Women in medicine: two points of view. II. Medicine and motherhood

Women surgeons. Results of the Canadian Population Study

OBJECTIVE

A national survey of women surgeons in Canada was undertaken to evaluate their ability to combine career with personal and family life.

SUMMARY BACKGROUND DATA

Despite increasing numbers of women entering the medical profession, women continue to select nonsurgical careers. Although there are many reports regarding women in medical specialties there is little information available regarding women who choose surgical careers. Such data will be useful in increasing the enrollment of women in surgical training programs.

METHODS

A 93-item questionnaire was mailed in July 1990 to the 459 eligible female surgeons. The survey was conducted using a modified Dillman 5-step computerized method. The study was closed in May 1991.

RESULTS

Of the 459 surgeons who were located, 419 (91.3%) responded. Most surgeons (65.5%) were married. Only 6.5% were separated or divorced. The majority married another professional (91.4%). One quarter married another surgeon. Of all women who married at least once, 70.9% had at least one child. Most surgeons delayed child bearing until after they had completed their surgical training. The majority of respondents were in active surgical practice (82.3% full-time, 6.0% part-time). The most common surgical subspecialty was obstetrics and gynecology (40.9%), followed by ophthalmology (21.2%), and general surgery (12.1%). Surgeons were rarely dissatisfied (4-9%) with career, marriage, health, friendships, financial status, and hobbies. Overall, 88.3% were happy with their decision to pursue a career in surgery.

CONCLUSIONS

Women surgeons practicing in Canada are able to combine productive careers with rewarding family lives and are satisfied with their decision to do so despite the compromises involved.

Women in academic medicine. Combining career and family

We conducted a national survey to explore how women in academic medicine balance career and family responsibilities. A questionnaire was mailed to all women 50 years of age and under who held full-time appointments in departments of medicine (n = 862), as listed in the faculty roster of the Association of American Medical Colleges. The survey included questions about childbearing and child rearing, attitudes about personal and professional issues, and role models. Of the 694 questionnaires that were delivered, over 80 percent were completed (n = 558). The mean age of the respondents was 38.1 years, and 63 percent had children. The 350 mothers had a mean of 1.9 children; only 3 had 4 or more children. Approximately half the respondents with children had their first child after completing medical training (mean age, 30.6 years), and they were absent from work for a median of 6 weeks post partum; 72 percent took no time off before labor and delivery, and 83 percent were back at work within 12 weeks. The majority were satisfied with their decision to have children and with their careers, despite the fact that 78 percent believed that their career progress had been slowed or markedly slowed by their having had children. We conclude that it is possible for women to combine motherhood with a fulfilling career in academic medicine, but it is difficult, and most such women believe that motherhood slows the progress of their careers.

Pregnancy during residency

To identify possible barriers to women physicians who wish to combine parenting with medical careers, we studied 56 of 64 pregnancies from the past 10 years in 63 of 66 Harvard-affiliated residency programs. Pregnancies during residency were common (one in eight married women in 1983) and were usually planned (77 percent). Most institutions were unprepared for pregnancies among members of the house staff; four fifths of the programs had no maternity-leave policy. No one quit a residency program because of pregnancy, and pregnancy rarely affected achievement of board certification. Whether the pregnant women found pregnancy during residency a "pleasant" experience was determined largely by whether the program director was supportive, whether the issue of pregnancy was openly discussed within the program, and whether the woman was permitted to return to work on a part-time basis for the first weeks after maternity leave. We conclude that pregnancy within residency programs should be expected and planned for and that if proper arrangements are made, it need not be a major problem for either the training program or the pregnant resident.