Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Abu Haidar Neuroscience Institute, American University of Beirut, Beirut, Lebanon.
PLoS One. 2022 Apr 20;17(4):e0267288. doi: 10.1371/journal.pone.0267288. eCollection 2022.
Gendered differences in career paths of medical graduates persist globally. We aim to explore the impact of domestic tethers on the career paths of physicians by studying gendered differences in domestic burdens of physicians as well as differences in perceptions around the impact of domestic work on professional advancement.
A web-based survey including 38 questions was sent to all 3866 physician alumni of the top academic medical school in Lebanon. Data was collected between November 2018 and January 2019, with up to three invite reminders. Overall, 382 were included in the final analysis, 124 women (32%), 258 men (68%).
The study had a response rate of 10.4%. Findings show that a greater percentage of men were married and had children (77.5% vs 62.1%, p = 0.004, 77.9% vs 51.6%, <0.001, respectively). Majority of both women and men held full-time positions (82.1% and 87.1%), having children however reduced the odds significantly [OR = 0.2, 95% CI: (0.1-0.6), p = 0.01]for women, while only older age reduced it for men (OR = 0.1,95% CI: (0.04-0.2), p<0.001]. Among full-time physicians, men and women spent similar time on professional activities (60.2hrs/wk vs 58.3hrs/wk, p = 0.32). Women spent more time on parenting and household work (23.5hrs/wk vs 10.4hrs/wk, <0.001; 8.9hrs/wk vs 6.0hrs/wk, p = 0.001, respectively). Women physicians' spouses contributed to 14.5 hours/week of total time on domestic activities whereas men physicians' spouses spent two folds more time on domestic activities (35.0 hours/week, P<0.001). Of physicians with children, a higher percentage of women than men reported that children prevented their career advancement or their participation in development opportunities (43.8% vs 15.9%, p<0.001; 50.0% vs 19.4%, p<0.001, respectively). A greater percentage of women than men scaled back their career after first child (31.3% vs 3.5%, <0.001). Of married/partnered physicians, fewer women than men reported their career took priority over their partner's when conflicts arose, (52.0% vs 86.0%, p<0.001).
These findings highlight the heavier impact of domestic tethers on the career paths of women physicians than men physicians. Men are more likely than women to hold full-time positions in the early advancement defining phases of their careers. Full-time women shoulder more domestic work than men and experience more professional advancement concessions. Closing persistent gender gaps in medicine requires addressing inequities in domestic burdens through strategies that include mentorship on domestic tethers, support of on-site child-care and advocacy for parental leave policies that encourage shared care-work.
全球范围内，医学专业毕业生的职业道路仍存在性别差异。我们旨在通过研究医生的国内负担方面的性别差异，以及对家庭工作对职业发展的影响的看法差异，来探讨国内束缚对医生职业道路的影响。
我们向黎巴嫩顶尖学术医学院的 3866 名医生校友发送了一份包含 38 个问题的网络调查。数据收集于 2018 年 11 月至 2019 年 1 月之间，并进行了三到三次邀请提醒。最终，共有 382 人纳入最终分析，其中女性 124 人（32%），男性 258 人（68%）。
研究的回应率为 10.4%。研究结果表明，更多的男性已婚且育有子女（77.5%比 62.1%，p=0.004；77.9%比 51.6%，<0.001）。大多数女性和男性都从事全职工作（82.1%和 87.1%），但有孩子会显著降低女性从事全职工作的可能性[OR=0.2，95%CI：（0.1-0.6），p=0.01]，而只有年龄较大才会降低男性从事全职工作的可能性[OR=0.1，95%CI：（0.04-0.2），p<0.001]。在全职医生中，男性和女性在专业活动上花费的时间相似（60.2 小时/周比 58.3 小时/周，p=0.32）。女性在育儿和家务劳动上花费的时间更多（23.5 小时/周比 10.4 小时/周，<0.001；8.9 小时/周比 6.0 小时/周，p=0.001）。女性医生的配偶每周贡献 14.5 小时的家务劳动时间，而男性医生的配偶则每周多花两倍的时间做家务（35.0 小时/周，P<0.001）。有孩子的医生中，报告孩子阻碍了职业发展或参与发展机会的女性比例高于男性（43.8%比 15.9%，p<0.001；50.0%比 19.4%，p<0.001）。更多的女性在生育第一胎后会减少职业发展（31.3%比 3.5%，<0.001）。在已婚/有伴侣的医生中，当出现冲突时，报告职业优先于伴侣的女性比例低于男性（52.0%比 86.0%，p<0.001）。
这些发现强调了国内束缚对女性医生职业道路的影响比对男性医生更为严重。男性比女性更有可能在职业生涯的早期定义阶段担任全职工作。全职女性比男性承担更多的家务劳动，并且经历更多的职业发展让步。要缩小医学领域持续存在的性别差距，就需要通过策略来解决国内负担方面的不平等问题，这些策略包括对家庭负担的指导、对现场儿童保育的支持以及倡导鼓励共同照顾工作的父母假政策。
