The cost of flexibility
Female doctors face the same challenges that other female workers do — including sexual harassment, discrimination and inadequate parental leave — and some specific to medicine. Even doctors with predictable schedules may work nights and weekends, can’t easily leave midday and often feel a drive to be available anytime their patients need them.
Training is arduous, expensive and long, and usually overlaps with the prime childbearing years, so many female doctors struggle with fertility and carry onerous student debt. Some might choose a specialty before they have children, then have a hard time switching to a more flexible job if they want to. And some of the ways in which medicine has changed have made it harder to balance work and family — like the time consumed by electronic medical records — so doctors are experiencing increasing rates of burnout.
“There are so many sacrifices that women physicians make in order to remain in their careers, remain working, things that aren’t taken into consideration when looking at how wonderful and flexible it can be,” said Aisha Haynie Smart, 41, a hospital medical director near Houston.
For her training, she said, she moved far from her family and delayed marriage and pregnancy. In her current job, she misses directly caring for patients. But she can leave midday or work remotely if needed — and unlike when she worked as a hospitalist and emergency doctor, she never misses a family dinner or her son’s Saturday swim lesson.
“I feel lucky in the sense that there were different options available,” she said.
There’s a downside when women cluster in certain specialties: In general, when a field becomes female-dominated, its pay and prestige drops. The risk of creating alternate, stunted career paths for women is “an issue that’s plaguing the labor force and companies in general,” Ms. Goldin said. “It is a risk throughout that solutions today become a problem tomorrow.”
One possibility — which could help alleviate this problem — is that more men will also choose less time-intensive specialties and ask for predictable hours. There’s evidence that’s happening. This year, 80 percent of male medical school graduates said work-life balance had a strong or moderate influence on their choice of specialty (up from 70 percent a decade ago, when the question was first asked), according to the Association of American Medical Colleges’ annual survey of graduates.