We conducted a national survey to explore how women in academic medicine balance career and family responsibilities. A questionnaire was mailed to all women 50 years of age and under who held full-time appointments in departments of medicine (n = 862), as listed in the faculty roster of the Association of American Medical Colleges. The survey included questions about childbearing and child rearing, attitudes about personal and professional issues, and role models. Of the 694 questionnaires that were delivered, over 80 percent were completed (n = 558). The mean age of the respondents was 38.1 years, and 63 percent had children. The 350 mothers had a mean of 1.9 children; only 3 had 4 or more children. Approximately half the respondents with children had their first child after completing medical training (mean age, 30.6 years), and they were absent from work for a median of 6 weeks post partum; 72 percent took no time off before labor and delivery, and 83 percent were back at work within 12 weeks. The majority were satisfied with their decision to have children and with their careers, despite the fact that 78 percent believed that their career progress had been slowed or markedly slowed by their having had children. We conclude that it is possible for women to combine motherhood with a fulfilling career in academic medicine, but it is difficult, and most such women believe that motherhood slows the progress of their careers. (N Engl J Med 1989;321:1511–7.) WOMEN physicians who decide to pursue academic careers and to have children choose to assume conflicting commitments. The time pressures of research, teaching, patient care, academic work, and publication, coupled with promotion and tenure deadlines, compete with the biologic imperative of the reproductive years. How have the increasing numbers of women physicians in academic medicine achieved a balance between career and family? There is substantial information available about the demographic characteristics of women in medicine. Studies describing the increasing number of young women who graduate from U.S. and Canadian medical schools have tabulated their choices of specialty, practice setting, type.
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