PONE-D-22-29362Maternity and family leave experiences among female ophthalmologistsPLOS ONE

Dear Dr. Mcglumphy,

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Isabelle Jalbert, PhD

Academic Editor

PLOS ONE

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Additional Editor Comments:

Congratulations for a very interesting study. Your reviewers have asked for several modifications and clarification which I encourage you to carefully consider. In addition, I support the requests to:

- include "in the United States" in the title of the manuscript

- provide a copy of the questionnaire as a Table or as Supplementary material

Please also consider the following:

- provide more details on how the survey questions were developed: were they based on existing instruments? were these pilot test? on who? etc.

- provide an estimate of the response rate based on the maximum number of people the survey was sent to

- comment on the generalizability of the results to the population of female ophthalmologists in the USA based on the data you have collected and what is known about the general characteristics of this population

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: N/A

Reviewer #2: No

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: It is interesting to see the real data provided by female ophgthalmologists regarding their experience with maternity leave and time for breast feeding and lactation support. Very useful paper, well done.

The authors should refrain from inserting their personal opinion and stay with the facts.

Minor comments

The first paragraph of the introduction is biased and removes the interest in reading this paper as the conclusions are already drawn. I suggest to remove line 1-10 from the introduction and discuss this in the discussion.

Please remove decimals if percentage is 10 or higher (not 40.1 but 40 %)

Page 3 line 19: if it increases from 1 to 2 %, this would be a moot paper. Please indicate what the percentage was 10 and 5 years ago and now.

This paper is only about the United States of America, regrettably often a backwater if looking at maternity leave. Please change the title of the paper to indicate that this study took place in the United States of America.

Page 4; which ophthalmology mothers group? Can you specify how this group was contacted

Table 1: mean hours worked: you mean per week? Please add.

N (%): 9 (0.05): the 0.05 is not percentage. Please change to 5%. Same below. Please change in all tables where you mean percentage.

Table 3: what do the numbers in the section: Participants reported experiencing… stand for (0.23 etc)?

Discussion: Please refrain from stating you are the first. Line 128: the question was not only about burnout, so this sentence should be modified. Same applies to line 212.

No information was provided about male dominance at the work place. Please adjust: “As some study participants commented, navigating maternity leave can134 be incredibly difficult, especially when one is working in a male-dominated workplace or is the first in the workplace to take maternity leave.”

Line 149: Most did not report financial hardship. Line is biased.

Why do you not call Express Milk: lactation support? Is it really called Express Milk time?

Line 198: add : in the United States of America.

an interesting paper about career choices and satisfaction early on in the USA is:

Factors Influencing Career Decisions and Satisfaction Among Newly Practicing Ophthalmologists.

Gedde SJ, Feuer WJ, Crane AM, Shi W. Am J Ophthalmol. 2022 Feb;234:285-326. doi: 10.1016/j.ajo.2021.06.011. Epub 2021 Jun 23. PMID: 34157277

Reviewer #2: The study evaluates the professional and social effect of maternity and family leave policies on female clinicians in the field of ophthalmology. It demonstrates the challenges currently faced by the female ophthalmologists which could provide evidence to improve the current system of family leaves to help and support the physician mothers and prevent burnout. I believe the manuscript provides important information and evidence to form basis for an improvement in the current family and maternity leave policies and thus, I recommend it to be accepted with corrections.

1. Methodology mentions the use of voluntary and anonymous survey link for recruiting the participants. Please mention the name and provide links for theses surveys in the methodology section.

2. Did the study include transgender population that identify themselves as women?

3. A copy of the survey form should be added in the methodology as a figure, or in the supplementary methodology section, for the ease of the readers.

4. Please describe the type of statistics used, number of participates, Mean, SD calculations, software used etc in the methodology section.

5. The study could also include differences in experiences of physicians with/without interventions during their pregnancy.

6. The study could also include scope of including researchers such as Ph.D.’s , Postdoctoral scholars, instructors in the ophthalmology department of the hospital set up in the future, and if their experiences align with the physician ophthalmologists.

7. Did the study include workplace (hospital) daycares for the physicians and if there were any financial support for the daycare cost? Daycare cost is another essential factor for new mothers undergoing financial stress and should be discussed in the discussion section.

Minor typos

1. Table 2 require formatting, there are some extra lines.

2. There are different font sizes in table 2 which should be consistent

3. The labelling of the tables are different, please current the headings “label Leave 1, leave 2 and leave 3” in Table 2 to first, second and third as mentioned in Table 3 and 4 to maintain consistently in the tables for the ease of readers.

4. In some places the numbers are written alphabetically while in other places its written numerically kindly correct it. For eg, in line 154 and 155.

5. Figure one is blurred and needs to be in a high resolution.

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Reviewer #1: No

Reviewer #2: No

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Maternity and family leave experiences among female ophthalmologists in the United States

PONE-D-22-29362R1

Dear Dr. Mcglumphy,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Bidisha Banerjee, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: (No Response)

Reviewer #2: The authors have addressed all the comments in an informative manner, and I recommend the paper to be accepted

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

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