For residents requesting FMLA, the program director should adhere to the human resources policies of their institution and applicable law when deciding whether to approve such leave requests, whether any time away from training must be compensated for, and whether the training period needs to be extended. The program director is responsible for ensuring that residents who complete less than 84 months of training but successfully finish the program receive comprehensive neurosurgical training and can practice as competent neurosurgeons after residency.

If a resident's leave results in completing less than 84 months of total training, the following conditions apply:

1. Any reduction in the standard 84 months of training must be deducted from the resident's 30 months of elective time.
2. When the resident applies for certification, their program director must provide a letter to the ABNS stating that the program director:
   1. Approved the leave leading to less than 84 months of training; and
   2. Confirms the resident received full training and successfully completed the residency in less than 84 months.

Taking time off or working a reduced schedule after residency may make it challenging for candidates for ABNS certification to meet primary certification requirements:

1. Submitting 125 consecutive cases within 18 months, and/or
2. Completing applications within three years post-training.

Requests for extensions must be submitted in writing to the ABNS office. Extensions granted will be appropriate to the specific circumstances of each case. The ABNS may also request documentation of the candidate's absence or reduced schedule, including institutional FMLA approval.