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Original Investigation
April 10, 2019

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

Author Affiliations
  • 1Division of Gastrointestinal and General Surgery, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
  • 2Department of Surgery, University of Massachusetts Medical School, Worcester
  • 3Center for Surgery and Public Health, Harvard Medical School, Boston, Massachusetts
JAMA Surg. Published online April 10, 2019. doi:10.1001/jamasurg.2019.0529
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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