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Burdened at home, some physician mothers consider career change

(Reuters Health) – Like many working mothers, female physicians with kids often handle most housework and childcare duties, and the high burden of domestic duties prompts some to consider a career change, a new study suggests.

Researchers examined data from an online survey of 1,712 female physicians with children who were working in U.S. hospitals in April and May of 2015. All of the women were members of the web-based Physician Moms Group.

Most participants were partnered or married, and most reported having sole responsibility for the majority of domestic tasks regardless of the type of medicine they practiced.

But the burden of domestic work weighed more heavily on women in surgery and other procedure-focused specialties, the study found.

Women in these “procedural” fields – all surgical specialties, as well as anesthesiologists, gastroenterologists and obstetricians-gynecologists – who reported primary responsibility for five or more domestic tasks were 50 percent more likely than colleagues with fewer household chores to report a desire to change careers.

In contrast, for doctors in non-procedural specialties like family medicine, the number of domestic duties they managed on their own didn’t appear to influence their desire for career change. About one in three women in these medical fields reported a desire to switch to a less demanding career or specialty no matter how many chores they had.

“As more women enter the surgical workforce, it is very important to discuss issues surrounding gender disparities and parenthood,” said senior study author Dr. Nelya Melnitchouk of Brigham and Women’s Hospital and Harvard Medical School in Boston.

“By ignoring this topic, there could be a loss of talented women and mothers in the medical and surgical workforces,” Melnitchouk said by email.

While half of medical school graduates in the U.S. are female, only about 14 percent of these women pursue careers in surgery, compared with 33 percent of men, the researchers note in JAMA Surgery. Many women choose instead to pursue “non-procedural” specialties like internal medicine, family medicine and pediatrics.

Both male and female physicians with kids tend to be less satisfied with their careers than their colleagues without children, previous research has found.

But unequal distribution of domestic labor has been documented as a driving force behind the scarcity of women in surgery and in leadership positions in medicine, the study team notes.

In the current study, 57 percent of women had sole responsibility for routine child care plans and 44 percent were responsible for solving backup child care options on their own.

Women, more often than their spouses, also had primary responsibility for domestic duties like cooking, grocery shopping, vacation planning, laundry and helping kids with homework.

For surgeons and women in other procedural specialties, the total burden added up. With sole responsibility for less than five domestic duties, about 43 percent of these doctors considered a career switch, compared with 57 percent of those bearing sole responsibility for five or more domestic tasks.

The survey wasn’t a random sample of all female physicians nationwide, and it’s possible the results don’t represent how all women in medicine feel about work-life balance.

Even so, the results do highlight a looming problem in the profession, particularly for women in surgery who may have a harder time controlling their schedules, said the author of an accompanying commentary, Dr. Julie Ann Freischlag, CEO of Wake Forest Baptist Medical Center and dean of the Wake Forest Baptist School of Medicine in Winston-Salem, North Carolina.

“It has to do with doing procedures, which sometimes get delayed or take longer and require your full attention,” Freischlag said by email. “The urgent and emergent nature of procedures plays into the stress as well.”

(This story has been refiled to correct typo in name spelling in paragraph 8)

SOURCE: and JAMA Surgery, online April 10, 2019.

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