Medical Women in surgical residency

[Smurfette]

After careful consideration, I would like to match into a general surgery residency program. I am a female 3rd year ms. Almost every physician that has inquired what field I am interested in, has discouraged this choice. The reasons have ranged from you can’t be a good mother and raise children as a surgeon to the more bluntly put... do you want a nanny to raise your children? I’m single but marriage and family are part of my goals. I’ve been told to pursue EM or Derm as a better life style choice. My thoughts are, why should I spend 4 years of my life in med school and 5+ in residency to go into a field that is not my first choice? But am I being unfair to my future family? Is surgery so all consuming that I need to make a different decision? These comments are from male physicians by the way. I’m attempting to seek out female surgeons but it seems very few do general surgery. Thank you for any advice.

I'm a general surgeon. For full disclosure, I am not married and don't have kids. If I did have kids, I feel like I could balance it with my current job from a work hours standpoint. Other than @Winged Scapula and a local colorectal surgeon, all the female general surgeons I personally can think of offhand have kids. I believe the official statistic for female surgeons is that 60% of them have kids. During residency, we had about one female resident a year take maternity leave. It wasn't easy for them, but they managed. Those who had kids in both residency and in practice would tell you it was easier once in practice as work hours and finances were better. I think the majority of the female general surgeons I know would also still be surgeons of some kind if they could do it over again, although some might change subspecialties.

A few comments. First of all, the concept of "women must do all the child-rearing" is outdated, misogynistic and judgmental. It's also not fair for male surgeons who trained in a different era to try and tell you how to raise a family or that the field is not good for women. This type of sentiment is changing as the baby boomers retire and women are increasing in number among all medical specialties. Work-life balance is viewed as increasingly important than it ever was in the past, and groups/employers have to recognize this in the recruiting process no matter the gender of those they are recruiting. Millennials especially tend to view raising a family as a joint effort, and not one in which the man works and the woman takes care of the house and kids, so there is better division of chores and child-rearing at home. What you will presumably look for in a partner is someone who looks at marriage as an equal partnership, and supports your career as much as his. [I'm assuming you are straight--apologies if that is not the case--but this would still be true regardless of your future spouse's gender]. With regard to raising a family, your partner is the more important factor to making it work and making you feel supported, not which field you go into. Maybe his job will have steady hours and he picks up the kids from day care/school every day. Or he's willing to be a SAHD. Maybe you'll need a nanny, or your parents/in-laws to help you out when the kids are really young. Maybe your hospital will have 24/7 day care. Maybe you'll be a surgical hospitalist and work 1 week on/1 week off and find balance that way. It won't be easy, but no one thinks being a parent, or a physician parent, is easy. However you find the solution, remember that working moms have been around for a while, including working single moms, many of whom have 2 or more jobs to make ends meet and pay for child care. The notion that working moms (but not dads) are automatically terrible, absent parents is simply offensive. Both my parents worked full time until my father died at a young age. My mother worked full time after that and was very much a present and involved parent. While she wasn't a physician, she certainly worked well more than 40 hours a week and raised 3 kids who are all successful in their own right. If anything, having kids was her motivation for all those years.

Second, I did not get a lot of encouragement myself to become a surgeon. I went with the field I liked the best, which was GS. I can't imagine NOT being a surgeon at this point. If I had gone into derm or EM, I would be unhappy but ultimately stuck in that career path. My being unhappy, in turn, would also affect those around me negatively as well. So I agree that it is unfair to your family to do something completely different and be miserable just because someone discouraged you from pursuing your real desire. If I "settled" for something else, I'd probably always wonder "what if?", which would not be healthy. I also believe that if you like what you do, you do a better job at it.

Third, to give you an idea of my lifestyle, when I am not on call, I pretty much can control my own hours. I can tell my office to block my schedule whenever I want if I have an appt or some obligation. I don't abuse that privilege, so don't get any flack for it when I do it. Rarely, I have a patient who needs to go to the OR on a night when I'm not on call, but that is not common. Sometimes my post-call day runs late, but I generally can anticipate when add-on cases will go based on what my previously planned schedule looks like. Depending on how busy my call night is, it may be feasible for me to go home and come back to do an appy or something after dinner or running an errand. I generally prefer to just stay at work and get it done, but if I had a spouse/kids, I could prioritize a little time at home first and go back (assuming the patient is stable and can safely wait a short time). Sometimes I don't get called in at night, while sometimes it's super-busy. I take call from home and go in when needed; if a consult can wait until the next morning, I see it in the AM. Life as a community surgeon after residency is generally very different from what students and residents see at an academic center.

Fourth, while I want to be positive in my comments, I do believe the field is harder for women in some ways. There are biases favoring men historically that are slow to change and the field is still male-dominated. While it's getting better, I generally assume I have to work harder and have better outcomes to be perceived as equal to my male counterparts. There are some excellent talks by Caprice Greenberg on the disparity between male and female surgeons with regard to promotions, pay and other factors that address some of these biases. The fact that we are now having these talks and conversations openly is huge for women.

I'm not sure if that is the type of response you were looking for. My feeling is, don't let other people's biases and expectations get into your head. You know yourself best. Don't settle for something else and be miserable thinking it's the only way to have a family. I feel like the more women we have in surgery, the more it will help to change the perception that it's a terrible career choice for women, and break down these barriers for future women entering the field. Surgery's not "easy", but it is rewarding.

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