The attending who “couldn’t afford” leave

Dr. B was an early-career cardiologist in a productivity-based compensation model. When his second child arrived, he calculated what even four weeks off would cost in lost RVUs and bonus. It was a number that made his stomach sink. His department technically allowed up to eight weeks of partially paid parental leave for all genders, but very few male attendings used it.

He ended up taking ten working days off, then returned to full clinic and call. At home, his partneralso a physicianstruggled with sleep deprivation and postpartum anxiety. At work, he felt guilty for every day he wasn’t there and resentful for how quickly life snapped back into high gear.

Months later, he admitted to a colleague that he wished he’d taken longer leave and pushed harder for a more sustainable financial arrangement. He realized that the short-term income hit might have been worth the long-term benefits to his family, his partner’s wellbeing, and his own mental health.

Dr. C and Dr. D: A two-physician couple who shared leave

Dr. C (an emergency physician) and Dr. D (a pediatrician) decided to try something different with their second child. Instead of having Dr. D take almost all the leave again, they coordinated back-to-back parental leaves: eight weeks for Dr. D immediately postpartum, followed by eight weeks for Dr. C when she returned to part-time work.

Financially, it required planning. They saved aggressively the year before and spoke candidly with their department chairs about coverage and expectations. To their surprise, both chairs were supportiveespecially when the couple framed their plan as an experiment in shared caregiving that could inform policy improvements.

The result? The baby had a parent at home full time for nearly four months. Dr. D’s postpartum recovery was markedly easier with a fully present co-parent for the second half of that period. Dr. C developed a different relationship with his infant than he’d had the first time; he became confident not just in “helping out” but in solo caregiving.

When Dr. C returned to the ED, a younger colleague asked him, half-jokingly, “So…was it worth it?” He didn’t hesitate. “Absolutely. I actually know my kid this time.” That sentence spread through the department faster than any official memo. Within two years, more male attendings began taking longer stretches of leave.

What these stories share

These experiences highlight a few recurring themes:

• Role modeling matters: When one father takes full advantage of a policy, others feel more able to follow.
• Money and metrics are real barriers: Productivity-based pay and tight staffing can quietly punish dads for stepping away.
• Partnership benefits are huge: Longer paternal leave often translates into better support for mothers and healthier family dynamics.
• Cultural change is slowbut possible: Each physician who treats parental leave as a normal, expected part of career life helps medicine evolve.

Conclusion: time to write a new prescription

For a profession obsessed with evidence and outcomes, medicine has been oddly slow to embrace long-term parental leave for fathers. We have robust data showing benefits for mental health, family stability, gender equity, and child development. We have emerging policies that acknowledge leave as a standard part of training and practice, not a personal favor.

What we still lack is full follow-through: consistent, meaningful, well-paid parental leave for fathers in medicineand a culture that actively encourages them to take it.

If we want a healthier profession, we can’t just talk about wellness and resilience while quietly expecting new physician dads to be back on rounds before the diaper pail is even full. The missing prescription is clear: long-term parental leave for fathers, written not as an optional add-on, but as a standard order in the care plan for physicians and their families.

It’s time to fill it.