Across all specialties, the number of women in medicine, and therefore the number of mothers in medicine, continues to rise. In academic medicine, women are still overrepresented in junior faculty positions and are scarce in the ranks of professor, department chair, and dean. As of 2011, only 13% of full professors and 14% of department chairs are women (AAMC). Motherhood has often been blamed for women’s failure to achieve these powerful positions (Wright, 2003). In spite of a persistent “glass ceiling,” women in medicine have contributed tremendous positive changes to the practice of medicine and to medical education. These changes will continue as women slowly move into more leadership roles and senior faculty positions.

At the medical school level, women’s health was historically ignored by undergraduate medical educators. In recent years, medical schools have been working to integrate women’s health and gender-based medicine into their curricula. At the residency level, more shared positions and options for reduced hours over a longer training period are becoming available. Availability still varies widely across specialties. For example, a recent search of FREIDA Online, a database with over 8,200 graduate medical education programs accredited by the ACGME found 36 family medicine residency programs with part-time or shared positions but none in orthopedic surgery. At individual programs, residency directors who are mothers themselves may promote better maternity leave and breastfeeding policies for their residents.

As for clinical practice, in spite of the differences seen among training programs in different specialties, fewer medical students are choosing primary care specialties. To use the women’s health specialty of obstetrics and gynecology as an example, AAMC data from 1999 to 2002 show a 20% decrease in student interest in primary care OB/GYN (AAMC, 2003). Due to factors such as “lifestyle” and the increasing cost of professional liability insurance, OB/GYN physicians now stop practicing obstetrics at a much younger age than previously (Weinstein, 2003; Pearce, 2001). Since more women are going into the field with lower clinical productivity than their male counterparts, functionally fewer physicians are practicing obstetrics, which has long-term implications for the physician workforce.

In academic medicine, a recent study at one medical school reported that 42% of the faculty were seriously considering leaving (Lowenstein, 2007).   One way to improve physician retention is to enhance faculty development efforts devoted to career and family balance. As a start, some universities have lengthened or even eliminated promotion timelines in exchange for professional achievements as the focus of eligibility for promotion. These initiatives help both men and women.

In light of widely reported career dissatisfaction among physicians of both genders, we would all benefit from more focus on personal and family well being. Physician-mothers in particular struggle to find this elusive balance. As their numbers have increased, so has physician dialogue on how to achieve professional success without sacrificing one’s personal success and vice versa.