Balancing Work and Family: Viewpoints from Different Careers
Women in Physiology Committee
Career Opportunities in Physiology Committee
Education Committee

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The APS Undergraduate Summer Research Fellowship (UGSRF) Program supports 24 undergraduate students in the labs of APS members for 10 weeks in the summer. This year the UGSRFs discussed possible career choices and the pros and cons of various careers.

One topic of recurring interest was that of balancing a demanding and highly satisfying job with having a family and life away from work. Here are a couple questions that were asked:

"My main concern with this type of [surgeon] position is the lifestyle that comes with it. Only 8% of surgeons are women and I believe this is due to the additional responsibility of childbearing that women face in a relationship. I am wondering if it is possible to have both the life of an overworked surgeon and that of a loving wife. Would it be possible to balance your life well enough to fit a child into the equation or will one end of the spectrum ultimately suffer?"

"I had the chance to shadow a cardiothoracic surgeon and even had the opportunity to ask him about his personal life. He described the difficulties he had in balancing his work with family, but stated that it was in fact his wife that was always there to take care of family responsibilities. Is it okay, or even possible for me to expect that situation in reverse?"

Responses by:
Christin Carter-Su, Ph.D., Basic Researcher
David I. Soybel, M.D., Surgeon and Researcher
E. Lisa Breen, M.D., Surgeon

Balancing Work and Family: A Physiologist’s View
Christin Carter-Su, Ph.D.
Department of Physiology, University of Michigan

(Excerpt from "Mentoring for Success in Physiology" by Christin Carter-Su, Professor of Physiology, University of Michigan, 2005 Recipient of the Bodil Schmidt-Nielsen Distinguished Mentor and Scientist Award, published in The Physiologist 48(4: 167, 172-178, 2005)

Being a successful woman with a husband and two children, I probably get asked most for advice about balancing work and family. This is the advice I give women (see Table 4), but most of it applies to men as well as women:

Family gives women happiness; Work gives women  self-esteem. For this reason, it is important to keep a balance in your life. You should not feel guilty for working and you should not feel guilty for having a family and wanting to spend some quality time with them. But there are ways that you can make your life easier.

Choose your mate carefully. It is difficult and time-consuming to work full-time and have a family. It is virtually impossible if you are expected to work full-time and handle all the traditional female roles of wife, house-keeper, care-giver and cook. It is best to find a mate who values your job equally with his/hers and will share willingly and equally in household responsibilities.

Get lots of outside household help. If both you and your spouse are working, you need to think of it as 1 and 1/2 incomes, not as two. You need to plan on spending at least 1/2 of an income on help. Hire someone to clean your house for you. Hire the best daycare provider possible, preferably someone who will come to your house and will also do the laundry and other household chores. Hire someone to mow the grass. In essence, hire someone to do those jobs that you do not like doing so that you will have time to do the things that you do want or need to do, such as spend quality time with your children and spouse or write up another paper for publication.

Build a strong support network. If like me, you do not have family in the area who can help when emergencies arise, you need to build a strong support network. When my children were young, my husband would ask every teenage girl he saw in our neighborhood whether she babysat. We made arrangements ahead of time with other friends and neighbors who had childcare to cross cover for each other if our childcare fell through. We paid for our children to attend before and after-school programs even when we had after-school childcare at home just so we could send our kids to those programs on those days we did need it, such as when I had to give an 8 am lecture, the childcare giver called in sick, or the teachers were having one of their many in-service training or reporting days. We got the phone numbers of our friends’ current and former caregivers, graduate and undergraduate students who were willing to baby-sit in a pinch, preschool student helpers, anyone who might be able to take care of our children on snow days, when our children were sick, or when our caregiver was unable to come for whatever reason. 

Form friendships with other working families. And as a corollary, try not to live in a neighborhood or send your child to a preschool where all the other families have a stay-at-home parent. Our daughters went to a preschool where a requirement was that both parents had to have at least a half time job. Until they were five and went to public kindergarten, our children did not realize there was such a thing as a stay-at-home mom. Our children’s preschool did not ask you to contribute food and help serve a Thanksgiving dinner—they prepared it and served it to you! Other working families can provide valuable information and emotional support. This is true for both men and women. It was one of my husband’s male colleagues who helped persuade us of the benefits of having at-home care for our newborn. Other working families can tell you how and where to find good help, the best preschools and summer camps for working families, how to cope with having one spouse out of town, where to buy the best “home-cooked” food to bring to school events, which sports teams have the best coaches and more importantly, the most convenient practice times, locations and car pools.

Forget about domestic perfection. There are times in your life when it is impractical to have the perfect house, the kind of house many of us grew up in. You need to make priorities. My husband’s and my priorities are to spend time with our children and each other rather than to spend time straightening the house, cooking gourmet meals or having a Sunset magazine garden. For quite a few years, we entertained at home only those friends we knew well enough to have over without straightening up the house.

Delegate. Learn how to delegate. This goes for the home as well as work. There was one year when it became obvious that I was not going to be able to get my grant application out doing it primarily by myself as I had usually done or even by getting help from just those people in my laboratory whose work was funded by that grant. In desperation, I announced to the laboratory that I needed everyone to stop working on his/her experiments and help with the grant. I had people looking up techniques, proof reading, shortening the text, checking references, working on figures, and buying food for everyone working on the grant. What was enlightening to me was finding out afterwards that no one really minded helping, despite some very long days and nights. Some in fact told me they really enjoyed it because it made them feel an important and integral part of the laboratory. They learned a lot about the science going on in the entire laboratory, and about what it takes to put together a grant application. I have never looked back! 

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Balancing Life as a Surgeon With Home and Family
David I. Soybel, M.D.
Associate Professor of Surgery, Harvard Medical School
Division of General and Gastrointestinal Surgery, Brigham & Women's Hospital

Many female students today would like a medical career but are concerned whether they can manage both a demanding career and a family. Being a surgeon (general and GI), I wanted to give you some insight into how I and my colleagues are balancing work, home and family.

The proportion of women in surgical specialties is increasing. Right now about 50% of each entering class in medical school are women. In many surgical residencies-- especially the most competitive ones-- 50% are now women.

Surgical residents are not overworked compared to other residents-- all are now mandated for training in an 80 hr per week time frame. Training Programs that fail to adhere to these standards can lose accreditation-- and have been put on probation quite readily when they showed a lack of sincerity in addressing the work hour limits on residents. In our surgical residency at Brigham and Women's Hospital in Boston, which is affiliate with Harvard Medical School, five of the seven incoming interns are women and the overall proportion of women in the residency is about 35 to 40%. The percentage of women on the Staff of General Surgery is about 20% and increasing each year with new recruitments.

Many of the women on our staff are married and have children or, if they are in the early stages of their careers, they plan to have children when the time is right. Several of these women have important or time-consuming leadership positions and practices that are high profile or involve complex clinical problems.

The solutions that each family finds for taking care of itself are quite varied, and many people figure it out. It isn’t easy but they take it as a challenge and work on it-- with their partners/spouses. Some don’t, but there are just as many men who don’t figure it out either. Certainly things are changing. Many surgical residents who are husbands are routinely taking paternity leave, something that was not offered, in fact unthinkable, when I was training in surgery 20 years ago. Many of our best residents who are men and women have signaled the older generation that they want to be surgeons but they are not willing to live in the hospital their whole lives just for the privilege. The principles on which they plan their careers are as follows:

1. You might be able to do it all, but not all at the same time. Pick and choose, for each phase of career and life, the things that are most important.

Many young surgeons plan specialty training, which limits the kinds of surgeries they do, but also limits their activities within that specialty. Choosing a specialty is like building a fence. It limits what you can do, but it can also keep out the riff-raff.

2. You are not the only person who can do what you do. If you have good coverage of your practice, then your patients will get good care for their unexpected problems whether you are there or not. So you can sign out on weekends and take your turn to cover only when scheduled. A well-oiled practice and group of colleagues/partners who work well together can provide coverage in a way that makes patients feel safe and respected. So by the time you want to go into practice, you will see this idea as the standard, not the vanguard.

3. It is important for both parents to get to important events in kids lives. So both have to help each other get there and not burden the other with tasks that may make it harder, not easier, to spend time with the kids at times that count.
The family chooses priorities and then uses resources (i.e., its income or social/family networks) to get both parents to the recital or the soccer play-off.

I think these principles of choosing are not unique to surgeons; we have just been a little slower to adapt them than other specialties.

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Additional Comments from a Woman’s Perspective
E. Lisa Breen, M.D.
Director of Anorectal Physiology Laboratory
Associate Surgeon, Brigham and Women's Hospital

1) Numbers are changing and women are choosing surgery. I think the statistic I just read was that in 2006, 42% of 1st year surgical residents nationally were women. When I saw that graph at ASE (Association for Surgical Education), it looked like 2006 was a big jump up and was only one year, but I would say trends are positive.

2) The challenge/concern most women express (although I suspect equally applicable to many young men) is the ability to combine a career in surgery with a meaningful role as a parent. I would say that various strategies employed by women, men and couples are emerging. The couple needs to define between themselves what role each will have in parenting their children (predominately the mother, the father or a split) and then structure their career to accommodate their other job- parenting. Parenting demands also change as children grow and your need to be home and available may change during the time of your career.

   a) For those who opt to do less parenting, all models of a career are open to them - the traditional long hour, lots of emergency coverage to one of the "newer" models

   b) For those who want to do more parenting, the biggest variable seems to be to decrease the unpredictability of their schedule as much as possible and likely the total amount of work they agree to do.
       i) Unpredictability is most often generated by patient care. Strategies to control this include:
          - subspecializing, so you feel you are an expert in a smaller amount of material and can better predict how your patients will do.
          - sharing care of your patients with trusted colleagues (a call group where you can depend on being "off call" in turn for caring for other's patient like they are your own at other times)
          - dividing your career between clinical care and other non-patient care activities (research, teaching, administration)

       ii) Taking on less work will free you up to go home and parent. My concerns here, however, are:
          - In some competitive patient environments surgeons who are viewed as less available will get less referrals and then not even be able to keep up the volume they feel they can handle.
          - The amount of income generated while doing less work may not be enough to pay the bills (nannies, housekeeper, household manager, etc.)

Overall, I feel positive. I think numbers are increasing and as more women (and "modern men") join the ranks of surgeons more solutions and strategies will evolve. The job, however, is no doubt demanding of time and stressful. Most of us would say that we get to the hospital earlier in the morning than our medical colleagues and often stay later. Luckily, the rewards are high and with some planning you can find a way to combine a career as a surgeon and a family.

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COMMENTS:

Balancing my career in academic biomedical research with having my family has been harder than I ever imagined it would be, and equally rewarding. I thrive on the sense of accomplishment I get from work. It is hard for me to imagine a less demanding career that would be as interesting or provide the same sense of accomplishment. I am also motivated by my sheer enjoyment of research. On the other hand, I definitely can’t say I never question whether the struggle has been worth it. I spent several years before finding my faculty position in a pretty unhappy state, not sure I would ever get a chance at research independence. Because the job market for faculty positions is pretty tight now, and looks like it will continue to be, I do think current trainees in biomedical research should approach their training with an open mind about career paths whether or not they have a family. On the other hand a lot depends on level of motivation, determination, recognizing, and seizing opportunities. I do think success is 9/10ths determination. Also having a flexible, supportive spouse is key. There have been 2 aspects in particular that have been the hardest for me - limitations on relocation and the time crunch.

Limitations on relocating for training and jobs. If you have a family, you probably have some limitations on your options for relocation. The good news is this limitation seems to have grown much less stigmatized in the last 10 years. It seems to me that many established people now have dealt with this issue personally. For me, I spent many years haunted by the knowledge that I wasn’t able to do postdoctoral training in my first choice laboratory. My postdoc was in CNS development when I really wanted to study kidney development. I finally had an epiphany last spring sitting in a Women in Physiology mentoring session at Experimental Biology listening to others describe their experiences. As the late great Gilda Radner as Rosanne Rosanna Danna used to say on Saturday Night Live, “if it’s not one thing, it’s another”. If you get to choose the postdoctoral training laboratory you want, then you end up getting scooped on your project and losing the high impact paper. In other words, there are usually pros and cons to any situation.
Instead of focusing on the compromises you have made, focus on recognizing and seizing the opportunities your situation presents. While I did postdoc training in CNS development instead of kidney, I did receive excellent training from an excellent scientist and very supportive mentor. I also seized an opportunity that arose to get involved in the American Physiological Society. I have met many people who have been supportive and valuable contacts, and helped me obtain my current position. Getting involved in a professional society is something you can do from anywhere, and is very valuable for getting to know people in your field who can help. Another workaround to the relocation problem is to recruit investigators from other institutions to collaborate with your mentor on the project you want. Now that there are more grant opportunities for postdocs with supply money this is more possible. People are often willing to contribute to a project if they think it is interesting, will be productive, and if you can make minimal and efficient demands on their time. For example, maybe you can visit their lab for a week to learn a critical technique and then get by on some brief occasional guidance.
All this said, you will probably have to relocate at some point to move up the career ladder. Don’t underestimate the importance of going where the opportunity is. This is one place where a flexible spouse is key.
The time crunch. We have kept our kids in group home-daycare (until 18 months old) and then institutional. We think of it as extended preschool. Who says preschool has to start at 3 years old and be part time? Our 3 kids have thrived on this schedule. It is hard sometimes shortening the day to accommodate pickup and dropoff, but we feel like we would be missing out on too much if we left that to someone else. We do take turns and periodically recruit other parents and babysitters to help when needed. As for getting things done at work, I try very hard to be as efficient as possible. You can usually find ways to do things faster if you really need to. On the other hand, I have had fewer publications since having kids, and it has taken me longer to advance from postdoc to faculty. I do think established scientists need to give junior scientists who are parents (especially women) a temporary break in expectations during childbearing years. I am optimistic that this message is gradually sinking in as frustration within the scientific community grows with the increasing age to first NIH grant and limited numbers of women advancing in academic research. Though it has taken longer, I am now faculty with a shot at succeeding at independence.
I cherish the time I spend with my family, and I feel in many ways it makes me a better person, a better colleague, and a better boss. I am more sympathetic to other people’s needs and motivations, a very helpful quality when it comes to people management. So maybe there are actually some advantages to balancing work with family!

Caroline Sussman
Mayo Clinic College of Medicine

 

It is possible to do both, but it may be at the expense of your own quiet time or interesting hobbies, beyond family, of course! Mothers inherently are able to multi-task and this is a must for working moms at home and in the lab and office. Try to stay current at work and don't put off to the last minute as invariably, that is when a crisis at home occurs. Interestingly, although I am an empty nester now, my parents are starting to need assistance with healthcare issues. So when life is going well, appreciate the ease of your work schedule associated with a smooth running home and personal life!
Accept that you may not always be able to do everything at work all the time. Accept that others at your academic level may advance more quickly because they do not have the same responsibilities or priorities at home as you. However, you have your family and your time will come when the nest is empty and you can attend every meeting, serve on different committees, manage more people and projects in your lab, enter into collaborations, write more review articles, serve on editorial boards, etc. Remember, coffee breaks or a one hour lunch break during the week at work can equal about a 2 hour field trip with a child, or leaving early a couple of days to hit the soccer field. Prioritize!
Most of all enjoy your children and spouse. Make time for them, but don't forget about yourself. I am lucky to have a close friend that is also in science. We have had a standing lunch date once a week for over 15 years. We discuss science, how to fit in a weekend away with our husband, joint grant proposals, our gardens, where to find a good technician, and before-how to deal with that teenage child, and now -how to fit taking care of parents into a schedule that has allowed our own personal and spouse time for the past few years! Life is about change as is science.
Eleanor Roosevelt once said, “A woman is like a teabag, you never know how strong she is until she gets into hot water.” So be flexible, work hard, and preserve!!! Most of all-enjoy! Science is a great career!

Barbara Alexander
University of Mississippi Medical Center