Difficulties Facing Physician Mothers in Japan

Abstract

Despite recent increases in the number of female physicians graduating in Japan, their premature resignations after childbirth are contributing to the acute shortage of physicians. Previous Japanese studies have explored supportive measures in the workplace, but have rarely focused on the specific problems or concerns of physician-mothers. Therefore, this study explored the challenges facing Japanese physician-mothers in efforts to identify solutions for their retention. Open-ended questionnaires were mailed to 646 alumnae of Juntendo University School of Medicine. We asked subjects to describe their opinions about 'The challenges related to female physicians' resignations'. Comments gathered from alumnae who graduated between 6 and 30 years ago and have children were analyzed qualitatively. Overall, 249 physicians returned the questionnaire (response rate 38.5%), and 73 alumnae with children who graduated in the stated time period provided comments. The challenges facing physician-mothers mainly consisted of factors associated with Japanese society, family responsibilities, and work environment. Japanese society epitomized by traditional gender roles heightened stress related to family responsibilities and promoted gender discrimination at work environment. Additionally, changing Japanese society positively influenced working atmosphere and husband's support. Moreover, the introduction of educational curriculums that alleviated traditional gender role was proposed for pre-and post-medical students. Traditional gender roles encourage discrimination by male physicians or work-family conflicts. The problems facing female physicians involve more than just family responsibilities: diminishing the notion of gender role is key to helping retain them in the workforce.

Women's Participation in the Medical Profession: Insights from Experiences in Japan, Scandinavia, Russia, and Eastern Europe

“…In a survey of 249 female Japanese physicians, gender discrimination regarding career choice, discrimination and sexual harassment in the workplace, high levels of stress concerning family responsibility, and lack of support regarding pregnancy and childcare in the workplace were reported. 23 Female obstetrician-gynecologists surveyed were more likely than their male counterparts to be single and childless, and 34% reported receiving advice from colleagues and superiors to postpone childbirth. 21 Only 50% of male and female obstetrician-gynecologists surveyed could obtain maternity or paternity leave.…”

“…21 Furthermore, childcare options in Japan are limited and expensive compared with other countries. 23 In 2009, the Japanese Medical Association reported that only 50% of hospitals had childcare centers onsite. 23 Unsurprisingly, given this environment, pregnancy and childcare appear to affect the number of hours worked and procedures performed by female physicians in Japan.…”

“…23 In 2009, the Japanese Medical Association reported that only 50% of hospitals had childcare centers onsite. 23 Unsurprisingly, given this environment, pregnancy and childcare appear to affect the number of hours worked and procedures performed by female physicians in Japan. In a study surveying 1301 members of the Japanese Society of Obstetrics and Gynecology, a significantly higher percentage of men reported handling deliveries and performing surgeries.…”

“…The employment rate among female physicians has been shown to decrease nine years after their graduation from medical school by 75%, primarily due to childbirth and childcare. 23,24 A certain proportion return to the workforce after they have finished raising their children, completing the ''M-shaped curve'' that describes the pattern of female workforce participation in Japan. 24 However, the percentage of women physicians taking leave is greater than the percentage returning to the workforce.…”

“…20 These findings have fomented concerns that women's increasing role in medicine is contributing to the physician shortage in certain subspecialties and regions in Japan. 17,19,23,25 However, one study predicted that Japan may not experience an overall shortage in physicians, but instead shortages of physicians in particular specialties which fewer young physicians are choosing due to quality of life factors or where women are underrepresented. 25 Kaneto et al (2009) pose the provocative question of whether women should feel obligated to work after receiving a medical education that is heavily subsidized by tax revenue, especially when there is a physician shortage in certain specialties and geographic areas.…”