Many Female Docs Sacrifice Family, Career to Achieve Work-Life Balance

ANAHEIM, Calif. -- Female physicians commonly adjust their career trajectories and family-building plans to balance their medical careers with child-bearing and parenthood, survey results showed.

More than 80% of female physicians reported that they delayed having children at some point in their career due to the demands of medical training, reported Jennifer Bakkensen, MD, a third-year fellow at the Northwestern University Feinberg School of Medicine in Chicago.

Additionally, some female physicians made significant career choices to accommodate their family-building plans, such as taking extended leave, changing the setting where they practice, or for a few, even leaving medicine, Bakkensen said in a presentation at the American Society for Reproductive Medicine annual meeting.

Overall, 34% of female physicians said they did not take opportunities to advance their careers in order to accommodate child-bearing or parenthood.

For the past two decades, research has shown persistent gender gaps in leadership in medicine, many of which have not narrowed, Bakkensen told MedPage Today.

"I think a lot of the knee-jerk reaction is that this is discrimination and discrimination alone," Bakkensen said. Adding that discrimination plays some role, she said the findings show that gender disparities are also a result of "larger societal pressures, societal norms, that are driving women to make these accommodations."

Women are increasingly represented in medicine, yet they continue to make up significantly lower proportions of leadership positions than men, Bakkensen said in her presentation. Approximately 16% of all medical school dean positions, 18% of department chair positions, and 25% of full-time professor positions were held by women in 2018, according to data from the Association of American Medical Colleges.

In this study, Bakkensen and colleagues conducted a survey to evaluate how female physicians adjusted their career and family-building choices to balance parenthood and working in medicine. The researchers distributed an online survey to female physicians through a national social media campaign between March and April 2022.

The team included 741 survey respondents in the analysis. Physicians who responded to the survey were 39 years old on average. Overall, 90% identified as heterosexual and 85% were married or partnered. Nearly 40% experienced infertility, and 55% used in vitro fertilization to conceive. A majority of survey respondents were white.

Around 20% of the respondents were residents or fellows, and 69% were attendings. Most respondents were trained in ob/gyn, internal medicine, or pediatrics, but lower numbers of physicians in family medicine, surgery, and emergency medicine also participated in the survey. Additionally, 43% practiced medicine in academic settings, 27% worked in private practice, and 21% practiced in community settings.

The majority of female physicians postponed their family-building plans due to career-related challenges. Of all respondents, 62% delayed having children in the past due to their medical career, and 18% were currently pushing their plans.

In total, 42% of women delayed family-building plans by 0 to 3 years. Nearly 30% delayed by 3 to 5 years, and 21% pushed their plans by 5 years or more, the researchers found.

Female physicians cited lack of time, lack of schedule flexibility, stress, and concern about burdening their colleagues as the top factors they considered in deciding when to have children. Fewer than 40% said that lack of a partner contributed to their choices about when to start a family.

While 27% of respondents worked 60 hours a week or more, 52% reported working between 40 and 59 hours a week, and 15% worked between 20 and 39 hours.

Many of the women who responded to the survey worked more hours than their spouses. Additionally, 54% were responsible for household maintenance roles such as cooking, buying groceries, and cleaning, and 64% were responsible for family maintenance roles, including childcare, doctor's appointments, and school forms.

Some physicians took additional measures to accommodate their family-building plans, such as taking extended leave more than 12 weeks (20%), choosing a different specialty (21%), reducing work hours (33%), or changing their work setting (19%), such as from an academic setting to private practice. Just 3% of the respondents left medicine to accommodate family-building.

The multimodal sampling technique used in this study may have limited these findings, as it may have subjected the research to sampling bias, Bakkensen said. Additionally she said there was a high proportion of infertility in the sample, which may indicate response bias.

Bakkensen said she hopes further research will inform policies around increased fertility coverage and parental leave.

"There's clearly more work to be done in evaluating the underlying etiologies of gender disparities in medicine," she stated. "These data shed light on potentially critical areas for affecting future change."

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