Quick Take: Association of Domestic Responsibilities With Career Satisfaction for Physician Mothers in Procedural vs Nonprocedural Fields

Although females currently account for roughly 50% of graduates from U.S. medical schools, there is a skew in terms of which residencies or medical specialties females go into, with females being much less likely to apply to surgical residencies. There is a need to better examine the challenges affecting work and family life for female physicians. Studies have shown that physicians with children have less career satisfaction than physicians without children, and it is thought that domestic responsibilities may play a role in career satisfaction and career choice. In this cohort study, investigators analyzed survey results from 1712 attending physicians who were female physician mothers in order to examine whether having more primary domestic tasks had an association with career satisfaction, and whether this was different for physician mothers who were in procedural versus nonprocedural specialties. Investigators found that 73.0% of respondents were in non-procedural specialties and 27.0% were in procedural specialties. Physician mothers reported having the sole responsibility for most domestic tasks compared with their spouse or partner, and there were no significant differences in the breakdown of domestic tasks in procedural vs. nonprocedural specialties. In a sub-group analysis, investigators stratified physician mothers by nonprocedural vs. procedural specialties and compared those who were primarily responsible for 5 or more domestic tasks to those who were responsible for <5 domestic tasks. For physician mothers in procedural specialties, those who were primarily responsible for 5 or more domestic tasks were more likely to have a desire to change careers compared to those who had <5 tasks (55.0% vs. 42.1%, p<0.008). For those in nonprocedural specialties, there was no such association between increased primary domestic responsibility and career dissatisfaction (p>0.99). Investigators performed a multivariate logistic regression analysis in the procedural physician mothers subgroup to assess independent factors associated with the desire to switch to a less demanding career/specialty, and found that the only factor independently associated with this desire was primary responsibility for 5 or more domestic tasks (OR 1.5, 95% CI 1.0 to 2.2, p=0.05). Taken together, the results from this study suggest that having primary responsibility for multiple domestic tasks may be associated with career dissatisfaction for physician mothers in procedural specialties. This study was limited in that it surveyed a group with voluntary membership, and used a retrospective survey design that may have been affected by recall bias and self-reporting.

Click to read the study in JAMA Surgery

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