Welcome to season 5, episode 6 of the ALiEM Medical Education in Cases (MEdIC) series! Our team (Drs. Tamara McColl, Teresa Chan, John Eicken, Sarah Luckett-Gatopoulos, Eve Purdy, Alkarim Velji, and Brent Thoma) is pleased to welcome you to our online community of practice where we discuss the practice of academic medicine!

This month, we present a case of a young attending physician anxious to return to clinical work after taking a 6-month paternity leave. Check out the case and join the conversation in the comments section! We’d love to hear your thoughts on this important topic!

The Case of the Post-Paternity Leave Blues

By Eve Purdy, MD FRCPC (candidate)

Jake bundles up his baby preparing to leave his house for the local coffee shop. He laughs thinking about how much leaving the house with a baby is like preparing for a medical procedure: prepare the necessary equipment, plan for complications, call for help when needed. After six months of paternity leave, and many mishaps, he feels competent to perform this task. His heart sinks, remembering that he is headed back to his clinical and academic roles in just over two weeks.

As he pushes the stroller down the familiar route that he and his new son have walked countless times during their awesome months of bonding he finds himself worrying about what it will be like to go back. “Will I function as efficiently in the department as I did before I left? Will I still have the same procedural skills? Will I be able to get back on the academic bandwagon? I don’t want to look stupid, maybe I should have been studying in the last few weeks. Will I regret taking the time off?” He enters the coffee shop, orders, and finds a table with his son, all the time still worrying.

“Hi, Jake! My goodness, look at your little guy! He is so big,” he hears a familiar voice and notices Dr. Jane Murphy headed his way. Dr. Murphy is one of the senior female faculty in his department. After exchanging pleasantries, Dr. Murphy asks when he will be headed back to work. “In about two weeks,” he hesitates.

“And how do you feel about that,” Dr. Murphy probes.

Jake considers for a moment whether or not to be vulnerable and disclose his concerns. He hasn’t shared his apprehension with anyone yet and he and Dr. Murphy are not close. Most of his mentors are male faculty but none of them have taken paternity leave and he isn’t sure that they would fully understand his anxiety about the looming “first day back”. He recalls that Dr. Murphy has four kids, took maternity leaves throughout her career, and she is a total boss. He decides that this may be a good opportunity to get some advice.

Jake opens up about his concerns about returning to work. “How did you do it so well?” Jake asks desperately.

Discussion Questions

  1. If you were in Dr. Murphy’s shoes, what advice would you give Jake about returning to work?
  2. What would have happened if Jake didn’t happen to run into Dr. Murphy? How can physicians returning to work after a prolonged leave seek assistance about their return?
  3. What department supports should be available for physicians post-sabbatical, prolonged sick leave, or parental leave?

Weekly Wrap Up

As always, we will post the expert responses and a curated commentary derived from the community responses 2 weeks after the case is published.

Our 2 experts for this month’s case will be:

  • Dr. Carolyn Snider
  • Dr. Brent Thoma

On April 13, 2018, we will post the curated commentary and expert responses to this case! After that date, you may continue to comment below, but your commentary will no longer be integrated into the curated commentary. That said, we’d love to hear from you, so please comment!

All characters in this case are fictitious. Any resemblance to real persons, living or dead, is purely coincidental. Also, as always, we will generate a curated community commentary based on your participation below and on Twitter. We will try to attribute names, but if you choose to comment anonymously, you will be referred to as your pseudonym in our writing.

Inspired by the Harvard Business Review Cases and initially led by Dr. Teresa Chan (@TChanMD) and Dr. Brent Thoma (@Brent_Thoma), the Medical Education In Cases (MEdIC) series puts difficult medical education cases under a microscope. On the last Friday of the month, we pose a challenging hypothetical dilemma, moderate a discussion on potential approaches, and recruit medical education experts to provide “Gold Standard” responses. Cases and responses are made available for download in PDF format – feel free to use them! If you’re a medical educator with a pedagogical problem, we would love for you to get involved in the MEdIC series! Send us your most difficult dilemmas (guidelines) and help the rest of us bring our teaching to the next level.[/su_spoiler]

Tamara McColl, MD FRCPC

Tamara McColl, MD FRCPC

Associate Editor, ALiEM MEdIC Series
Emergency Physician, St. Boniface Hospital, WRHA
Academic Lead, Educational Scholarship
Department of Emergency Medicine
University of Manitoba