The demanding path to becoming a physician — with its years of training and long hours that continue into practice — makes family dynamics and partner support particularly crucial to career success. The at-times burdensome lifestyle of a physician carries implications beyond the clinic and into our personal lives. And no relationship is likely to be more impacted and impactful than domestic partnerships and marriages. Given the large time and financial investment in medical training, and a medical system where physicians are desperately needed in so many areas, it is especially worthwhile to understand the factors that facilitate professional practice. According to the AAMC, while women physicians account for only 38% of clinically active physicians, we now make up more than 50% of medical students. Continued growth of the physician workforce will depend on understanding and adequately supporting the needs of women physicians.
What kind of domestic partnerships best facilitate women physicians? Throughout my time in training and practice, I have seen women physicians live in a wide variety of households. Couples pursuing medicine in the same field together. Two physician households with partners of different specialties. Single parents. Long-term, long-distance relationships both with and without children. Partners with non-medical careers, ranging from less demanding and flexible to highly competitive and demanding positions. Women physicians with men as stay-at-home partners. But despite the wide breadth of arrangements that I would expect to represent a wide breadth of social support for women physicians, in reality, I have largely seen women physicians continue to carry a large domestic responsibility, in addition to frequently demanding clinical responsibilities.
Depending on your source, it is typically estimated that between 20%-40% of physicians are married to another physician. This is not particularly surprising given that a majority of physicians in training spend a large portion of their dating years in medical training, where long hours of studying and work mean that a large amount of their social contacts are with other aspiring physicians. Given that both partners have dedicated many grueling years to achieving their career goals, it would seem intuitive that within these relationships, we would see both men and women physicians making career sacrifices. However, the numbers suggest otherwise. A small study published in 2019 of early career physicians found 30.6% of women versus only 4.59% of men physicians were working part-time, and 77.5% of the women working part-time or not at all cited family as the factor that influenced their job decision. Based on these numbers, it is logical to deduce that women in two physician partnerships are largely making the accommodations necessary to support a family.
This raises the question of if women’s careers are better supported when they serve as the primary breadwinner for the family, supporting either a stay-at-home spouse or spouse with fewer career demands and larger flexibility. A qualitative study examining the impact of parenting on physician careers notes that in households where women describe themselves as the primary breadwinner, they continue to report also carrying a heavy child care burden. Particularly in my own field of ob/gyn (not exactly heralded as a lifestyle speciality), it is common for the woman physician partner to be the primary financial support of their household. In these partnerships, I have seen greater efforts to accommodate the logistics of the woman's career needs and goals. However, while women in this role are more likely to be given career priority, the women I have encountered taking on the breadwinner role often state that they are still heavily relied on to ensure that child care and household needs are met, as well as carrying the brunt of the emotional load of parenting.
Referring to the mental work (planning, organizing, emotional understanding) of day-to-day tasks, mental load is increasingly receiving attention as part of the domestic burden placed on women as the social understanding and acknowledgment of gender roles and expectations progresses. Regardless of partner career dynamics, women, and therefore women physicians, consistently carry more of the mental load in their partnerships — a burden that compounds the inherent mental demands of medical practice. Medicine is a job that comes with its own heavy mental load. For every patient that desires to take an active role in their medical care, there is another who wants to be told the best course of care. It is not uncommon for patients to share their personal burdens with us, cry in our offices. And while the impact of this is not exclusive to women physicians, it may be more pronounced. When studied, it has been shown that women physicians spend more time on average with patients, receive more messages from patients, and that patients share more emotional information and expect larger support from women physicians.
Study after study has shown that women physicians reduce their hours and leave clinical practice at higher rates, in addition to retiring earlier than men in medicine. Burnout is higher among women physicians. The same body of work describes that lack of accommodation and flexibility felt by women physicians, particularly those supporting families, is a significant factor in their ability and willingness to continue clinical practice. Retaining our vital women physician workforce and supporting women in achieving their individualized career aspirations will require moving clinical practice requirements in ways that allow for better work-life balance across medical specialties, encouraging flexible solutions to providing needed patient care and administrative opportunities, and promoting these changes not just for women but for also for men, who we all need to continue to evolve and grow their domestic role to ensure all women physicians are able to achieve their career goals.
How would you improve the system for women in medicine? Share your solutions in the comments.
Dr. Erica Jacovetty is an ob/gyn practicing in Maine. She enjoys reading, pie making, and gardening. Dr. Jacovetty is a 2024-2025 Doximity Op-Med Fellow.
Illustration by Diana Connolly
