Alexandra Puscek had long felt that she wouldn’t start a family until she was well into the beginning of her career.
But three years after graduating from Harvard University with a degree in biology, while working as a lab technician, Puscek extended this time frame significantly. She decided to go back to college and earn an M.D./PhD specializing in oncology, which would mean at least eight more years of school. Puscek, now 25 knew she would have to hold off at least until she was in a residency program before even thinking about having a child.
“I imagine we will be having our first kid while I’m in a (residency) program somewhere,” said Puscek, who got married last February, and is now studying for the Medical College Admission Test. “We definitely wouldn't have children until I was admitted to a program and we were stationed somewhere for the eight or nine years that would take. It’s a daunting thing to think about having kids before residency.”
The dual medical and PH.D degree is among the most rigorous academic tracks – and it is especially difficult for a young woman with plans to have a family in her 20s or early 30s. Between long days in classrooms, hours on the job during residency, dissertation requirements, research, teaching, the pressure to publish, and the struggle to achieve tenure, when is there time to have and raise a child?
The answer that many women doctors and professors have found is, well, “never” – and some opt to drop their pursuit of a tenured teaching or research position at a university in favor of their family, strangling their career hopes and depriving top universities and laboratories of a substantial portion of the talent pool.
“We have internalized this idea of what it takes to be successful in this field, and that’s by staying on this particular straight, upright path, and any deviation from that path means suffering a terrible disservice to your career,” said Hannah Valantine, a physician and professor at Stanford Medical School.
Indeed, the decision by many women to choose family over profession is not just limited to medicine; virtually all women on the academic tenure track face the same challenge. This is clearly shown in the skewed employment ratios at Stanford University, which has one of the more gender-equal faculties: as of September 2011, only 26.4 percent of the school’s faculty was female, and women made up only 21.3 percent of tenured faculty, according to the Stanford Office of Faculty Development and Diversity.
Some of this disparity may be the result of discrimination against women, particularly in the sciences, which only makes the situation more untenable for female Ph.D. candidates who are postponing having children until they are tenured; in choosing to initially pursue their careers they could very well be heading towards a dead end.
“It’s kind of like other forms of discrimination that are no longer socially accepted,” said Jessica Green, 36, an Assistant Professor of Political Science at Case Western Reserve University. “You don’t see out-and out blatant statements of ‘you can’t do this because you’re a woman,’ but it’s there.”
Green just gave birth last month and is taking a semester off unpaid -- a benefit that Case Western extended despite having to offer only twelve weeks unpaid maternity leave under current federal law. But Green worries that this blip in her career will count against her at her tenure review. “I was allowed to extend the tenure clock,” she said. “The question is, when you go up for tenure, do they say, well she really took seven years instead of six (to complete requirements) and kind of sotto voce adjust their expectations accordingly.”
To navigate the tricky terrain of raising a child and maintaining a high-pressure, high-level career in academic or medical research spheres, women are often forced to come up with creative though not always fully palatable solutions.
For example, Amy Wrzesniewski, an Associate Professor at the Yale School of Management, who has a three- and a five-year old at home and is up for tenure next year, is taking advantage of the flexible hours that academia offers. “Academia is a brutal number of hours but you get to choose what hours those are,” said Wrzesniewski. “The way I worked it out was to work during crazy hours while (the children are) sleeping. For me and a lot of other people that’s been the way we dealt with it.”
Other women simply don’t take maternity leave. Kaiama Glover, a recently tenured Professor of French at Barnard College, said that when her daughter, now five, was born, she worked right through her legally permissible time off, although she was relieved of her teaching duties.
“I wasn’t up for tenure yet,” said Glover. “Looking back, I have some regret about not really being on break with the baby because of the stress and working for tenure. When you take maternity leave, the clock technically stops, but as any academic knows, taking time away from your career never really happens. Having the leave does not alleviate the anxiety…to move quickly.”
Similarly, Ashleigh Shelby Rosette, a professor at Duke’s Fuqua School of Business, says she reduced her teaching load when her twins, now aged four, were born, “but I didn’t stop my research. I just kind of slowed down. I think the internal pressure to keep working is far greater than the external pressure. You can’t turn it off. The drive you have doesn’t just peter out."
And Laurie Kohen, an attending physician in dermatology at Henry Ford Hospital in Detroit who has a two-and-a-half year old daughter and a four-month baby, said that she and other women will frequently narrow their choices and gravitate towards medical specialties with more flexible hours to balance home and work demands. “Dermatology is very woman-friendly,” said Kohen. “It’s easier to see patients on a part-time basis. It’s not as easy to do surgery on a part-time basis.”
Faced with overwhelming evidence that women are under-represented in top academic ranks and specifically in medical and scientific research and other advanced healthcare professions, Stanford’s Valantine decided to tackle this problem head-on.
“Women make up 50 percent of graduates from medical school, but they have less than 20 percent of tenured faculty positions,” said Valantine who estimated that even with a concerted effort to improve tenure opportunities for women it could take 28 years to get to a 50/50 gender ratio at full professor rank at Stanford alone. At the national level, she said, it might take 48 years. “We better do something rapidly. If we’re not drawing from our entire intellectual capital, we’re really not going to be leaders in research and education.”
After two years of planning, Valantine and Caroline Simard, a social science researcher and PhD herself, began a pilot program at Stanford this year in which participants will do self-reflection exercises to better define their life goals. After that, each student will work closely with their department chairs to plan their tenure track and careers, with the aim of creating more flexibility and a culture that nurtures it.
“We ask them to imagine what career and life is now, and try to imagine what it might be in three and ten years,” Valantine said. “You can say, I’m going gung-ho and working full time right now, but in three years, I would like to back off a little bit on my clinical role and have time to write papers, or have a child."
The initial groups at Stanford Medical School consist of 50 to 60 men and women, divided up by specialization, with between five and 20 people in each team. Importantly, each group is coached on how to talk to their supervisors about their specific home and work balance choices, without feeling defensive or, if they are taking a slower career path, inferior to their full-speed ahead colleagues. Part of the program even involves trying to arrange for baby-sitting services or home delivery of meals if necessary.
“These are the conversations not occurring, they’re almost taboo to talk about,” Valantine said.
“It’s not just a women’s issue,” she added. “It’s a path to excellence.”