Maternity leave for physicians, residents, and fellows
Six guaranteed weeks in training, and a different math as an attending.
Physicians face two very different versions of this. Residents and fellows now have a guaranteed six weeks of paid leave under the ACGME policy, with real rules about boards and training time. Attendings coordinate an employer policy, short-term disability, and a state benefit that a physician salary quietly outgrows. Both reward planning the details in advance.
Five questions. No email, no credit card.
Why we built this page
Christine works shoulder to shoulder with doctors, residents, and fellows every shift. She has watched brilliant clinicians who manage everyone else's care get lost in their own leave paperwork. We could not leave them out.
From Christine and Steven
Quick answer
Two paths, four things to nail down.
- 1. Trainees: six weeks at full salary. ACGME requires it for your first approved leave, from day one, benefits continued.
- 2. Trainees: protect your boards. Six weeks once during training does not require an extension. Beyond that, confirm with your board.
- 3. Attendings: policy carries it. Your employer policy is the main paid piece; the state benefit is capped and replaces little of a physician salary.
- 4. Watch production pay and call. RVU or collections comp can drop even when the job is protected. Get the salary-guarantee answer in writing.
The physician picture, in plain English
Residents and fellows: the ACGME six weeks
Effective July 1, 2022, ACGME-accredited programs must provide at least six weeks of leave paid at 100 percent of salary for a resident or fellow's first approved medical, parental, or caregiver leave, available from day one of the program, with health and disability benefits continued throughout. This was a genuine change: before it, trainee leave was a patchwork that often forced people to burn every vacation day or extend training. It is a floor, so ask whether your institution offers more.
Trainees: boards and training time
The parallel ABMS policy requires specialty boards to allow a minimum of six weeks away once during training without requiring an extension and without exhausting your vacation or sick time. Beyond six weeks, or depending on your board's total-training requirements, you may need to make up time or adjust when you sit for boards. The move is to talk to your program director and read your specialty board's leave policy early, because the details differ by board and specialty.
Attendings: the policy carries it, the state benefit is capped
As an attending you coordinate the same pieces as other employees, but the proportions are different. Your employer's parental leave policy is usually the piece that actually funds your leave. Short-term disability covers the physical recovery weeks. And state paid family leave, where it exists, is capped at a weekly maximum that represents a small fraction of a physician's income, so it helps but does not carry the leave. The question that moves the most money is whether your employer policy stacks with the state benefit or offsets it.
Production pay, call, and the income you do not see
If your compensation is productivity-based, RVUs or collections, your income can fall during and after leave even though your job is protected, simply because you are not generating billings while you are out and your panel takes time to rebuild. Ask whether you have a salary guarantee or draw during leave, how productivity targets are prorated, and how call is redistributed. These answers, in writing, can be worth more than the leave benefit itself.
Locums, 1099, and practice partners
Not every physician is a W-2 employee. Locums physicians, 1099 contractors, and practice partners are effectively self-employed for leave purposes, with no employer FMLA, STD, or policy, and access to state programs only through opt-in enrollment done in advance. If that is you, the plan is the self-employed one, including an individual disability policy and coverage for your patient panel. Our self-employed maternity leave guide covers it.
Why the coordination pattern matters
Same wage. Same leave. Same state. $10,800 different.
12-week leave. $1,500/wk earner. Connecticut. The pattern in your employer's handbook determines whether the two systems stack or cancel each other out. Most parents never ask which pattern applies.
This is the one conversation with HR that swings $10,000+ of household income on a single leave. Read how to ask the question or see our methodology.
Paid leave benefits by state (2026)
The 13 states plus DC with paid family leave. For attendings, note the weekly cap, since it sets how little of a physician salary the state benefit replaces. Click your state for the full guide.
| State | Program | Weekly max (2026) | Weeks for bonding | % of wages |
|---|---|---|---|---|
| California | California SDI + PFL | $1,765 | 18-20 (SDI + PFL) | 70-90% |
| Colorado | Colorado FAMLI | $1,448.02 | 12 (+4 pregnancy complications) | up to 90% |
| Connecticut | CT Paid Leave (CTPL) | $1,016.40 | 12 (+2 pregnancy complications) | up to 95% |
| Delaware | Delaware Paid Leave | $900 | 12 parental / 6 family or medical | 80% |
| District of Columbia | DC Paid Family Leave | $1,190 | 12 parental / 12 family / 12 medical | 90% (bend-point) |
| Maine | Maine Paid Family & Medical Leave | $1,249.12 | 12 (all reasons combined) | up to 90% |
| Massachusetts | MA PFML | $1,230.39 | 20 medical or 12 family (26 combined cap) | 50-80% (bend-point) |
| Minnesota | Minnesota Paid Leave | $1,423 | 12 family + 12 medical (20 combined cap) | up to 90% |
| New Jersey | NJ FLI + TDI | $1,119 | 12 bonding + 6-8 TDI medical | 85% |
| New York | NY Paid Family Leave | $1,228.53 | 12 | 67% |
| Oregon | Oregon Paid Leave | $1,692.16 | 12 (+2 pregnancy-related) | up to 100% (low-wage) / bend-point |
| Rhode Island | RI TDI + TCI | $1,150 | 8 TCI bonding + up to 30 TDI | 60% (TCI) |
| Washington | WA Paid Family & Medical Leave | $1,647 | 12 family / 12 medical (16 combined cap) | up to 90% |
Rates verified against state agency sources. See our methodology. States without mandatory maternity leave programs are still covered by federal FMLA (12 unpaid weeks with job protection at employers with 50+ employees).
What to ask your GME or HR office (in writing)
- Trainees: how do the ACGME six weeks, my vacation, and any institutional parental leave stack for my situation?
- Trainees: given my specialty board, will my planned leave affect training completion or board timing?
- Attendings: what does the parental leave policy provide, and does it stack with or offset the state benefit?
- Attendings: do I have short-term disability, and am I inside the enrollment window?
- If my pay is production-based, do I have a salary guarantee or draw during leave, and how are targets prorated?
- How is my call coverage handled, and am I expected to make it up?
Mistakes physicians make
- Trainees not knowing the six weeks are guaranteed and paid. It applies from day one; do not assume you must burn vacation.
- Trainees planning leave without checking the board rules. Beyond six weeks, training-time and exam timing can be affected.
- Attendings over-counting the state benefit. The cap makes it a small share of a physician salary. The employer policy is the real lever.
- Ignoring production-pay effects. A protected job can still mean a smaller paycheck if comp is RVU-based. Get the guarantee in writing.
- Locums and partners assuming they are covered. They are effectively self-employed and must arrange coverage in advance.
Physician maternity leave FAQ
As a resident or fellow, what am I guaranteed?
Under the ACGME policy effective July 1, 2022, every ACGME-accredited program must provide at least six weeks of leave paid at 100 percent of your salary for your first approved medical, parental, or caregiver leave, and you are entitled to it from the day you begin the program. Your health and disability benefits continue during the leave. This is a floor, so your program or institution may offer more.
Will taking leave extend my training or delay my boards?
Not automatically for the first six weeks. The ABMS policy requires member boards to allow a minimum of six weeks away once during training without requiring an extension of training and without exhausting your vacation or sick time. Beyond six weeks, or depending on your specialty board's total-training requirements, you may need to make up time or adjust your exam timing. Confirm the specifics with your program director and your specialty board early, because the rules vary by board.
Is the six weeks on top of vacation and sick leave?
Generally yes. The policy is designed so the six weeks do not come out of your vacation or sick banks, which means you may be able to add accrued time to extend beyond six weeks. Ask your GME office exactly how the six weeks, your vacation, and any institutional parental leave stack for your situation.
I am an attending. What does my leave look like?
Like other high earners: your paid leave comes from your employer's parental leave policy, short-term disability for the physical recovery weeks, and your state's paid family leave program if it has one. The wrinkle is that state benefits are capped at a weekly maximum, so for a physician salary the state program replaces only a small slice of income. Your employer policy is usually the piece that actually carries the leave.
Why is my state paid leave benefit so small compared to my pay?
Every state program caps the weekly benefit, often somewhere between about $1,000 and $1,800. That cap is a meaningful share of an average wage but a small fraction of a physician's, so the percentage of your income it replaces is low. This is why the employer policy and how it coordinates with the state benefit, stacked versus offset, matters more for physicians than the state benefit itself.
I am a locums, 1099, or practice-partner physician. What then?
Then you are effectively self-employed for leave purposes: no employer FMLA, no employer STD or policy, and access to state paid leave only if your state allows opt-in and you enrolled ahead of time. The self-employed playbook applies, including an individual disability policy and planning coverage for your patient panel. See our self-employed guide for that path.
How do call schedules and productivity pay affect my leave?
If your compensation is production-based (RVUs or collections) rather than a flat salary, your income can drop during and after leave even when your job is protected, because you are not generating billings. Ask whether you have a salary guarantee or draw during leave, how your productivity targets are prorated, and how call redistribution is handled, and get the answer in writing before you plan.
How does Parental Leave Pro help physicians?
The free check sorts you into the trainee path or the attending path and shows what applies. A paid plan maps the ACGME six weeks plus accrued time for residents and fellows, or the policy-plus-STD-plus-state coordination for attendings, estimates the real replacement given state caps, and writes the questions for your GME or HR office. Christine works alongside physicians, residents, and fellows every shift, so this one is close to home.
Plan your leave in 60 seconds.
Free check that sorts you into the trainee or attending path. A paid plan maps the six weeks or the policy-plus-STD-plus-state coordination, and writes the questions for your GME or HR office.
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