Practical Guidance

FMLA and medical leave in residency: what protects you

Short answer

The FMLA gives eligible employees up to 12 workweeks of unpaid, job-protected leave a year for serious health conditions and family reasons, but generally only after 12 months and 1,250 hours of work, which many first-year residents have not reached. The ACGME separately requires institutions to provide at least six weeks of approved medical, parental, and caregiver leave once during training, starting on day one. Your specialty board decides how leave affects training completion.

Leave in residency is governed by three sets of rules that do not line up neatly: federal law, the ACGME, and your specialty board.

If leave and discipline have crossed paths in your training, tell us the dates: start a confidential intake.

The FMLA

The Family and Medical Leave Act gives eligible employees up to 12 workweeks of unpaid, job-protected leave in a 12-month period for a serious health condition, the birth or placement of a child, or caring for a family member with a serious health condition.

The employer must keep group health coverage in place during leave, and restore you to the same or an equivalent position.

Eligibility generally requires 12 months with the employer, 1,250 hours worked in the past 12 months, and a worksite with at least 50 employees within 75 miles. Many first-year residents have not reached 12 months yet.

The FMLA also prohibits interfering with, restraining, or denying FMLA rights. Discipline for using protected leave is the kind of fact counsel wants to know about.

The ACGME's leave requirements

Separately, the ACGME Institutional Requirements require sponsoring institutions to provide residents at least six weeks of approved medical, parental, and caregiver leave once during training, available from the first day the resident is required to report, with pay and continued health and disability insurance. Your institution's leave policy sets out how it applies.

Your specialty board

Your board, not your program, decides how much time away still counts toward completing training, and when training must be extended. See how one board frames it.

Where problems start

  • Leave taken before FMLA eligibility, with only the institution's policy to rely on.
  • A disciplinary process that advances while a resident is on leave.
  • A return-to-work condition that is never defined. See fitness-for-duty evaluations.
  • A remediation plan whose clock keeps running during leave.

What to do

  • Request leave in writing, and keep the approval and its dates.
  • Ask in writing which policy and which law your leave falls under.
  • If you are on a remediation plan, ask in writing that its clock pause during leave.
  • If you need a change at work rather than time away, see how to request an accommodation and accommodations in residency.

If this is happening to you

Facing a deadline from your program? Tell us what you have received and when your deadline is. We will review your situation confidentially and point you to the right next step: start a confidential intake.

Resident Help is not a law firm, and submitting an intake does not create an attorney-client relationship. If your situation needs a lawyer, we will tell you and help you find one.

Common questions

Do residents qualify for FMLA leave?
Residents are employees, so the FMLA can apply once they meet its eligibility rules: generally 12 months with the employer, 1,250 hours worked in the past 12 months, and a worksite with at least 50 employees within 75 miles. Many first-year residents do not meet the 12-month requirement yet.
What leave does the ACGME require for residents?
The ACGME Institutional Requirements require sponsoring institutions to provide at least six weeks of approved medical, parental, and caregiver leave once during training, available from the first day, with pay and continued health insurance. Check your institution's leave policy for the details.
Can my program discipline me for taking protected leave?
The FMLA prohibits interfering with, restraining, or denying FMLA rights, including disciplining someone for using protected leave. If a disciplinary process advanced while you were on protected leave, note the dates and raise it with counsel.

Sources

If this is happening to you

You can send us a short note in about ninety seconds. It is free, it is confidential, and it does not commit you to anything.

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This post is general information and not legal advice. Institutional policies and board rules change, so confirm the version in force on your dates.