Paper finds early-career female family physicians experience unique obstacles to professional and academic success, work-life integration and wellness

By Jennifer Stranges

Individual and systemic challenges specific to female family physicians in their first five years of practice create obstacles that can result in disproportionate rates of burnout and negative impacts on career trajectories, according to a new paper co-authored by Dr. Tali Bogler of St. Michael’s Hospital’s Academic Family Health Team.

The article, published today in Canadian Family Physician, is authored by three female family physicians nearing the end of their first five years of practice and outlines practical strategies to achieve gender equity and work-life integration.

The paper highlights systemic challenges including implicit and overt bias, a shortage of women in leadership positions, a lack of supportive and comprehensive leave policies, and gender-based pay inequities. Individual challenges include imposter syndrome, balancing personal and professional responsibilities, and restrictive gender norms.

“The 2017 Canadian Medical Association National Physician Health Survey demonstrated that female physicians and early career physicians reported the highest levels of burnout,” says Dr. Bogler.

“What we didn’t know was why. This paper aimed to explore that from a first-person perspective and provide practical strategies to specifically support female family physicians.”

The paper calls for implicit bias and sexual harassment training for physicians of all career stages, more flexibility in scheduling to respect work-life responsibilities, and a review of which payment models widen or lessen the gender-pay gap. Female family physicians typically spend longer with patients and give more attention to psychosocial issues, putting them at an earning disadvantage compared to their male counterparts, who typically see a larger volume of patients for shorter visits, the paper states.

Dr. Bogler also notes that implicit bias and sexual harassment training for physicians – both men and woman – of all career stages is important on an ongoing basis.

“Training can be done in interesting ways – for example a book club or an engaging workshop. Finding a safe space to talk about these biases on an ongoing basis is critical,” says Dr. Bogler.

The authors also called for the development of comprehensive family, caregiving, and medical leave policies, citing that a lack of these policies disproportionately affects women and those in early career.

“The fact of the matter is – in terms of parental leave – it’s typically happening during the early years of a physician’s practice,” says Dr. Bogler.

“Physicians are building their practice during this time, so that’s when we need the most support with the transition in and out of parental leave.”

There are solutions that female family physicians can individually initiate, including exploring peer-to-peer support groups, mentorship and by setting boundaries. The paper notes that the development of electronic medical records have created an expectation of 24-7 availability for physicians.

While the paper largely explores the challenges for early-career female family physicians, Dr. Bogler notes that these challenges may be amplified for women with intersecting forms of social positions such as race and sexual orientation.

This paper is an example of how St. Michael’s Hospital is making Ontario Healthier, Wealthier, Smarter.

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About Unity Health Toronto

Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit www.unityhealth.to.