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Table of Contents
MUSINGS
Year : 2019  |  Volume : 2  |  Issue : 1  |  Page : 1-3

On being a surgeon and a mother


Department of Thoracic Surgery, Tata Memorial Hospital, Mumbai, Maharashtra, India

Date of Web Publication9-Sep-2019

Correspondence Address:
Sabita Jiwnani
Department of Thoracic Surgery, Tata Memorial Hospital, Mumbai - 400 012, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/CRST.CRST_23_19

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How to cite this article:
Jiwnani S. On being a surgeon and a mother. Cancer Res Stat Treat 2019;2:1-3

How to cite this URL:
Jiwnani S. On being a surgeon and a mother. Cancer Res Stat Treat [serial online] 2019 [cited 2019 Sep 17];2:1-3. Available from: http://www.crstonline.com/text.asp?2019/2/1/1/266445



I had never thought about becoming a mother. Parenthood was never on my radar, and somehow, the only thing I seemed to care about was advancing my surgical skills. Hence, when I learned I was pregnant, it was at the threshold of starting my specialty training in thoracic surgery, and I was stumped.

The pregnancy was not easy, but I had supportive colleagues, friends, and family who stood by me. I wasn't prepared for the life after my son was born, the sleepless nights seemed endless, and the days were equally demanding. I joined back work in just under four months and most people warned me that it was not prudent to resume so soon. Also, on some days, it felt like they were right. Pumping milk at work in between cases, reaching late for morning academic meetings and rushing home even when interesting cases were still on in the operating room filled me with regret and sometimes rage. In addition, while I thought I was missing out on important events at work, there were so many milestones I missed at home too; for instance, the first time my son stood up on his own or his first sports day in play school. For a while, it felt like I was really running fast in all directions and reaching nowhere.

I love my son, he is the best part of my day and my life, and I love my work. For a few years, it felt like it was impossible to have both and attempt to excel at both, being a thoracic surgeon and a mother. After a few failures and setbacks, I realized that there was no such thing as the so-called “work–life balance.” As a surgeon and as a mom, I would always miss out on a few things, both at work and with my son. And, although the guilt really never went away, I learned to live with it.

I have been luckier than most women who have decided to follow a surgical path. I never had to face any major discrimination or harassment because of my gender during my early surgical training years, and even later, when I chose to become a cancer surgeon and then do thoracic surgery, I always had the support of my colleagues and family. My spouse being in the same specialty has been a boon most of the time because he understood my work pressures; however, sometimes, it also felt like a curse because we both would end up being busy on the same days and reaching home late. Living with my in-laws and having my parents staying close were life-saving choices both for our son and us. I have seen my colleagues with young children and no family support struggle to manage their children at home and in day-care.

However, with being a mom, as in being a surgeon, the work never ends. There are times when you have to take calls during parent–teacher meetings or reply to queries about mathematics homework in the middle of a busy outpatient day. There are times your child is sick, and you still need to be at work, take tough decisions intra-operatively, and go about dealing with postoperative complications when you would rather be at home. In addition, there are meetings you want to go for, but you have to opt out due to the school project deadlines or scheduled football matches. Balancing the two roles can get overwhelming but small rewards such as being able to reach on time for a school game, make it worth all the effort.

Spousal and family support goes a long way in establishing stability at the home front, and I learned the hard way not to be ever ashamed to ask family members for some extra support. Hiring additional help and staff is easier in India than in most other countries, and these women have been my lifelines when my child was younger. Building and nurturing these relationships required some effort but has gone a long way in maintaining a safe and loving environment for my little one.

Even though almost 50% of the medical graduates are women, a small percentage of these actually choose surgical fields.[1] Most female physicians are still riled at being mistaken for nursing or other paramedical staff instead of doctors.[2] Moreover, it is not just the patients but also the peers, seniors, and colleagues who typically imagine a male doctor who is in charge.[2] Pursuing a surgical career can be a daunting task for many women even in the 21st century, as most surgical specialties tend to remain male-dominated and indifferent to unique needs of women with small children.[3],[4] Surgical training can be grueling with the long hours that need to be put in, the emphasis on hierarchy and the learning curves to the surmounted.[4] The length of training is almost a decade long, and long breaks for pregnancy and maternity are next to impossible and frowned upon. Even without a break, many specialty women surgeons are at the end of their reproductive years when they complete their training.[5]

A survey among members of the Association of Women Surgeons aimed at assessing the parenthood experience during surgical training [6] found that 78% of the women received maternity leave of 6 weeks or less, and 72% found this leave duration to be inadequate. 95% of the respondents considered breastfeeding important, but almost 60% were forced to abandon it earlier than they wished to due to inadequate lactation facilities. A large number (39%) strongly considered leaving surgical residency, and almost 30% reported that they would discourage female medical students from pursuing a surgical career. Lack of institutional support for childcare and also lack of mentorship on balancing parenthood with a surgical career were highlighted by this study. Another study by the same authors [7] found that many female surgery residents perceived stigma during pregnancy. The greatest impact was felt by residents whose institutions did not have a formal institutional maternity leave policy and those who altered their fellowship training plans because of challenges of childbearing.

A recent study published in JAMA looked at the impact of domestic responsibilities on career satisfaction among physician-mothers.[8] Not surprisingly, this study found that mothers with >5 domestic tasks and in procedural specialties had higher career dissatisfaction. Domestic labor is often unequally divided, with mothers shouldering the major load leading to challenges in balancing their work and children. This study has not only highlighted that spouses and partners of physician moms need to be more involved in sharing domestic responsibilities but also for the need for the extra help and outsourcing of domestic work they should be able to hire and get.

Recent social media campaigns on gender equity, equal pay, unconscious and conscious bias, and gendered expectations have brought many women to address these issues publicly and raise awareness not only among their female counterparts but also among their male peers.[9],[10] Women who typically felt isolated in their male-dominated departments or hospitals are now reaching out to form mentoring relationships, partnering with each other for support as well as collaboration.[10] Physician and surgeon burnout is a sad reality rather than just a fancy term, and it affects more women than men where they end up making life-altering choices and moving away from the careers they spent their lives working for.[11]

Recent years have seen tremendous strides taken by women to come to the forefront of surgical associations and leadership.[12] In 2017, Dr. Barbara Bass became the third female president of the American College of Surgeons (ACS), Dr. Leigh Neumayer began serving in her role as the first female chair of the ACS Board of Regents, and Dr. Diane Farmer became the first female chair of the ACS board of governors. More than 20 women became chairs of surgery at academic institutions across the United States. The #ILookLikeASurgeon, an online social media campaign gained momentum on Twitter with 150000 tweets and mentions, is being used by over 35,000 users and resulted in a brilliant cover of The New Yorker featuring women in surgical masks and gowns.[13] Widespread visibility of these initiatives has helped to focus attention on the gender gap in surgery. However, with these successes, we often forget our biological clocks,[14] and this issue was touchingly addressed by a bariatric and foregut female surgeon this year in the Time magazine.[15]

Hence, while we are all striving to do our best and balance both worlds, a lot of effort would also have to come from our male colleagues, friends, family, patients, and all those whom we come in contact every day, not only in recognizing the hardships women face but also to help foster an environment conducive to encouraging women surgeons to start and raise their families.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
ACGME Residents and Fellows by Sex and Specialty; 2015. Available from: https://www.aamc.org/data/workforce/reports/458766/2-2-chart.html. [Last accessed on 2017 Jul 31].  Back to cited text no. 1
    
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Rowen L. The medical team model, the feminization of medicine, and the nurse's role. Virtual Mentor 2010;12:46-51.  Back to cited text no. 2
    
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Sanfey HA, Saalwachter-Schulman AR, Nyhof-Young JM, Eidelson B, Mann BD. Influences on medical student career choice: Gender or generation? Arch Surg 2006;141:1086-94.  Back to cited text no. 3
    
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Park J, Minor S, Taylor RA, Vikis E, Poenaru D. Why are women deterred from general surgery training? Am J Surg 2005;190:141-6.  Back to cited text no. 4
    
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Abbett SK, Hevelone ND, Breen EM, Lipsitz SR, Peyre SE, Ashley SW, et al. Interest in and perceived barriers to flexible-track residencies in general surgery: A national survey of residents and program directors. J Surg Educ 2011;68:365-71.  Back to cited text no. 5
    
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Rangel EL, Smink DS, Castillo-Angeles M, Kwakye G, Changala M, Haider AH, et al. Pregnancy and motherhood during surgical training. JAMA Surg 2018;153:644-52.  Back to cited text no. 6
    
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Rangel EL, Lyu H, Haider AH, Castillo-Angeles M, Doherty GM, Smink DS. Factors associated with residency and career dissatisfaction in childbearing surgical residents. JAMA Surg 2018;153:1004-11.  Back to cited text no. 7
    
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Lyu HG, Davids JS, Scully RE, Melnitchouk N. Association of Domestic Responsibilities with Career Satisfaction for Physician Mothers in Procedural vs Nonprocedural Fields. JAMA Surg 2019. doi: 10.1001/jamasurg.2019.0529. [Epub ahead of print].  Back to cited text no. 8
    
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Luc JG, Stamp NL, Antonoff MB. Social media as a means of networking and mentorship: Role for women in cardiothoracic surgery. Semin Thorac Cardiovasc Surg 2018;30:487-95.  Back to cited text no. 9
    
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Luc JG, Stamp NL, Antonoff MB. Social media in the mentorship and networking of physicians: Important role for women in surgical specialties. Am J Surg 2018;215:752-60.  Back to cited text no. 10
    
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Dimou FM, Eckelbarger D, Riall TS. Surgeon burnout: A systematic review. J Am Coll Surg 2016;222:1230-9.  Back to cited text no. 11
    
12.
Pories SE, Turner PL, Greenberg CC, Babu MA, Parangi S. Leadership in American surgery: Women are rising to the top. Ann Surg 2019;269:199-205.  Back to cited text no. 12
    
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Logghe H, Jones C, McCoubrey A, Fitzgerald E. #ILookLikeASurgeon: embracing diversity to improve patient outcomes. BMJ 2017 Oct 10;359: J4653.  Back to cited text no. 13
    
14.
Phillips EA, Nimeh T, Braga J, Lerner LB. Does a surgical career affect a woman's childbearing and fertility? A report on pregnancy and fertility trends among female surgeons. J Am Coll Surg 2014;219:944-50.  Back to cited text no. 14
    
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Salles A. I Spent My Fertile Years Training to Be a Surgeon. Now, It Might Be Too Late for Me to Have a Baby. TIME; 3 January, 2019. Available from: http://time.com/5484506/fertility-egg-freezing/. [Last accessed on 2019 Jun 27].  Back to cited text no. 15
    




 

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