Family Practice Vol. 20, No. 4, 486-488
© Oxford University Press 2003
International Health Care Research |
Patterns of child-bearing behaviour amongst female hospital doctors and GPs
Department of Primary Care and General Practice, Primary Care Clinical Sciences Building, University of Birmingham, Birmingham B15 2TT, UK.
Correspondence to Dr SM Greenfield; E-mail: s.m.greenfield{at}bham.ac.uk
Sinden NJ, Sherriff JM, Westmore SEL, Greenfield SM and Allan TF. Patterns of childbearing behaviour amongst female hospital doctors and GPs. Family Practice 2003; 20: 486–488.
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Abstract |
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Background. The number of females entering and graduating from medical school is currently increasing and, as a result, the problems they face if they wish to work as doctors and have a family are becoming more apparent.
Methods. A questionnaire study of 105 female GPs and 98 female hospital doctors was carried out in Birmingham, UK, to determine doctors’ experiences and views of child-bearing whilst working as a doctor.
Results. Of the GP responders, 81% had children compared with 49% of hospital doctors. GPs were shown to work fewer hours than hospital doctors. Problems were identified relating to the everyday difficulties faced whilst working and raising a family.
Conclusions. The results highlight the need to address the difficulties faced by females pursuing this demanding career.
Keywords. Childbearing behaviour patterns, female GPs, female hospital doctors.
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Introduction |
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The number of women entering medical school has increased from 51.7% in 1994 to 56.5% in 1999.1 This means that >50% of graduates produced by medical schools are female. Current figures regarding final career destination for females suggest that there is an imbalance between hospital and general practice.2 Factors contributing to this trend include a preference for working in a smaller organization or for self-employment. It has also been shown that factors within medical training and role modelling may discourage women from hospital medicine or from certain specialties.2,3 Another important influence may be the perceived greater flexibility of the general practice environment in terms of organization of work. For women, the choice between a career in hospital or general practice may be influenced mostly by conflicting responsibilities between career and husband, and between career and children. Females enter general practice with a view of being able to work part-time and have children.4
No previous study has compared the experience of GPs and hospital doctors, or looked at the relationship between these career choices and child-rearing patterns. The study described here compares female GPs’ and hospital doctors’ views about the advantages and disadvantages of raising a family within their respective speciality.
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Methods |
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The study was carried out within Birmingham Health Authority (HA). A list of all female GPs working within the area was obtained from the NHS regional directory.5 Eleven of the 14 hospitals in the HA agreed to participate in the study. Information about the number of female doctors was provided by each hospital. PRHOs were excluded from this study, since their position is common to both GPs and hospital doctors. Ethical approval was obtained from all local research ethics committees.
A questionnaire was sent to 183 female GPs and to 241 female hospital doctors. The questionnaire considered work-related issues such as grade, average number of hours worked per week and socio-demographic characteristics. It also considered the number and ages of children each doctor had, career stage of the doctor when the children were born, the demand for childcare and the time of day it was required. Open questions were also included to allow respondents to express their opinions regarding the raising of children whilst working as a doctor.
Common themes amongst the responses to the open questions and their frequency were noted. This was done separately for GPs and hospital doctors in order to be able to identify the relative importance of particular themes and to enable comparison of themes.6–9 Statistical tests were carried out on the quantitative data. A chi-square test was used to compare marital status and the number of doctors who had children between the two groups. A t-test was performed for mean age of the groups and for mean hours worked per week. The advantages and disadvantages of having children whilst working as a doctor were analysed using a test of proportions.
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Results |
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A total of 203 (47.9%) of the 424 questionnaires were complete and suitable for analysis. There was a higher response rate from GPs. GPs were older (chi-square GP = 42.2, HD = 37.5, P = 0.01), more likely to be married (P = 0.01), worked fewer hours per week (t-test GP = 35.7, HD = 50.4, P = 0.01), and were more likely to have children; 81.0% (85/105) of GPs and 49.0% (48/98) of hospital doctors had children (Chi-square P <0.001).
Hospital doctors currently requiring childcare used a mean of 30.9 h/week compared with 23.7 h by GPs (P = 0.03). The main change in working pattern after having children was to decrease the number of hours worked or to go part-time.
Table 1
summarizes the perceived disadvantages and advantages of combining a career with family life. The most commonly mentioned problem for hospital doctors was related to childcare;
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". . . little time to spend with my children during the working week. Difficulties with coping in the school holidays when I need to ‘farm out’ the children to family and friends. Difficulty in picking up children from school due to current full time work commitments."
GPs were significantly more likely than hospital doctors to have had problems during the school holidays (P = 0.02).
Hospital doctors were significantly more likely to say they had no time to study (P = 0.01).
"Studying can only be done at home if they are asleep."
Among hospital doctors, the main advantage was felt to be financial.
"I can afford to send them to private school."
The main advantage for GPs was said to be that it made them more aware of patients’ problems,
"It is better as a GP as you can understand parental concerns. I do not dismiss my patients as perhaps I would have done before having my own children."
A total of 54.8% (57/105) of GPs and 43.9% (43/98) of hospital doctors stated that they took children into account when considering their career. Hospital specialities perceived to allow for both career and family were psychiatry, anaesthetics, radiology, A&E and community paediatrics. Of the GPs, 64.9% (37/57) had chosen general practice because they perceived this career to have fewer working hours.
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Discussion |
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GPs were found to be significantly more likely to have children than hospital doctors. Of the GPs who considered children when choosing their career path, many chose general practice specifically because of the potential to work fewer hours. However, they subsequently experienced conflicts between their career and family life. Hospital doctors faced similar predicaments.
These findings are reinforced by the recent release of a report from the Federation of the Royal College of Physicians.10 Improvements needed for the future would include more availability of part-time work for hospital doctors and easier access to childcare facilities during unsociable hours. An increased awareness of women’s needs whilst raising a family is also required from hospital staff, patients and the government. Provisions must be made as soon as possible to reduce the occupational problems of female doctors enabling them to balance a successful career and family life without detriment to either.
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References |
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1 UK accepted applicants: statistics for 1994–1999. http://www.ucas.com/figures/archive/eua/uk/acctot.html (last updated 2/11/ 2000). Consulted on 4/1/2001.
2 Allen I. Doctors and Their Careers: A New Generation, Vol. 1. London: PSI Publishing; 1994: 9–10.
3 Allen I. Any Room at the Top? A Study of Doctors and Their Careers, Vol. 6. London: PSI Publishing; 1988: 56.
4 Swerdlow AJ, McNeilly RH, Rosemary Rue E. Women doctors in training: problems and progress. Br Med J 1980; 281: 754–758.
5 http://www.birminghamhealth.org.uk/local_services/local_hospitals2.htm as consulted on 23/05/2001.
6 Reid N. Health Care Research by Degrees. Oxford: Blackwell Scientific Publications; 1993.
7 Ryan GW, Russell Bernard H. Data management and analysis methods. In Denzin NK, Lincoln YS (eds) Handbook of Qualitative Research. Thousand Oaks (CA): Sage; 2000: 769–802.
8 Miles MB, Huberman M. Qualitative Data Analysis. Thousand Oaks (CA): Sage; 1994.
9 Stevenson FA, Barry CA, Britten N, Barber N, Bradley CP. Doctor–patient communication about drugs: the evidence for shared decision making. Soc Sci Med 2000; 50: 829–840.[CrossRef][Web of Science][Medline]
10 Federation of the Royal College of Physicians. Women in Hospital Medicine: Career Choices and Opportunities. London: Royal College of Physicians; 2001.
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