have a larger amygdala than their non-ad-
opted counterparts, suggesting grossly and
irreversibly altered emotion and fear pro-
cessing networks.
Paid parental leave (for both parents) is
associated with decreased infant mortality,
less postpartum depression, more breast-
feeding, more follow-up doctor appoint-
ments and more involved dads—all things
that promote healthy brain development.
State of the Residencies:Physicians,
Heal Thyselves
As a physician trainee and a dad, I’ve been
surprised that resident leave policies are
ironically inconsistent with knowledge of
brain development and what the medical
profession itself recommends.
In 2013 the American Academy of Pedi-
atrics released a policy statement “Paren-
tal Leave for Residents and Pediatric Train-
ing Programs” that emphasized “the AAP
recommends that regardless of gender,
residents who become parents should be
guaranteed six to eight weeks, at a mini-
mum, of parental leave with pay after the
infant’s birth.” As a resident, Yale allowed
me two weeks of paid leave because I am a
man fathering a child. Surprisingly, Yale
offers six weeks to men adopting a child
and six weeks to women either mothering
or adopting a child. While this policy is not
equitable or universal (infants of men fa-
thering a child get shortchanged), Yale’s
meager leave is sadly among the better for
physician trainees.
Demand for parental leave clearly ex-
ists: a recent study published in Academic
Medicine reported that among fathers in
residency training, 89 percent cited paren-
tal leave as an important benefit. From de-
livery through the first months of brain de-
velopment, studies have shown that a fa-
ther’s presence has a strong impact on child
development and attachment behaviors.
Nearly half of male residents, and over a
third of female residents are parents. If we
estimate that there are over 100,000 resi-
dents in the U.S., we can expect at least25,000 pregnancies (half of residents are
women, and more than half will have ba-
bies during residency) over the course of
their around four-year training, or roughly
6,250 pregnancies each year. Those 6,
little brains need to form secure attach-
ment. And yet parental leave policies re-
main inconsistent with our own evi-
dence-based recommendations.American Med-chismo
Anyone willing to pursue over a decade of
postgraduate training to care for strangers
in the middle of the night might want more
than a few days to welcome their child into
the world. At the end of our residencies my
wife (also a psychiatry resident) and I will
have a combined 27 years of post–high
school education (she, 12; me, 15) and four
postgraduate degrees in the medical scienc-This period of social and familial
isolation was euphemistically referred to
as a “monastic” existence.