This report summarizes findings from a baseline survey of faculty in the first phase of a study of the SOM, SVM, and CBS at UCD. Notably, we found that awareness of family-friendly policies and the details of their implementation is low at all three schools, even though the CBS was included in a career-flexibility accelerator intervention funded by ACE and the Alfred P. Sloan Foundation and the SOM has developed and promoted a program taken as a model by other UC-system medical schools. Use of the policies has been very low, whether assessed by self-report or by direct report from the Deans' personnel databases. Women were more aware of and made more use of the policies than men, and assistant professors were more aware and made more use than those at higher ranks. This likely reflects the interest in and need for family leave for pregnancy, most commonly among younger women faculty.
Lack of awareness is one obstacle to use of family-friendly policies, but our survey identified numerous other self-reported barriers. A significant number of faculty reported choosing not to request family-flexible accommodations, and this is more common among women than men in SOM and SVM. This difference was not observed in CBS and may reflect a different attitude or work-life culture in healthcare academic careers than in those in science. This could also be related to patient care obligations, including on-call responsibilities, and to differences in compensation plans. In all three schools, a substantial percentage of faculty who did take time off reported not taking as much time as they wanted. In the SOM and SVM, significantly more men than women would have wanted to take more time off than they did. This may reflect perceived biases against time off for men, discomfort with taking time off, concerns of being stigmatized, or institutional culture. The reported barriers to using policies were generally similar across schools, although more women than men in SVM and CBS cited financial reasons for not taking time off. Women in all schools reported more concern than men about the undue burden on their colleagues, heavier service load, other repercussions in their departments, obligations to grant-funded research, or slowing career progress.
Our survey also indicated that absence of career flexibility affected women much more significantly than men, particularly for SOM faculty. SOM women were much more likely to report remaining childless or having fewer children than they desired. A lower percentage of women reported having children living at home, even though equal numbers of men and women reported being married or in committed relationships, and more women than men were<age 50.
Our findings for the SOM are consistent with previous studies that have tracked the impact of professional careers on professional women. In a 20-year longitudinal study of 160,000 Ph.D. candidates, compared to men, women were less likely to be married with children, reported having fewer children than desired, and were more likely to report remaining single because of their career.19
Women who had children early were more likely to remain nontenured than their male counterparts. Interestingly, women faculty in CBS and SVM did not demonstrate these same gender disparities. This may reflect the success of the campus's long-standing family friendly policies in CBS and a uniquely supportive culture in SVM where the majority of students and higher proportions of faculty are women.
We wish to emphasize that family-friendly policies are not just a women's issue. Our study found that more than half of men and women faculty have children<age 18. Faculty of both genders show a strong interest in on-site child care, and similar and substantial percentages of men and women report other significant family responsibilities. A strong majority of men and women in all schools in our study reported increased satisfaction just knowing that these policies exist and that they might need to use them in the future. In addition, reports on generational differences, including those specific to academic medicine, emphasize that work-life balance and family time are particularly important to both men and women of the younger generation.25–28
This priority is anticipated to have a growing effect on medical faculty career satisfaction, recruitment, and retention.29–37
As a result, the AAMC's recent faculty satisfaction survey (COACHE) included a strong emphasis on work-life balance and career flexibility to aid schools in evaluating these issues.
Our study has some limitations. The response rates among the three schools ranged from 42% to 52%, leaving open the possibility of substantial response bias. However, our response rates are on the high side of typical for such studies,38,39
and the respondents were broadly similar to the faculty composition of the three schools in age, gender, academic rank, and series. The survey we used for this study did not use skip logic or branching, as this was not a functionality in Survey Monkey for the scenarios posed in the surveys. Therefore, every faculty member was provided the opportunity to answer every question on both awareness and usage. We found some discrepancies between the Deans' personnel records on use of family-friendly policies and self-reported use. This may reflect a difference in periods covered (just the most recent 3 years for the Deans' data but the last 10 years in the survey) or misinterpretation by faculty of whether time off was in fact credited to family-friendly leave rather than to vacation or sick leave.
Our study, despite some limitations, offers considerable strength in its broad pattern of response across all ages, both genders, and university ranks. Another strength is the ability to compare across two health science schools and a biological nonhealth science school, all having access to a broad array of family-friendly policies. Our findings strongly confirm that family-friendly career flexibility policies are important personally to faculty of both genders and that faculty believe that this will improve recruitment, retention, and satisfaction. Our study also indicates the need for further education of faculty to increase awareness and for education of chairs, department managers, and administrative staff so that they can better support faculty, provide correct information, and participate in enhancing a culture that acknowledges and accepts the importance of work-life balance and the many obligations faculty members juggle in their lives. The written comments included with the survey demonstrate the emotion and profound effect caused by lack of use and knowledge. Differences between men and women were observed regarding barriers and effects on family, but secondary analyses suggested that awareness and interest might vary by age group. More detailed study of the interrelationship among gender, career stage, age, and faculty setting (school, series of appointment) may help to elucidate barriers either in awareness or in implementation that offer the potential for targeted interventions.
Our findings can provide important insight into similar issues at other US schools of medicine. Our next steps are to implement an Accelerator Intervention in the SOM that is designed to increase awareness and use of policies. Tools will include a dedicated family-friendly policy and career flexibility brochure, a new website for the SOM linked to other relevant school and campus sites, and dedicated presentations, workshops, grand rounds, faculty meetings, internal media, and materials for new faculty orientation. In addition, we will examine the interrelationship among age, gender, and career status to identify barriers to awareness or use that may suggest targeted improvements. We will be resurveying faculty on an annual basis for a total of 3 years to assess change in awareness and use. Furthermore, we plan to examine the effect of awareness/use on merit and promotion actions and career satisfaction over a 3-year period. Lastly, we hope to explore success model(s) that define personal and professional characteristics affecting performance, awareness, use of options, and satisfaction. This will include working closely with the SOM leadership to address faculty expectations and additional improvements for fathers, singles, lesbian, bisexual, gay, and transgender (LBGT), and others. Other schools of medicine may want to consider similar efforts in order to ensure a vibrant, productive, and satisfied faculty workforce.