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

Educational Objective To identify the association of domestic workloads with self-reported satisfaction in mothers who are either proceduralists or nonproceduralists.
1 Credit CME
Key Points

Question  Is increased domestic workload, particularly for proceduralists, associated with career dissatisfaction among physicians who are mothers?

Findings  In this survey study, physician mothers in procedural specialties who were solely responsible for 5 or more domestic tasks reported a desire to change careers more often than did those responsible for fewer than 5 tasks (55.0% vs 42.1%).

Meaning  For proceduralist mothers, self-reported higher levels of domestic responsibility were associated with career dissatisfaction; increasing numbers of mothers in the medical workforce may create a demand for more equitable distribution and/or outsourcing of domestic tasks.

Abstract

Importance  Physicians who are mothers face challenges with equal distribution of domestic duties, which can be an obstacle in career advancement and achieving overall job satisfaction.

Objectives  To study and report on the association between increased domestic workload and career dissatisfaction and if this association differed between proceduralists and nonproceduralists.

Design, Setting, and Participants  Data for this study were gathered from April 28 to May 26, 2015, via an online survey of 1712 attending physician mothers recruited from the Physician Moms Group. Statistical analysis was performed from August 25, 2017, to November 20, 2018.

Main Outcomes and Measures  Univariate analysis was performed for respondents who reported sole responsibility for 5 or more vs fewer than 5 main domestic tasks. Independent factors associated with career dissatisfaction or a desire to change careers were identified using a multivariate logistic regression model.

Results  Of the 1712 respondents, most were partnered or married (1698 [99.2%]), of which 458 (27.0%) were in procedural specialties. Overall, respondents reported having sole responsibility for most domestic tasks, and there were no statistically significant differences between procedural and nonprocedural groups. Physician mothers in procedural specialties primarily responsible for 5 or more domestic tasks reported a desire to change careers more often than those responsible for fewer than 5 tasks (105 of 191 [55.0%] vs 114 of 271 [42.1%]; P = .008). This difference was not noted in physician mothers in nonprocedural specialties. In multivariate analysis of the proceduralist cohort, primary responsibility for 5 or more tasks was identified as a factor independently associated with the desire to change careers (odds ratio, 1.5; 95% CI, 1.0-2.2; P = .05).

Conclusions and Relevance  Physician mothers report having more domestic responsibilities than their partners. For proceduralist mothers, self-reported higher levels of domestic responsibility were associated with career dissatisfaction. Increasing numbers of mothers in the medical workforce may create a demand for more equitable distribution and/or outsourcing of domestic tasks.

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Article Information

Accepted for Publication: January 15, 2019.

Corresponding Author: Nelya Melnitchouk, MD, MSc, Division of Gastrointestinal and General Surgery, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 (nmelnitchouk@bwh.harvard.edu).

Published Online: April 10, 2019. doi:10.1001/jamasurg.2019.0529

Author Contributions: Dr Lyu had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: Lyu, Davids, Melnitchouk.

Drafting of the manuscript: Lyu, Davids, Scully.

Critical revision of the manuscript for important intellectual content: Lyu, Davids, Melnitchouk.

Statistical analysis: All authors.

Administrative, technical, or material support: Melnitchouk.

Supervision: Davids, Melnitchouk.

Co-first authors: Lyu, Davids.

Conflict of Interest Disclosures: None reported.

Funding/Support: Dr Lyu is supported by the National Library of Medicine Institutional training grant for research training in biomedical informatics and data science (T15) under award T15LM007092.

Role of the Funder/Sponsor: The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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