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Paediatr Child Health. 1998 Nov-Dec; 3(6): 387.
PMCID: PMC2851299

A prescription for fairness

Physicians have always recognized that children’s well-being is central to what we do. Recently, we have begun to realize that a physician’s well-being is also important because it is key to how well we can care for children. Many factors can compromise a doctor’s physical and mental health, not the least of which are the ever-changing demands on us. Consider the diverse challenges facing our profession:

  • ensuring all children and youth have access to health care;
  • maintaining the quality of health care to children and youth despite hospital restructuring and economic constraints;
  • integrating new technologies into our work; and
  • having a well-balanced professional and personal life without succumbing to the evils of stress.

Reconciling these objectives – especially a balance between personal and professional life – is not easy, especially when you are a resident. Pregnancy, illness and other circumstances all necessitate time devoted to one’s personal life and time away from training. How can residents take care of their lives and families without compromising their careers? And what happens to the colleagues who are left behind to replace them, when there are fewer and fewer residents available to carry the load? Is it possible to establish policies that will be fair to everyone involved?

With 280 members, the Residents Section is the largest group within the Canadian Paediatric Society (CPS). They know first-hand how wider changes to the health care system have affected paediatric training. They have seen how a lack of Canadian standards for short term leave in residency programs can cause stress among residents and staff alike. It was with these concerns that the section set out to establish guidelines for short term leave two years ago. Throughout the process, I was fortunate to observe their enthusiasm, dedication and professionalism as they diligently gathered data from across the country and formed their recommendations.

The resulting document, “Paediatric Residency Programs: Guidelines for short term leave” (pages 425–426), recommends minimal standards for Canadian programs. But the authors also address a more fundamental issue, one that might be summed up by paraphrasing an old adage: “Treat your medical colleagues as you would like to be treated.” The guidelines established by the residents are applicable to the whole medical profession, for at their core the guidelines seek fairness among colleagues.

Professional stress is not a new phenomenon. What is new is how we recognize it and what we choose to do to help alleviate it. The CPS is not the only organization to be concerned with these issues. While the residents were working on their guidelines for short term leave, the Canadian Medical Association produced a policy on physician health and well-being (1), and the Royal College of Physicians and Surgeons of Canada published an article on the impact of parental leave on resident education (2). Clearly, achieving a balance between one’s personal and professional life is something with which all physicians need to be concerned.

Thanks to the CPS Residents Section for leading the way and bringing such an important issue forward. Of course, the guidelines are just the first step in a much longer process that requires the goodwill of all paediatric residency programs in Canada to set it in motion. People running the training programs need to find innovative strategies to replace residents on leave, strategies that both accommodate the needs of residents who require leave, and do not compromise the personal and professional lives of the residents and staff who are left. The residents are counting on us!


1. Canadian Medical Association Physician health and well-being. Can Med Assoc J. 1998;158:1191–200. [PubMed]
2. Gold JH, Fréchette D, Des Marchais J, et al. Parental leave: Impact on resident education. Annals RCPSC. 1998;31:240–3.

Articles from Paediatrics & Child Health are provided here courtesy of Pulsus Group