The Workgroup on Parenting’s monthly evening event—the “Nighttime Parenting in Medicine Café”—is open to
all and is held on the third Thursday of the month from 7:30 to 9:00 pm EST by Zoom. For more information on the
Workgroup on Parenting please visit: https://www.sgim.org/communities/task-forces/women-and-medicine

Parenting is a highly rewarding, long-term, and high-stakes commitment. For physicians, parenting demands can have a negative effect on career trajectory and prospects for academic promotion, even in the best of times. Academic physician-parents need support from their institutions, chiefs, co-workers, and professional societies to fulfill their demanding dual roles. In response, the SGIM’s Women and Medicine Commission (WAMC) formed a Workgroup on Parenting in 2020 to begin a parenting initiative.

In the past, women physicians received little encouragement to have children. Beth Lewis, MD, writes, “When my mother was admitted to medical school in the 1950s, there were few women in medicine, and she was told that she shouldn’t ever have children. She returned to work within a week or two of giving birth to each of her children, and it was tough. The message was clear: in order to succeed as a physician, work needed to come first. In the workplace she was expected to act and perform as though her children did not exist.”

Although attitudes improved since our parents’ generation, clinic charting, answering e-mails, and completing academic work can stretch long into the night after homework, carpools, and baths for children are completed.

The COVID-19 pandemic cast large numbers of physician-parents into crisis mode and upended any semblance of balance. Abrupt and radical changes in schooling routines, the acute inability to obtain reliable child care, and the pervasive fear of infecting our families with an infectious disease are stressors that are unprecedented in their precipitous onset and universal reach. The ability of physician-parents to keep up with clinical responsibilities, research, scholarly endeavors, educational work, and administrative duties has become nearly impossible to manage. Ongoing chaos caused many parents, especially women, to cut back work hours, or leave work altogether.

The WAMC’s support for parenting initiative has the following three major goals:

  1. To increase SGIM programming around parenting issues including monthly meetings throughout the year to equip physician-parents for success;
  2. To form a community for networking and to provide a safe space for members to vent, troubleshoot, share experiences, and feel supported;
  3. To work with leaders throughout SGIM to increase their support for parents at their institutions, and to identify concrete strategies for helping physician-parents to succeed.

Building Community through Monthly Meetings and Networking

The Workgroup on Parenting launched monthly meetings for SGIM members and guests in November 2020. The “Nighttime Parenting in Medicine Café” invites physician-parents to meet virtually and discuss solutions with invited speakers. The meetings are designed to be entertaining, useful, and encouraging. Zoom-bombing children, pets, and family members are welcome.

In its first meeting, “Parenting During the COVID Pandemic with Thanksgiving,” Dr. Kerri Palamara shared strategies and insights on dealing with parenting stresses during the pandemic from her work as director of the Massachusetts General Hospital Center for Physician Well-Being. After icebreakers to orient and connect the group, Dr. Palamara articulated and validated the many stressors physician-parents are experiencing today, ranging from exposure concerns, extreme workloads at home and at work, challenges with home and remote schooling, dynamic and new work environments, moral dilemmas, abundant worry (parental, financial, medical, career, etc), professional development delays, fatigue, and social isolation.

To manage these stressors, Dr. Palamara focused on three skills: 1) identifying feelings and needs using principles of nonviolent communication, 2) sharing your emotional whiteboard with others from the work of Nataly Kogan, and 3) self-compassion using the principles developed by Kristin Neff and colleagues. Workshop participants had the opportunity to practice these principles together in small groups using real-life experiences and to debrief as a large group to reflect on the experience and lessons learned.

In December, “Work-Life Imbalance” was presented by Dr. Deborah Kwolek. Participants reflected that the work-life balance is forever in flux and can be an unrealistic ideal. Participants were encouraged to ask themselves: How do you define success? Who do you allow to judge you? Can you set yourself free from your own criticism? Will you love yourself and be happy?

When lives seem balanced, babies, illnesses, deaths, natural disasters, or global pandemics upset the equilibrium. Participants were given advice for navigating difficult times: Don’t forget the aces in your back pocket: an MD degree, grit, intelligence, work ethic, and contacts. Stand up and fight for what is right. Pick your battles. Strategize. Be bold. Seek wise counsel. Advocate for yourself in a way that also benefits others. If you blaze a trail, others will benefit.

When we are under extreme stress, we switch to survival mode and lower expectations temporarily if needed. Remember that even if you fall, you can get back up again. Get support from colleagues and mentors and stay positive- remember that your career is a life-long endeavor.

Video recordings of the monthly presentations will be available on-line for those who cannot attend the gatherings. Future topics will include negotiating, self care, scheduling strategies, and managing work and home.

Annual Meeting Programming

The Workgroup on Parenting will host a special symposium and workshop at the Annual Meeting in addition to the parenting panel and usual WAMC programming.

A Special Symposium, “We are family: parenting challenges and institutional responses for academic physicians during COVID and beyond,” will involve a lively discussion of parenting challenges, solutions and potential action steps from a Department of Medicine chairwoman, a chief of General Internal Medicine, an associate program director (APD), and the director of a physician-wellness program. Childcare issues, schooling issues, and emotional issues will be addressed with possible solutions, including extensions of deadlines related to research and other obligations, virtual visits, work-life boundaries, flexibility in scheduling, and fairness among faculty with differing scheduling needs. The need for institutional and cultural changes to support faulty and residents who are parents will be affirmed.

A Workshop, “Thriving, rather than just Surviving: Parenting and Medicine during the COVID-19 Pandemic,” will identify participants’ parenting-related challenges, provide a safe space for discussion, and encourage peer/near-peer support to help identify solutions. Participants will be given strategies for healthy work-life integration that they can propose to their departmental/organizational leadership. This workshop will form the basis for an expansion of the ongoing parenting network within the Workgroup on Parenting. Participants will be encouraged to exchange contact information to support their peers/near-peers after the workshop individually, or join the WAMC Workgroup on Parenting program.

Working with Leaders in GIM to Effect Positive Changes for Physician-Parents

For physician-parents to thrive, they require the support of effective leaders. The WAMC Workgroup on Parenting seeks to equip leaders with practical strategies gleaned from medical and business resources1-3 as well as from the experiences of our members. Suggestions include the following:

  • Connect physician parents to, or foster the creation of, social support networks
  • Share available mental health and stress-reduction resources and encourage their use
  • Work with benefit specialists to address issues such as leave, childcare, and coverage for medical expenses in case of illness
  • Right-size job expectations providing flexibility of work
  • Ensure all leaders are on the same page with issues such as expectations of the team and the exceptional impact of this crisis on physician parents
  • Provide certainty and clarity, wherever possible
  • Assess physician stress, identifying and addressing specific drivers of stress at the organizational level
  • Recognize that everyone’s situation is different
  • Approach physicians with empathy and compassion

Conclusions and Next Steps

The Workgroup on Parenting welcomes all parents to join our initiative. We will share personal experiences when parenting challenges are felt acutely during and after the COVID crisis. We are particularly supportive of residents and junior faculty and hope to engage and retain members who feel overwhelmed with the pressures of academic medicine. We will foster re-entry for members who have left medicine or SGIM and would like to return.

We will advocate for physician wellness, and fight against chronic stress and burnout. We will also work to reverse trends in which learners (residents and medical students) and junior faculty may be discouraged from pursuing advanced careers in medicine, such as sub-specialty, academic, or leadership roles, due to parenting responsibilities or their desire to become parents.

Knowing that positive changes will need to be supported by the top levels of GIM, we hope to earn the buy-in of the chairs, chiefs, PDs and other leaders who are part of SGIM.

Corresponding author:  Deborah Kwolek, MD (dkwolek@mgh.harvard.edu).

References

  1. Thomas L. How to support parents juggling kids and working remotely. https://www.forbes.com/sites/maurathomas/2020/10/13/how-to-support-parents-juggling-kids-and-working-remotely/. Forbes. Published October 13, 2020. Accessed January 15, 2021.
  2. Resources for Healthcare Leadership. https://www.ama-assn.org/delivering-care/public-health/caring-our-caregivers-during-covid-19. AMA website. Updated June 17, 2020. Accessed January 15, 2021.
  3. Sumpter D, Zanhour M. 3 ways companies can retain working Moms right now. https://hbr.org/2020/11/3-ways-companies-can-retain-working-moms-right-now. Harvard Bus Rvw. Published November 12, 2020. Accessed January 15, 2021.

Issue

Topic

COVID-19, Leadership, Administration, & Career Planning, Medical Education, Sex and Gender-Informed Medicine, SGIM, Wellness, Women's Health

Author Descriptions

All authors are members of the SGIM Women and Medicine Commission’s Workgroup on Parenting.

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