A Mind-Bending Thought: Career Flexibility in Academia

By Amparo Villablanca, MD, and Lydia Howell, MD

Is your academic health center a place that talented individuals want to join, and where they want to stay and grow their careers? We would all like to think that “yes” is the obvious answer to these questions. But the expected shortage of physicians continues to widen, and competition to recruit and retain faculty will become even more difficult.

These challenges are compounded by changing expectations about work and family, particularly among the younger generations of physicians. As physicians, educators, and researchers in our respective fields, we have experienced challenges related to work–life integration in our own careers, and we’ve seen our colleagues struggle to deal with these, too. We both have developed a considerable interest in strengthening work–life policies to recruit and retain talented faculty in academic medicine. We are co-PIs on an NIH grant to study attitudes, awareness, and use of career-flexibility policies at UC Davis and how these factors influence career decisions and satisfaction, especially for women.

Our work is pertinent to all academic medical institutions. We want to share our findings to date in this post and prompt our AAMC colleagues to think about this issue, too. We strongly believe that an academic workplace that provides sufficient flexibility can have a competitive advantage in attracting and retaining top talent. Other industries have already found significant benefit from work–life career flexibility programs, including major cost savings, decreased turnover, and increased productivity.

As recently published in the American Journal of Medicine, our faculty survey revealed a high level of support for career flexibility policies among all generations and genders, which surprised us: Many policies address childbirth and childcare that don’t frequently pertain to individuals over age 50, particularly men. This high level of support likely reflects concern for younger colleagues based on the older generation’s challenging experiences during the early part of their careers. Additionally, a large majority of respondents agreed that having family-friendly work–life balance policies increased their career satisfaction, including a large percentage of all generations and genders who reported that they might use these policies in the future.

Interestingly, younger men and older women emerged from this survey as at-risk for work–life conflict. These two groups reported the lowest satisfaction with flexibility policies and the lowest use. We hypothesize that young men may be experiencing conflict surrounding traditional male cultural roles as high-achieving primary breadwinners and the younger generation’s value that men play greater roles as fathers and partners. Likewise, many older women are juggling their career responsibilities with the needs of adult children who are not yet independent, or as caregivers for elderly parents. Comments associated with our survey indicate members of the faculty are concerned about negative bias and repercussions by colleagues or leaders who might not understand these needs. We plan to further explore these issues to improve flexibility policies, perhaps leading to paternity leaves, support for eldercare, or other options.

Flexibility policies are clearly not enough. UC Davis’ career flexibility policies were implemented campuswide in 1988 and updated in our school in 2004. They provide generous leaves for births, adoptions, and illness of loved ones, personal disability, plus tenure clock stoppage and extension. Our institution also provides flexible work hours and distance technologies to support work from afar. Despite these many opportunities for flexibility, few individuals are utilizing them. Our research demonstrated a variety of perceived barriers, including concern about over-burdening colleagues, particularly among women. Academic institutions must therefore establish a culture that fosters support for work–life flexibility. We are working with school leaders to get the word out that policy use is provided as a benefit to all faculty, and that colleagues are supportive. In just the first year, we have seen a significant improvement in attitudes and reduced concern about barriers.

We hope that our work at UC Davis will reveal successful strategies for supporting flexibility and work–life integration that will be applicable to your own institution. As the premier organization in academic medicine, the AAMC has an important role in addressing career issues like this, both on the individual and institutional levels.

There are many facets to optimizing recruitment and retention in science and medicine. Are we, as an enterprise in innovation, considering family-friendly and career flexibility options as strategically as business and industry to optimize our success? Should the AAMC play a larger role in this area? Please share your comments to this blog. We look forward to an active discussion of these important issues with our peers.

—Amparo Villablanca, MD, is a professor of cardiovascular medicine at the UC Davis Health System. She can be reached at avillablanca@ucdavis.edu.

—Lydia Howell, MD, is the chair of pathology and laboratory medicine at the UC Davis Health System. She can be reached at lydia.howell@ucdmc.ucdavis.edu