As more women enter medicine, the need to balance the rigorous training period with family priorities becomes more acute.

Yes.Because of changing demographics, all hospitals will face the question of parental leave for residents. It would be much better for them to have policies in place than to respond in a piecemeal way that burdens everyone. In a survey I coauthored on women in academic medicine, we found that 25 percent had had their first child during residency and 18 percent during fellowships.

In medical schools today, 35 to 40 percent of the students are women. In some, it's 50 percent. Most women delay pregnancies till after medical school, so there will be many pregnant residents in the future.

The American Medical Association reports that fewer than 45 percent of the programs have specific maternity policies. This is in sharp contrast to private industry, which recognized that they are needed in order to retain and attract the best staff.

With the decline in medical-school enrollment, there'll be increasing competition for residents. Those hospitals with parental-leave policies will be favored by applicants.

Today, fathers want to be -- and are -- more involved in child-rearing. This is reflected in the push for national legislation in this area. There is no evidence that interrupting a residency has an adverse effect on physician quality. I'd worry more about the long-term consequences of not interrupting work when one feels a strong need to. I have seen firsthand that parental-leave policies work. Our hospital had a husband and wife share a residency. During that time, they had two children. We had the benefit of two residents. It was good for us and good for them.

Sadly, the U.S. is the only industrial nation lacking a nationwide parental-leave policy. As doctors, we should be a model of what is good for people. Parental leave is an idea whose time has come. -- Wendy Levinson, MD Assistant chief of medicine, Good Samaritan Hospital, Portland, Ore. No. Parental-leave policies would profoundly interfere with a process that has allowed hospitals to turn out bright, well-trained doctors through uninterrupted residencies.

Most people would be puzzled why someone would want to start a family during residency training. Starting a family is difficult enough under the best of circumstances. Trying to do it when time demands and work pressures are so high makes little sense. As for paternity leaves, it is simply unfair for a man to ask his fellow residents to increase their workloads. In the past, those residents who have fathered children have had no difficulty continuing their duties. There is no reason they can't continue to do so.

Whether one is a man or a woman, the decision to go to medical school is made with knowledge of what's in store. The timetable has proven itself. If we tamper with it, we risk diluting its strength. One of the most lasting parts of a resident's education is the continual exchange of information over the years with colleagues in the same program and in allied disciplines. This process would be harmed by a leave of absence.

The simple truth is that medicine is and will continue to be an extremely demanding occupation. Requests for parental-leave policies are part of a pattern of growing resident requests. Where residents have gone wrong is in believing their relationship to the hospital is typical of employer-employee relationships. It is not.

Entering a residency, one knows ahead of time that one is going to have to sacrifice a part of oneself in exchange for training as a physician.

In my opinion, it is best that medical education and training remain this way and not be turned into a business. -- Frank Rogers, MD Surgeon, Whittier, Calif.; delegate to the American Medical Association

1990, Physician's Weekly, a Whittle Communications Publication; reprinted with permission