Knife before wife, or so they say

James Berwin

James Berwin is a Specialist Trainee (ST8) in Trauma and Orthopaedic Surgery in the Severn Deanery.

Knife before wife, or so they say. But what if you and your partner both have careers, and you want to start a family? In this modern day and age, is knife before life the only way?

Ahead of the birth of our daughter, my wife and I considered the amount of time we would take off on parental leave. My wife is a plastic surgical trainee; I’m an orthopaedic trainee. We are at similar stages of training and are essentially on identical pay. Given the equality in our professional lives, why then would it be fair to divvy up parental leave in anything other than equal measure?

Disclaimer: there are many ways to do parental leave. The choices you make are specific to your situation. This article is not designed to pass judgement on those choices, rather to explain what I did and why, in the hope that it may help others feel able to take the time they want on parental leave.

Why take shared parental leave?

The ‘Share the Joy’ campaign launched by the government to promote shared parental leave (SPL) states that less than 2% of eligible parents in the UK take up the opportunity [1]. The explanation for this low uptake is multi-factorial, and could include financial considerations, office culture and professional reasons. Whilst there are barriers to taking SPL, from my experience the balance is tipped firmly towards being overwhelmingly positive. Sadly, there are perceptions, firmly held by some, which may be the legacy of a generation for whom work-life balance was inconceivable.

Many of my senior colleagues have spoken of their regret in not spending more time at home watching their children grow up. “Cherish those early years, you don’t get them back”, they say. In their defence, they didn’t have a choice. Shared parental leave was only made possible in April 2015. My hope for today’s generation of young doctors is a positive culture change that is supportive of modern professionals trying to balance their careers with family life.

Burnout

We are in the midst of a burnout pandemic. The BOA tells us that current levels are at 58%, up from 40% in 2018 [2]. Burnout is characterised by feelings of being overextended and the depletion of one’s emotional and physical reserves. Poor work-life balance is a major contributor to burnout, which itself is an important contributor to attrition from surgical training programmes. This represents a loss of both financial investment and human capital and its prevention is therefore vital to protect our future workforce. Thankfully, I have not experienced burnout myself, but taking SPL during those early weeks and months of my child’s life may have helped prevent it.

Gender equality

Female surgical attrition is a proportionately greater problem [3], a fact illustrated by the decreasing numbers of women at increasing levels of the surgical hierarchy (women make up 55% of UK medical school graduates [4], 41% of core surgical trainees, 30% of surgical specialty trainees and 12% of surgical consultants) [5]. This is reflected in the corporate world with only 7% of UKs FTSE 100 companies being chaired by women [6]. One possible explanation for this phenomenon is that work and home life is not yet shared equally between partners on a societal level.

A conscious or subconscious bias appears to exist against colleagues who choose to take an extended period of parental leave or work less than full time (LTFT) [7]. Women on the ‘mummy track’ perceive that they are taken less seriously at work or are viewed as less committed and are therefore given fewer opportunities. This may be a contributing factor towards the glass ceiling preventing women from reaching their professional potential. If it were normal for men and women to share parental leave equally, this bias would begin to dissipate. By achieving equality at home, you take a big step towards achieving equality at work.

Let’s address the perceived disadvantage of taking time out for parental leave. In the grand scheme of a 30+ year career: does anyone honestly believe that six months out will significantly impact one’s training and subsequent professional capability? Having been back at work for almost a year, I don’t think it has. The positive impact that time out has had on my family, however, is huge. Taking SPL has reduced the impact of delayed career progression for my wife. More importantly, by being around as a full-time Dad for those formative months of my daughter’s life, I feel as comfortable with ‘how my baby works’ as my wife does – her schedule, what she eats, how to comfort her, or where her swim nappies are! This means much of the mental load is shared equally between us and has proven to be an unexpected and valuable investment in my wife’s career and sanity going forward, extending far beyond the end of our parental leave.

What much of society has failed to grasp is that the next step in improving gender equality is not just improving women’s ability to achieve at work – it’s improving men’s ability to achieve at home. Society is largely OK with women who have careers and want to start a family. We understand that they will need to take time out of work to do this. Allowances are made. Far less common is the notion that men may also want to take an extended period of parental leave. That was a big part of what motivated me to do it. Why should my wife get the lion’s share of all that time spent with our baby? I wanted that too.

I often wonder how many men would like to take SPL but feel they can’t for fear of judgement. Many guys I know talk about doing it, very few make the jump. The bottom line is that gender equality works both ways. To create a culture free from bias, more men need to take extended parental leave. Be part of that change.

What are you entitled to as a parent in your child’s first year of life?

In the first year after birth or adoption of your child, you are now entitled to 50 weeks of parental leave and 37 weeks of statutory pay to be shared between you and your partner. This is in addition to the two weeks of statutory maternity and paternity leave you each get. You can share those 50 weeks however you like and can choose to take it at the same time or separately. There are of course certain stipulations and rules. The BMA has a useful page on it [8].

Provided you have been with the NHS for 12 months or more, continuously, by the 11th week before the expected week of childbirth, parents are entitled to Occupational Maternity Pay (OMP). OMP is determined by the NHS and consists of eight weeks full pay, 18 weeks of half-pay, 13 weeks of Statutory Maternity Pay (SMP) and 13 weeks of unpaid leave. Your pay (or half-pay) is determined by your average salary over the eight weeks prior to the 15th week before the expected week of childbirth. SMP is £151.20 per week. This is shared out between you if you overlap your parental leave, so the total amount of leave and pay is the same regardless of how you split it up.

As of 1st April 2019, enhanced shared parental pay was made available to consultants, specialty doctors, associate specialists and junior doctors in Scotland. Full details can be found on the BMA website.

It’s important to remember that you can take Shared Parental Leave in Touch (SPLiT) days. These enable you to go back to work for a day or more at a time before your parental leave officially ends. They are designed to ease the transition back to work. A couple is entitled to 20 SPLiT days to be divided between you however you want. You are entitled to be paid at your basic daily rate minus any statutory or enhanced shared parental pay you are already receiving for that day. If a SPLiT day is worked in the full pay period of SPL (or during accrued annual leave, which is of course also paid at full pay), you are entitled a day-in-lieu following your return to work.

What did I do?

I took 22 weeks of SPL in addition to two weeks of statutory paternity leave and two weeks of accrued annual leave. My wife and I decided to take our parental leave at the same time, and she went back to work eight months after our daughter was born. Many thought we were mad, pointing out that we’d have to fork out more on childcare and suggesting that my wife wouldn’t want to go back to work at eight months as it would be too soon. The best of the lot was one colleague who asked if we were just trying to have a jolly! (Those of you with small children will know that, whilst having a new baby is a wonderful time, it’s anything but a jolly!)

Like so many of the personal /professional lines that are crossed every day at work, the response to all those critics is “it is none of your damned business”. These are your rights as a new parent, end of story. It’s like those friends and family members who give unsolicited advice about how to care for your baby: thanks, but no thanks. Just like the technicalities of raising your child, how you choose to spend your time raising them is up to you. Carte blanche. Do it however you want. Subject to terms and conditions, of course.

What were the negatives?

As I have alluded to, you will take a financial hit whilst on shared parental leave. Once you’re on statutory pay, you are facing a weekly combined budget of £151.20 per week. It did help that our parental leave coincided with the height of the COVID-19 pandemic and lockdown, so opportunities for spending money were thankfully limited, and I think it was worth it, not least because, in the grand scheme of the combined income my wife and I will make over the entirety of our careers, it’s peanuts.

The other challenge was administrative. Dealing with HR is difficult at the best of times, but as SPL isn’t common it was difficult to find someone who knew how it worked. I’ll be honest, it was a headache.

My advice would be to find out whether there is a member of HR who champions parental leave. Most trusts nationwide also have appointed consultant clinicians in a mentorship role to support trainees taking time out of training (SuppoRTT mentors). They are generally easy to find and may be able to help with overcoming obstacles.

What were the positives?

I will cherish the six months I spent on shared parental leave for the rest of my life. My wife and I overlapped our leave. We shared the good times and the difficult times. Whilst there were certain tasks only my wife could do, there was plenty I could do too. That felt good. There is no doubt that it has made life after parental leave easier too.

If I’m honest, I also experienced firsthand how boring (and at the same time exhausting!) looking after a newborn can be. Those with recent experience of this will no doubt agree. But whilst it may not have been a jolly all the time, I imagine it was much more fun doing it together than doing it on your own.

Conclusion

I recently heard the phrase, “you can’t be what you can’t see”. It refers to minority groups breaking into professional spheres or spaces that have historically lacked diversity. Well, there you have it. A male orthopod who took some time out of training to look after his child. Not so exceptional when you say it like that. Especially when it’s what our female counterparts have been doing all along.

References

References can be found online at: www.boa.ac.uk/publications/JTO.

Have you seen our parenthood guidance?

The BOA has compiled a comprehensive resource of guidance and information which can be viewed at www.boa.ac.uk/parenthood.