A BMJ paper in 2016 investigating the work-life balance of doctors in training in the UK, showed that the lack of work-life balance in postgraduate medical training negatively impacted on trainees learning, particularly women with children. I believe the situation now is not much different, if not worsened by the COVID pandemic.
I am currently an internal medicine trainee in Year 1 and have completed the foundation programme as well as medical school in the UK. Getting married last year and the prospect of likely to having children in the, makes me quite apprehensive on how I will manage to balance this with training. Looking at my colleagues, particularly senior registrar females who have children, being a doctor in training and balancing it with family is not an easy task and requires a lot of organisation and childcare planning.
Less than full time training (LTFT) is becoming increasingly popular and as of 2018 approximately 11.3% of UK trainees are LTFT. Although I am currently a full-time trainee, I still get informed about LTFT webinars and support (provided by Health Education England) which I believe is a sign on how this is becoming widely acceptable and common. The flexibility of less than full time training makes me feel that this is quite a good option and I might just after all manage it.
Although this is a good option, having a young family can be quite expensive and LTFT comes with a pay cut understandably and also training time is exponentially increased. It is one of the major cons that we must keep in mind while undertaking LTFT.
Being a specialty trainee also means in addition to the long hours, we have to further use our spare time we have for membership exam revisions and e-portfolio management. This does take a significant time out of our life outside of work, and I personally felt that this was what affected me the most and my time with my family (particularly studying for exams after work). We are provided with study leave, which is helpful, however requires very careful planning and much advanced notice with our rostered on-call shifts and exam timings. I have to say that our colleagues who are going through the same things are quite supportive and will gladly swap on call shifts as well as the senior doctors.
The NHS statistics shows that the proportion of NHS doctors who are women are growing annually since 2009 and the gender gap within specialties are narrowing. There is still the pronounced gender gap among specialist doctors in the UK with 50,000 men for just under 30,000 women on the specialist register. Whereas in the GP register, women outnumber men with 35,000 female GPs to 27,000 male GPs. Being a GP is also an option I considered, particularly for the work-life balance due to the reduced hours and shorter training time, however decided against it in the end to join internal medicine. I feel this is a thought that a lot of my colleagues have while applying to specialty training as well and likely the reason for the gender gap seen. I was glad to see however that the number of women taking up leadership roles such as chief executives and directors are also increasing since 2009.
Even after all the negatives I have listed above, I believe it is possible to have a work-life balance being a trainee and as a woman, with the right support and by prioritising our goals. I believe there is support in place to optimise our work-life balance as much as we can afford at the moment for the women in our workplace and that is quite a big feat, which I am sure a lot of previous female doctors and male colleagues, have strived for to make it better and feasible for everybody. However, seeking that support and practically implementing it can be quite challenging particularly with the staffing crisis and the rightful expectation to deliver quality care that our patients deserve. We are moving towards the right direction for support for female trainees as well as male trainees albeit slowly, and we will keep striving for it.
Dr. Fathima Rawther
Dr. Fathima Rawther is an Internal Medicine Trainee at Oxford University Hospitals (upto March 2022), currently working on plans to move onto Germany soon to continue her professional career there. She graduated in 2019 with MBChB (with Hons.) from The University of Buckingham and completed her foundation training within the Oxford Deanery. Her particular interests include Evidence-Based Medicine on which she is doing a part-time Masters with the the University of Oxford.
Declaration of interests
I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: none.