omen won the majority of the U.S. medals at the Rio Olympics. Hillary Clinton is campaigning hard to become the country’s first female president. This may suggest that we have finally arrived at the mythical finish line and “having it all” goal of the feminist movement. Even President Obama, a father of two girls, had something to add to the conversation in his recent article, “This is What A Feminist Looks Like”.
But it doesn’t feel as if we have arrived or that the proverbial glass ceiling has been shattered. The role of women at home and work remains highly politicized and steeped in stereotypes. This tension plays out in a unique way in academic medicine, particularly pediatrics, where women comprise more than 57 percent of pediatricians and 70 percent of pediatric residents.
Despite their numbers, women hold a minority of leadership positions. Across all academic fields, 14 percent of department chairs are female. In pediatrics, with a higher percentage of female physicians, only 25 percent are female. Access to medical school isn’t the problem. Women now comprise 48 percent of medical school students in the United States.
Experts have attributed this inequality to a variety of factors. These include a voluntary withdrawal from medicine (including academic medicine) or leadership positions, inherent power differentials and stereotypes that lead to decreased opportunities for leadership, and biological factors and responsibilities at home that foster the perception of decreased dedication. Women are entering academic medicine, but they are not staying long enough to reach leadership positions.
As a pediatric cardiologist and a developmental pediatrician who are both interested in academic medicine, we believe that all of these contribute to the problem.
We were raised by mothers and grandmothers who encouraged us to believe we could be whatever we wanted and could “do it all.” We benefit from the sacrifices of women who came before us and fought for equal rights at home and at work.
As we progress in our careers and personal lives, though, the reality of what we are experiencing is at odds with the messages of prior generations. Today’s messages for women — in what they read and in their daily interactions at work — are muddled, full of judgment, and confusing.
Female physicians “can’t have it all,” Dr. Karen Siebert once wrote in the New York Times. “Medicine shouldn’t be a part-time interest to be set aside if it becomes inconvenient; it deserves to be a life’s work,” she claimed. We (and those who have supported us along the way) voluntarily make emotional, physical, and financial sacrifices to become physicians. But we may also choose to take a step back to raise families. Neither are insignificant decisions. But it shouldn’t be one that is judged — implicitly or explicitly — by others who don’t understand each person’s individual journey.
Anne-Marie Slaughter generated a national conversation about this phenomenon in her 2012 essay in the Atlantic, in which she describes the journey of raising a teenager while maintaining a demanding position as the first female director of policy planning in the US State Department. She argued that equal opportunity for women at work does not exist. In fact, it cannot exist without significant policy changes that support work-life balance.
Women are judged if they take off too much time from work. They are also chastised if they don’t take enough time off. Take the case of Marissa Meyer, the CEO of Yahoo, who was criticized in the media this spring for not taking an “appropriate” amount of maternity leave and returning too soon to her high-powered position.
To be sure, women have made significant strides toward equality in medicine. Men also struggle with balancing their roles as parents and physicians. Navigating work and life is difficult for women and for men. Both make personal decisions to leave medicine or decrease the time they spend practicing it for many reasons, and these reasons are right for them. Perhaps one legacy of the women’s movement is the opportunity to choose the way we construct our lives with work and family.
These choices create a new reality for women that is an amalgamation of work and personal lives, not an either-or-all phenomenon. Just as the practice of medicine involves making difficult choices when clinical outcomes are uncertain, so does the emerging picture of what women can be in medicine.
Women should be told early that they will need to make sacrifices in every part of their lives to create that elusive balance. And that’s okay. It doesn’t mean you are doing something wrong, but doing something necessary.
Women’s lives have their own developmental stages. Some are about our careers, others are about caring for others. Some life stages are about both of these at the same time. We should have the freedom to choose and not fight ourselves when moving from one to another or deciding to stay put.
Most of all we need to stand behind our choices — to work, to stay at home, to have a family, to not have a family, to do both — and not be saddled with regret or anguish. Supporting one another in executing these choices should be the next mission of women in medicine, and the workplace in general. Only with this frame of mind and an open honest dialogue can we address the existing dearth of inequalities and female leadership in medicine and encourage women to stay in the game.
Angira Patel, MD, is a pediatric cardiologist at Ann & Robert H. Lurie Children’s Hospital of Chicago, and assistant professor of pediatrics and medical education at Northwestern University Feinberg School of Medicine. Sarah C. Bauer, MD, is a developmental pediatrician at Lurie Children’s Hospital and assistant professor of pediatrics at Northwestern.