I had a familiar conversation the other day with yet another female medical student.
“I really loved surgery!” she said, “but I was concerned about the lifestyle so I decided on _______________.”
Lifestyle, it turns out, almost always seems to be code for having a family (maybe it’s just the kind of students who are apt to seek me out as I have yet to encounter someone who is concerned that a surgical career will hamper their aspirations to compete in triathlons or become national fencing champions or write books for the general masses–I personally know surgeons who manage to work full time and do all of these).
The other day, I came across yet anther discussion board on what advice to give to women in search of “mommy friendly” medical specialties. There were lots and lots of suggestions, some were full time jobs with predictable hours and others were part-time jobs but not one of the suggestions was a surgical subspecialty.
Not. A. Single. One.
Sigh. This makes me sad for my chosen specialty and for all the promising young women who will not go on to realize their potential as amazing surgeons.
I would be lying if I said that surgery is lifestyle friendly. In fact, anyone who has followed this blog for more than a millisecond knows that many of our daily woes outside of work arise from the demanding hours and high stress of our career choice. But the question is: What does mommy friendly even mean? This is not the same as the “mother’s hours” often noted as selling points in help wanted ads. There may be ways to go really part-time or certain very specific specialties that enable a woman to only have to be at work when her kids are at school I suppose. But I have to believe that mommy friendly is about more than just the hours.
I know, I know. You are just waiting for me to launch into the cliche of it’s quality, not quantity. But I won’t.
Because the truth is I wrote all the words above nearly 500 days ago. It turns out I never finished because I don’t know what mommy friendly means when it’s used as an adjective for a career.
Since I first wrote the beginning of this blog post, I have spent well over a year of my life as a surgeon and a mother. I even wrote an open letter to young women with the same opening line evidently having forgotten about this draft. That letter, now read more than 15 thousand times, doesn’t define mommy friendly either.
Paid maternity leave. Private pumping rooms. Childcare. A promotion clock that doesn’t penalize for maternity leaves.
To be sure any work place can provide these but do the amenities in and of themselves mean the associated profession is mommy friendly? Not if the backhanded comments or outright displays of resent persist. Often, the culture of the profession is at odds with these progressive work place policies. And these replies on what medical career to choose clearly indicate that the culture of medicine has not caught up to modern times.
Luckily, however, not every one is reading the same message board. And so this week across the country a whole new crop of women begin training as surgeons. They are less a minority and more just reflective of the demographic of modern surgery. Hopefully, they will all become surgeons (there is still some attrition in our programs nationally) and some will become mothers. And my hope is that, together with the men they are training with, they will foster a culture in which is it no longer necessary to ask if surgery is a mommy friendly.
Hot Heels, Cool Kicks, & a Scalpel 
A Slice of Hope.
I am a female surgery resident, planning on going into trauma surgery, a new mom, and I’m writing this while pumping between clinic patients and taking call. In the almost ten years since I started medical school I have seen a lot of changes within the field of surgery. I went to medical school on the east coast where in a 5000+ bed hospital with a huge department of surgery and a major level 1 trauma center employed exactly 2 female surgeons, one of whom quit before I left. I, too, was one of these medical students who loved surgery but struggled with idea that I’d have to give up the potential to have a family. I was lucky enough to have a wonderful mentor who encouraged me to continue with surgery and insisted that surgical specialties offer a wide range of lifestyles. When choosing a residency program, I looked for one that had at least some women attendings and residents and gave bonus points to any programs where those female residents had children. I started my residency 6 years ago as one of two female interns in a class of 10 that was graduating its last year of all-male chiefs. In that time our program has undergone changes to include a new woman chair of the department of surgery and a female surgeon who is the new dean of the medical school. Since then our program has been attracting lots of promising young women to surgery. We now have had three classes of 9/10 women residents. Whereas in my intern year we admired the strength of the one female resident brave enough to have a baby during training, now it is common place for us. I had my baby 7 months ago, as did 6 of my fellow residents, as will 3 more within the next few months. Some are now having their second child born during residency. Many of us are making it work even with resident/physician husbands. Paid maternity leave and pumping rooms are a great help for sure, but changing attitudes about what defines a surgeon is what seems to be making the biggest difference. As more women enter the field and having children becomes the norm rather than the exception, I can’t help but have hope for the future. Together we women surgeons can reach out to those medical students who struggle, as I did, with a love of surgery and a fear of what that might entail. The presence of each new surgeon-mom helps pave the way for a “mommy-friendly” work place.
I am a medical student in the midst of a surgical sub-I and with a kid at home. It is hard. It is absolutely only possible because my husband makes it possible. It makes me feel like my future is oddly at his mercy. But all the male surgeons with families can ONLY DO IT because their wives or partners make it possible. And yet I am sure they don’t feel they are at their wife’s mercy. And I know it’s not my husband who makes me feel that way (99% of the time). Nor do I have much of a tendency toward “Mommy guilt”. … But what you said in your earlier post is absolutely true. The number one factor for being a woman in surgery is a supportive spouse. This is the number one factor in any adult’s happiness much of the time, sure. But for women in medicine, women in surgery, even more so. And as a strong independent woman, there is something about that dependence I don’t like.
your article resonates with me, my original plan was to do trauma/vascular surgery, until I spent student time at a LARGE EXCELLENT surgery program. Well, that cured me that “I couldn’t have it all!”. So, I am loving being in half academic medicine and half in clinical medicine. The best of both worlds.
About residencies in the USA, after working in South Africa for 13 years I was impressed by the fact that BOTH men and women who have kids can do residencies (called registrars) PART TIME for several years in order to have time with their kids. So how about is USA????
Even though in some areas over 50% of the doctors are women, the profession has NOT changed to reflect the needs of women. Girls, where are WE, in making a change?
Mary