No abstract

ncreasing numbers of women are graduating in medicine in Australia 1 and overseas. 2,3 This has led to a "feminisation of medicine", 4 and concerns have been expressed that women work fewer hours than men, primarily because of family commitments. 5 Such criticism focuses on the competing demands of being mothers and doctors, and the career breaks taken by women to care for children. 4 Balancing the two roles can be challenging. Doctors must prioritise patient care, often to the detriment of their own needs and those of their families. 6,7 Motherhood can be as personally rewarding as medicine, and similarly requires placing another person's needs before one's own. 8 In this systematic review, we identify what is known about women balancing motherhood and medicine by examining the published research into their experiences and perspectives. Methods Search strategy Our systematic review was prospectively registered with PROSPERO on 30 April 2019 (CRD42019116228). We searched the CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE, PsycINFO, Web of Science, and Scopus databases in November 2019 for relevant published studies with the same search string: female/women AND doctor*/physician*/clinician* AND family OR child* OR mother* OR parent AND "family work relationships" OR "work life balance" OR "work home culture" (Supporting Information, table 1). Study selection and data extraction The titles and abstracts of articles identified by our search were screened by two authors (RH, MN), and the full text of relevant articles were then assessed according to our inclusion criteria: Articles were excluded if doctors were not explicitly objects of the study, sex was not a variable in the study, or motherhood or parental experiences were not reviewed. Disagreements about inclusion were resolved by consensus between the two authors. Screening identified 101 potentially relevant articles. After excluding nine because no English language versions were available, 43 not specifically related to motherhood or medicine, one undergraduate study not about doctors, and twelve non-research articles, 35 original research studies were included in our systematic review (Box 1). Thematic analysis We undertook an integrative review synthesis of the included research studies. Information was categorised according to emergent themes and synthesised. A quantitative meta-analysis was not attempted because of marked differences between studies in the outcomes and variables assessed. Results Nineteen of the 35 research studies (32 quantitative, three qualitative studies) were from the United States, and three each from Japan and Germany. The quantitative studies were either cross-sectional surveys or longitudinal in design (32 to 10 866 participants each) from specific specialities to large multi-centre studies. The qualitative studies included focus groups and semistructured interviews (eight to twenty participants each) (Box 2; Supporting Information, tables 2-4).

No abstract