Concerns about childcare are an often cited reason for women to leave (or never enter) male-dominated fields such as surgery – and these concerns need to be addressed. However, a recent study by Nadya Fouad suggests that childcare concerns might not be the main culprit that drives women away.
In her survey with women who held engineering degrees the author found that most women who had left engineering had not done so in order to stay at home and raise a family but had rather left the industry to work someplace else. Moreover, the reason these women cited were very similar to those that men usually cite for leaving their jobs – inhospitable work climate and a lack of opportunities for career advancement (although caregiving responsibilities were also an often cited reason).
This demonstrates once again that leaving certain occupations is not due to some inherent lack of interest among women. On the contrary, women and men are looking for quite similar things in their careers – but men might just have an easier time achieving these goals in male-dominated fields.
Gender discrimination has obvious negative effects such as keeping women from rising to leadership positions or achieving equal pay. That alone should be enough reason to address these issues but there is also evidence that demonstrates the negative impact of perceived gender discrimination on women’s motivation – one of the key ingredients to high quality work.
Sharon Foley and colleagues investigated these issues in a sample of solicitors. Not surprisingly, they found that women perceived higher levels of gender bias against women and more personal gender discrimination compared to their male counterparts. This perceived personal gender discrimination was directly linked to two important motivational outcomes. First, it predicted solicitors’ organisational committment, and second, higher perceived gender discrimination was associated with higher intentions to leave the organisation.
This study shows how important gender equality is not just for its own sake but also for keeping women motivated and committed and ultimately ensuring that their talent and expertise is not lost.
Work-life-balance or the anticipated and actual lack thereof is a widely cited cause for the under-representation of women in surgery. This is especially true for women who have a family or are planning to have one as women continue to carry most of the weight when it comes to childcare and household chores.
A study by Sullivan and colleagues investigates this issue in a large sample of surgical residents in the US. They found that generally married residents and those with children have the highest levels of work satisfaction. However, this difference was driven by male participants. As expected, female residents reported high levels of stress regarding home life as well as finances when they were married or had children.
These results once again stress that while creating equal opportunities at work is important, it is not enough to tackle gender inequality. As long as women continue to be responsible for more family related work, it is thus crucial to go beyond that and provide them with opportunities to combine both work and family and still achieve a good work-life-balance.
Despite the low number of women in surgery, those who do decide to become surgeons generally report high job satisfaction that does often not differ very much from that of their male counterparts. However, do they achieve their satisfaction in different ways? A study by Nasim Ahmadiyeh and colleagues investigates this issue.
They interviewed a sample of male and female surgeons who were all married and had children using semi-structured interviews and found, among other things, that men and women in surgery did indeed report similar levels of career satisfaction. In addition to that they also did not differ in the degree to which they had made trade-offs between their careers for their personal lives or vice versa. However, when talking about the reasons for their satisfaction and dissatisfaction, men and women differed. While male surgeons mostly named internal job characteristics as reasons for dissatisfaction, female surgeons spoke much more often about a lack of support and lack of credit. Furthermore, women also seem to rely on different strategies for success. They stressed the importance of social networks – professional as well as personal – far more than men did. This, of course, makes sense if they experience a lack of support.
These findings indicate that networking opportunities such as Women in Surgery are indeed very important and beneficial for female surgeons as they address the lack of support experienced by them.
As women continue to carry a larger part of the responsibilities regarding housekeeping and childcare, it is not surprising that they generally find it harder to achieve satisfactory levels of work-life-balance in occupations that are generally associated with long working hours such as medicine. A recent survey study looked at how the perception of hospital doctors’ work-life-balance was related to burnout and intentions to quit their job and how whether this depended on gender.
The author found that work-life-balance was the most important predictor of burnout and that support from superiors and co-workers as well as working in a family friendly environment significantly lowered burnout. Interestingly, support from co-workers was the most important factor for female doctors, whereas support from one’s superiors and working in a family friendly work environment was more important for male doctors. Similarly, work-life-balance and support for co-workers were related to female but not male doctors’ intentions to quit, while working on a rota working pattern was predictive of male but not female doctors’ intentions to quit. Overall, women also reported higher levels of burnout.
This is interesting, as it shows that reducing burnout and retaining skilled doctors, might be achieved quite differently for men and women. It also shows that the fact that women are still responsible for the majority of domestic tasks is reflected in their higher need for a work-life-balance and that this issue needs to be addressed, both at and outside of the workplace.
Surgery is a very varied career and different people have different reasons for liking it. Here are some more things that people see as the best things about working in surgery:
“I think it’s the patients, definitely. Being able to diagnose somebody with a problem, take him to the theatre, fix it and come back and say ‘I fixed your problem’ or at least ‘I made it easier for you’ if it’s something that you can’t cure. But it’s definitely the communication with the patients.”
“On a day-to-day basis it is very varied. You never really know what you’re doing. You know your schedule but you don’t know the patients, you meet them for the first time sometimes and that is exciting.“
“It’s a fantastic job. It’s different from what people from the outside think. I don’t spend all my time operating. I operate four days a week, but often it’s only a half day rather than a full day. … I see people who are considered for an operation or who I’ve operated in the past to see how they are getting on and that sort of thing. So it’s not up to your elbows in muscles and guts all the time. It’s quite a balance and I like that.”
“It’s a very independent job. So if you don’t like to have a boss, people telling you what to do, then surgery in the UK is perfect because once you are consultant and you have the chance to work in a team that works with you rather than against you then if you need somebody to give you a hand, you can, and if you want to do things on your own and be completely independent, then you can do that, too.”
Just like surgery, academia is a time consuming career to have and poses a challenge to a good work-life-balance. Radhika Nagpal, a professor for computer science at Harvard, is a woman who made it into a field that is – just like surgery – still very male dominated. In a recent guest blog post on Scientific American she talks about how she manages her life, her career, her family and her happiness. Although not all her points may apply to surgery, her article is certainly worth a read and contains some useful advice for managing a demanding career in general.
In her article she describes seven things she did to make sure to enjoy her life and her career despite its demands:
- Pretending that her position was a seven year post-doc to take the pressure off her and rather enjoy being able to work with some amazing people in her field
- Stopping to take advice and rather go her own way (such as focusing on her research instead of trying to network like crazy)
- Creating a “feelgood” e-mail folder that contained her successes such as job offers and which she could read when things weren’t going as well
- Working fixed hours in fixed amounts – both in her career and as a parent.
- Trying to be the best “whole” person that she can. Realising that it is impossible to be the best, most dedicated academic who spends all her time working as well as the best parent who dedicates her entire life to her kids and the best partner who is there for her other half in every moment, supporting him always and unconditionally, she decided that it was a much more attainable goal to be neither of those but rather the best “whole” person who combines a little bit of all of this.
- Finding real friends outside of her field who are not concerned with her career.
- Having fun “now” rather than constantly working towards a future in which the fun is hopefully going to happen.
To read the full article (do it! It’s really inspiring!), click here: The awesomest 7 year postdoc or how I learned to stop worrying and love the tenure track faculty life
Surgery is a challenging career, but it can also be incredibly rewarding. Here is what some women and men in surgery have to say about why it is so great to be surgeon:
“You’re changing lives. It is a real privilege. You get the opportunity to really engage with people at a really important point in their lives and to make a difference.”
“The smile on the patient’s face when you told them that you – well, not cured them of cancer – but that you had taken away that mass. I think you can’t do that in any other specialty other than surgery. You can’t fix something – of course there are medicines and drugs but they don’t give an instant fix. It’s so rewarding when you’ve done an operation and you’ve done it on your own. You’ve fixed that person. It’s brilliant. It’s a really good feeling.”
“I love how it’s different every day. You’re dealing not only with patients, I’m dealing with the parents as well as the children. It’s not a desk job. You’re working closely with physicians, the nursing staff in wards and theatres. What I love about it is that with surgery you have a direct effect on patients. Whatever you’re doing – you’re taking out that cancer, you’re repairing the hernia, you’re doing something with your own bare hands that helps that patient. … It’s fun, it’s practical. It’s intellectual and practical at the same time.”
“The best part of the job in my current specialty, which is orthopaedics, is that it’s such a team effort. Surgery in general is a team effort, especially in the operating room. It’s a flat system, there is no hierarchy. Anyone can make a call to say ‘oh, this is wrong’ or ‘you need to check this’, so it’s not a case of ‘the surgeon said it and that’s it’. … And also, there are a lot of people involved – Physiotherapists, nurses, occupational therapists – and it’s with the involvement of everyone, that team effort, that you achieve a save discharge for the patient.”
“It’s a wonderful live. It really is. It isn’t a job, it’s a life’s work – which is why I’m still doing it, even in retirement.”