Medicine and motherhood: Shifting trends among female physicians from 1922 to 1999

Purpose. Retrospectively examine the balance between medicine and motherhood over the last 80 years, with particular emphasis on the conflict between medical training and childbearing. Method. In 1996, a questionnaire was mailed to all 863 women who matriculated at Yale University School of Medicine from 1922 to 1999. The questionnaire asked for information on personal and professional demographics, career satisfaction, child rearing, and childbearing. Results. Of the 586 responding women (70% response rate), 82% of those over 40 were mothers. Female physicians without children were more likely to be in surgical specialties, less likely to be in primary care, and more likely to work full time than were their female colleagues with children. The average age of women when they matriculated at medical school increased over the 80 years. Before 1950, 24% of the women with children had them during medical training. Between 1950 and 1989, 42% of the women with children had them during medical training. The length of maternity leave increased over the eight decades, although the level of satisfaction with length of leave dropped. Conclusion. More absolute numbers of women are having children during medical training, increasing the demand for longer leaves, greater training flexibility, and child care opportunities. The authors conclude that more changes are necessary in the training of doctors and the practice of medicine that place greater emphasis on the importance of caring for one's own family as a physician. Recommendations for some of these changes are provided.