Women who become doctors must often choose between motherhood and medicine. I’m a mother and a surgeon. I never thought of choosing between the two, even though my employers often asked me to.

Today I work as a trauma surgeon in a busy practice. It’s been a long journey since the day five years ago when I sat outside the office of the chairman of surgery at a prestigious hospital to interview for my first job.

As my husband and I dressed our children for day care that morning, I felt proud to show them that their mom could follow her dreams. After six years of grueling training, I was finally going to be a trauma surgeon.

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Wearing a long black skirt and matching hijab, I felt confident going into the interview. There was a shortage of trauma surgeons, and I had excelled in my training. My patients did well, my outcomes were good, my evaluations were outstanding. I had aced test after test.

Pregnant with my sixth child, I went to the interview knowing I could do the job, that I had survived all the times supervisors told me to quit because I couldn’t be a mother and a surgeon.

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The chairman of the department who conducted the interview didn’t see things the same way I did.

“You’ve accomplished nothing over the past six years,” he said, tossing my curriculum vitae across the long mahogany table. In spite of my recommendations, my publications, and my training, once I mentioned my children he felt that I didn’t have the right “focus” to practice in an academic setting.

I’ve learned to deal with the overt discrimination that comes with being a visual minority in medicine. When I was denied access to the operating room as a third-year medical student because of my hijab, I knew it was up to me to open the door. I learned to maneuver through the system until my presence became routine.

Resistance against motherhood, on the other hand, seemed to be a tornado that only gained strength with time. When I was a newlywed surgery intern, a senior female resident told me that “anyone who chooses to get pregnant in a surgery residency is selfish.” When I became pregnant with my first child a month later, there were no well wishes and I was told I should quit.

“It’s never been done, and it’ll never be done,” a faculty member said. “The last pregnant resident in the program was a third-year resident, and she still hasn’t come back from maternity leave six years later.”

When I asked about the maternity leave policy, I was told there was none. And when I asked why there wasn’t a policy, especially with a previously pregnant resident in the program, I was answered with an embarrassed silence.

The opposition to my pregnancy made me anxious. I found it hard to sleep at night. I cried in moments of solitude. I wanted to share my fears about losing my residency position, but I didn’t want to show weakness. Obsessively reading surgery textbooks late at night was the only thing that calmed my nerves.

When I returned from maternity leave, I was eager to improve, to show I was serious about my career. I asked the attending surgeons questions at every opportunity. They remained skeptical.

In response to one of my questions, a supervising surgeon responded, “I don’t know why you’re going through the trouble. You’ll never finish this training, and even if you do you won’t be productive.”

After I told my colleagues about my second pregnancy, another supervisor complained to one of my male resident colleagues, “These damn girls! All they do is f— things up by coming here and getting pregnant.”

No matter how well I performed as a surgeon, my “choice” of motherhood was seen as a shortcoming. With each pregnancy, I was advised to pursue more “family-friendly fields” since my “priorities had changed.” But surgery remained my dream.

Although women have comprised more than 50% of medical students since 2017, motherhood continues to be a problem because the hospitals and clinics where we work haven’t changed to accommodate us. The decision to have a family is complicated by the fact that there is no standard approach to how the medical field deals with pregnancy, whether that’s in medical school, residency, fellowship, or professional practice. Hospitals are chronically understaffed in residency training, and maternity leave is seen as an undue burden on residents’ colleagues. By the time most women finish residency, they may have only a few years left to get pregnant, and hundreds of thousands of dollars of debt to consider.

Even among women who don’t plan to have children, the possibility they might have children can be used against them when being considered for a position. A mentee of mine was recently asked in a fellowship interview if she planned to start a family. Although such a question is illegal, there was no way for her to answer, or even report the question, without jeopardizing her career.

A recent JAMA article showed that young women physicians cut back their work hours at substantially higher rates than men in an effort to reduce work-family conflicts, especially if they have children. Fatherhood, on the other hand, is not an obstacle. My male colleagues were celebrated when they became dads, which I appreciated but found infuriating.

A New York Times article recently described medicine as a stealth family-friendly profession that offers flexibility and part-time work. Family-friendly is not the medicine I know. As a surgeon in training and a mother, I constantly had to push back against the suggestion that as a mother I could never be interested in a demanding field or work full time.

The Times article glorified the fact that hospitals and clinics “allow” women to work part-time, letting us care for our families and continue to work. It minimized the fact that we are paid thousands less for the same work as men (about $41,000 less a year in surgery). It also did not mention that “part-time” in medicine can easily mean 40 to 50 hours a week of work, much of it unpaid.

The article also missed the reality that while some women choose the part-time path, others must go that route because medicine continues to be an inflexible field. It forces some women to abandon their true passions and settle for scraps: lower pay, fewer opportunities, and less career advancement. It’s no surprise that top leadership positions in medicine are still dominated by men.

The onus to fix these issues should not be on those who are affected by it. But unless women and their allies demand and drive the necessary changes, they will never happen.

The solutions start with acknowledging this discrimination and having honest conversations about how to do better, not by glorifying the status quo.

Qaali Hussein, M.D., is a board-certified trauma and acute care surgeon practicing in Florida and mother of six.

  • To call me “emotional” because I point out that you don’t know how to read data is quite telling of your deep seated misogyny. Look up work by Dr Aurora if you want to learn.

  • Dear Dr. Qaali Hussein
    You are a phenomenal woman, an inspiration to all young girls who want to have professional careers. I’m so proud- you’re a phenomenal strong Somali American Woman. Blessings.

  • I do admire medicine for leading the progressive way forward… but there’s also an argument to be made to just be patient… plenty of people are now waiting until well into 30s to have kids. I find it interesting that everyone in medicine wants to get married and have kids at a younger age vs. other professions. Perhaps the field is more realistic about the risks of delaying children… but it’s also an honorable, coveted profession and it has always been know that sacrifice is required.

  • This issue is another case of the worst kind of hypocrisy in this country. What makes a mere finite creature think they possess the ability to determine what a persons, desires, skills, motivation, God-given gifts and/or talents should or even could be limited to. They shut out a persons potential to participate in a field that is desperately needed and severly under-staffed. Shame, shame, shame on one’s arrogance to fight that hard and to be that evil that they would go through such lengths to discourage a person from reaching their (obvious) God-given gifts and abilities they are born with (and took the time to educate and develop themselves) to offer this gift to the world. Although I do not know you but I feel inspired to say; Thank you so much Dr Qaali Hussein for enduring the wickedness and making your mark. So sad that “lower leveled thinking mankind” has not yet figured out that at the end of the day….We Are All The Same! Best wishes in your practice, we are blessed to have your gift.

    • “What makes a mere finite creature think they possess the ability to determine what a persons, desires, skills, motivation, God-given gifts and/or talents should or even could be limited to.”
      Why don’t you ask yourself that question, as to why I should be limited in participating with my family because someone else won’t work full time? Why should we have to give up a date night during the week, when a full time person splits the work rather than making my family lose more? How about considering a medical marriage, and my spouse maybe is a physician. Maybe they’d appreciate me helping wash the dishes, vacuum, rather than having to destress and detox from work, so that I can’t spend time with them asking a woman how their day went?

      Don’t you think a male deserves to be a father in his home equally as a female deserves to be a mother in her home?

      “They shut out a persons potential to participate in a field that is desperately needed and severly under-staffed.” No one is shutting them out. What I’m pointing out to you are facts. Consider every one else instead of your own self (selfishness). “Shame, Shame, Shame” on selfishness and narcissism to the point that you think that patients are not going to want to know they have a doctor there, not one who is burned out from having to take care of those who aren’t willing to work full time. Are you willing to tell them face to face why they should be deprived of a parent and spouse and family member do your selfishness to not share the load?

      “So sad that “lower leveled thinking mankind” has not yet figured out that at the end of the day” again, go to all the family members and explain to them why males have lower leveled thinking mankind thoughts when they want to be with their families also. You don’t think that is “wickedness” and tell me by what cosmic right gives you the power to decide, any more than I do?

      Had one female that worked part time for a year, got paid full time, for breast feeding. That’s not legal – has to be done on their own time. Had another that stayed a year and then left (wanting to be with their husband). Had another who illegally was doing the breast feeding thing (same issue as #1 example) and then blocked the handicapped bathrooms doing it, putting us at risk for ADA federal lawsuits. After a place was set aside for them, it was “inconvenient”. Then we tried another place, but that had to change because (gasp) patients needed the office for business. Then we had another situation where a single female had several years of getting told she has no family so everyone else took Christmas and New Years off and she couldn’t have it. YES that is a real story. She finally told them I have family also, I’m putting my chit in and spending it with my family, take your turn like everyone else. Another one was where the switch between who was on call for Thanksgiving and who was on call for Christmas was decided and paid for, woman wanted to go home with the kids and paid for plane tickets, etc. and then just dumped it out on the coworker to lose their time off and do both holidays. Not the first time that happened. Another one, married a well to do person and stopped after medical school. Never went to residency. Do you know how much that hurts someone else who could have turned out to be a doctor, now who is “shut out a persons potential to participate in a field that is desperately needed and severly under-staffed.”

      So you were talking about equality? Where’s the equality for the patients, the spouses, the kids and family of those dumped upon? If “we are all the same”, then consider equality for the other groups involved.

  • Amazing article!!! Your struggle yesterday is the reason for your success today! So happy for what the future holds for you.

  • “Although women have comprised more than 50% of medical students since 2017, motherhood continues to be a problem because the hospitals and clinics where we work haven’t changed to accommodate us. ”

    Exactly! Medicine has to accomodates the patient. We already have to juggle around your (double booked) schedule. If you are getting tossed around from doctor to doctor, then it makes it hard to establish a relationship, is why we are not loyal to one doctor/practice. We already have to juggle our work/family lives, to ask us to do more? Really? At the rates we pay?
    Trauma surgery, you are there when you have to be there for the patient. Would someones’ family be concerned if the surgeon didn’t show up and needed someone else to pull out of their schedule to come in? Yes.

    Add in, do your coworkers have to pick up for you more than they do any one else? Surgery already takes a lot of a persons’ time. Asking others to take their precious time away from their family, more than others? Consider them also.

    Instead of looking at the “me”, think about the needs/wants of the people that pay you. If there is a retail clothing store open from 9 pm to 6 am, they’re probably not going to get a lot of customers (unless its NY or Cal.). Its not condusive to the lifestyle of their customer. Start thinking of it like that, it does make sense.

    No offense intended, but if you are the male in a group that has had to work more overtime so people can work part time and still get paid full time, not for just 1 month, 3 months, but a year and more, you’ll reconsider.

    • Why do you think someone has to cover for Dr. Qaali? Where, exactly, does it say that? Should men also not be allowed to have children and work?

    • Reread the article please. Cutting back work hours and part time means that someone else has to pick up the slack. By the first comment I copied below from the article, that means young male physicians.

      “A recent JAMA article showed that young women physicians cut back their work hours at substantially higher rates than men in an effort to reduce work-family conflicts, especially if they have children. ”
      “The Times article glorified the fact that hospitals and clinics “allow” women to work part-time, letting us care for our families and continue to work. It minimized the fact that we are paid thousands less for the same work as men (about $41,000 less a year in surgery). It also did not mention that “part-time” in medicine can easily mean 40 to 50 hours a week of work, much of it unpaid.”

    • Your point is as clear as mud. The JAMA article and this article (which I have read several times thanks for the condescension) point out that women cut down paid work hours because our jobs are inflexible. The author makes the point that part time is often more than full time, especially for women. Not to mention, when all of this discrimination is controlled for, you STILL make tens of thousands of dollars more than women for the same work. (Although our outcomes are on the whole better). So where is this stunning sense of entitlement coming from?

    • You and others still are having an emotional rather than rational response. Of course the job is inflexible. What did you expect? I gave an example showing life, especially as a trauma surgeon, runs for the patients, not for your family. Patients don’t get shot 9 am to 2 pm so you can get off work for your kids’ piano recital at 5. That is common sense.

      Again, the hours are common sense. Serno, your registrars (or attendings in USA), residency, all that should have been known when you were in, much less when you were in undergrad deciding on med school. Who goes thru medical school, residency, and then comes out wondering why this is an issue?

      What papers actually control for this? https://www.fiercehealthcare.com/practices/one-big-difference-between-male-and-female-general-surgery-residents-a-30k-gap-salary
      https://www.beckershospitalreview.com/compensation-issues/female-surgeons-aim-for-30k-less-in-salary-than-their-male-counterparts-study-finds.html

      How is it that wasn’t looked for before starting off in a name calling situation rather than looking up data? Or even quoting the sources you named to see how well the study was done? Granted you can’t verify my experiences, but they are not unique.

      Reminds me of the David Webb situation. A lady humiliated herself and is known for throwing her team under the bus because she made assumptions and started name calling, demeaning someone else, for a different view point. Think about the reputation it gives to every one on here and the subject they’re speaking on.

    • “Full” and “part” time. I have to wonder about people who don’t know that those terms can’t be equated to a 9-5 retail/union job. This is not retail, you are dealing with people who need you, maybe right then. If you can’t work all together 40 to 50 hours, then that is something that needs to be negotiated out with the employer.

    • Emotional response: Shame, shame, shame; arrogance; that evil; wickedness; discrimination;
      stunning sense of entitlement. All words that are used by SJW’s in attempts to shut down discussion due to claiming a “moral superiority” vs. facts. I don’t share that “religion” and as you and others aren’t following my “religion”, your claims have no meaning for me and the many others like me.
      I’m using “common sense”, a lot more examples and again, I see a one line response but no links/data/research to indicate your point. I gave 2 more articles to be looked up, which weren’t addressed in your response. This means you got upset and wrote before looking at the articles. Meaning that you and others won’t look at the data there and try and correct those problems before making claims again, rather than fixing documented shortcomings.
      Btw, in salary negotiation, there is also the future factor in what will you bring to the table in the future. If I have to look at less revenue coming in, or causing issues like schedule juggling a lot more than others, I won’t be as inclined to give you more at the beginning. Opportunity loss. If there is a mass shooting, etc. I would need a trauma surgeon, and one who can’t help out and focus on the patient like my other TS’s, means peoples’ lives at stake.
      If I am your employer and I see someone discussing business examples and research before an SJW approach to issues, I’m not going to be as inclined to be positive to you. I do stick up for those who are disadvantaged, but I do it in a very different way, on the data/research. I think you might find that to be more advantageous in your dealings with business.

      PS Maybe ask to erase your 2nd duplicate posting?

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