The transition from parental leave back to the Emergency Department (ED) is a high-risk period for physician burnout and attrition. The abrupt return to non-circadian shifts and clinical demands is often difficult to reconcile with the physiological and psychological needs of a family in early infancy [1]. The challenges in return to work apply to birthing and non-birthing parents alike – whether someone is a new mom, a new dad, a new biologic parent, or a new adoptive parent – and are often compounded by the fact that many physicians lack access to adequate parental leave and return earlier than they otherwise would.

For all new parents, the postpartum period brings significant sleep fragmentation and restructuring of domestic labor. Working an emergency medicine schedule, including night shifts and irregular scheduling, can make meeting the demands of the newborn period difficult. Balancing these demands is even more difficult for the more than one-third of physician mothers who are required to make up clinical time lost during their leave [1]. 

While returning to work can be difficult for any employee, there are aspects of returning to emergency medicine that make it even more challenging.  The most commonly reported negative experiences among returning parents include inadequate time for breast pumping (34.6–48.2% of physician mothers), insufficient lactation facilities (15.4–32.2%), and difficulty securing childcare (35.3%) [1]. Perceived discrimination is also prevalent, with 18% of first-time physician mothers reporting discriminatory experiences following leave [1]. Returning to work is more difficult for parents without stay-at-home partners.  New mothers are less likely to have stay-at-home partners than new fathers: this likely contributes to why nearly three-quarters of new physician mothers report that they reduced work hours or considered part-time work within six years of completing training [2]. 

Attrition is costly to departments as it is expensive to find, hire, and train new physicians. Attrition also fails to capitalize on the decades emergency medicine physicians spend in training. Supportive policies that facilitate the return-to-work of all new parents can make the career of emergency medicine more sustainable, improve wellness and morale, and reduce attrition. 

Evidence-based recommendations from the academic institutions, such as Indiana University, the American Academy of Pediatrics, and other professional societies support flexible scheduling options including less strenuous shifts, reducing night shifts, and shortening the number of shifts worked in sequence by returning physicians [3, 4]. Additionally, studies show the burden of implementing such policies is low. By applying these principles to the return-to-work period, departments can move beyond a survival mindset toward one of career sustainability, better supporting physician parents and strengthening long-term workforce retention [1, 5, 6].