‘Carer effect’ of parenting impacts female doctors most, study shows

By Megan Howe

12 Jan 2021

Female doctors’ working hours drop significantly if they have children, while male doctors work longer hours once they become a parent in a phenomenon dubbed the ‘carer effect’ by new Australian research.

In dual-doctor households, female doctors cut their working hours by an even larger margin after becoming a parent, while the working hours of male doctors didn’t change as a result of parenting, according to the study by health economists from the University of Adelaide

The findings suggested the onset of parenthood could worsen the gender earnings gap and impact female doctors career advancement, the authors said.

The study analysed data from nine waves of the longitudinal Medicine in Australia: Balancing Employment and Life (MABEL) survey of doctors between 2008 and 2016, looking at hours worked per week in relation to having children and partners’ working status. The survey collects data annually from more than 10,000 Australian doctors, 40% of whom are specialists.

The findings, published in Social Science & Medicine, showed that female doctors in clinical practice cut their working hours by 20.4% or 7.9 hours per week after becoming a parent. In contrast, male doctors worked an extra 4.2% or 1.9 hours per week after entering parenthood.

For each extra child a female doctor had, there was a further small drop in their working hours, while male doctors who had three or more children worked an extra 3.3 hours per week.

The drop in female doctors’ working hours was biggest when their children were young (0-4 years) and they gradually increased their workload as children got older.

The study also revealed that the working status of female doctors’ spouses had a strong influence on their work: those with a partner who worked full-time cut their working hours by the largest margin when they had children, compared with those with a part-time or non-working partner.

In households where both spouses were doctors, having children resulted in females cutting their working hours by 31.4%, while male doctors did not report a change in working hours with parenthood.

“Collectively, these findings point to the presence of strong gender division in family responsibilities among medical doctors, even in households comprising two highly qualified professionals,” the authors wrote.

They said the true impact of the ‘carers’ effect’ was likely even greater, because the MABEL survey only captures data on doctors currently working in clinical practice – those on maternity leave, home duties or not in clinical practice at the time of the survey were not included.

Study author Dr Terence Cheng (PhD), senior lecturer in the School of Economics at the  University of Adelaide, told The Limbic he was surprised the gender division patterns seen in the general population were very similar in medicine, given doctors had invested a huge amount in human capital development and medical training to become highly qualified.

The findings suggested female doctors were more likely to work part-time than males after having children, which was often viewed as a signal of a lack of commitment to a career, he said.

“This raises questions about what employers can do to help doctors come back into the workforce after child rearing, and about the availability of part-time positions to recognise that, at least in the early stages, doctors want to take an active role in childcare at the same time as keeping their career going,” he said.

Employers needed to ensure doctors working part-time had equal support and access to opportunities for career advancement as their full-time peers, the study states.

Dr Elizabeth Shaw, an interventional cardiologist who works full-time as a staff specialist at Hornsby Ku-ring-gai and Northern Beaches Hospitals as well as in private practice in Sydney, said the findings would ring true for many female doctors.

A mother of two children aged five and seven years, Dr Shaw said her husband took a year off his work in the finance field after they had each child, to enable her to return to work.

She continued her advanced training when her daughter was six weeks old, and the family moved interstate so she could take up an interventionalist scholarship when her son was eight weeks old.

“I was lucky to have a very supportive husband,” she said.

She is now the family breadwinner and her husband is a stay-at-home dad.

However, she said women doctors faced a lot of “mother guilt’ about working full-time when they had young child.

“The guys never get that,” she said.

Dr Shaw, who is a founding member of Women in Interventional Cardiology Australia/New Zealand, a group aimed at promoting the career to female doctors, said there was a need for more part-time and job-sharing positions.

But a “mindshift” was also needed across all subspecialties of medicine to ensure women who changed their working patterns due to family responsibilities were not perceived as being less committed to their career.

Her message to female doctors is that they can manage work and family if they are determined to do so.

“It is possible – you can get through if you keep at it,” she said.

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