Academic Medicine Faculty Perceptions of Work-Life Balance Before and Since the COVID-19 Pandemic
Question How is the COVID-19 pandemic associated with academic medicine faculty perceptions of work-life integration?
Findings In this survey of 1186 medical, graduate, and health professional school faculty, more faculty considered leaving since the COVID-19 pandemic than before. Faculty with children, particularly female faculty with children, were more likely to consider leaving since the pandemic.
Meaning These findings suggest that the stressors of integrating work and life are higher in female faculty than male faculty, highest in women with children, and may have been heightened by the COVID-19 pandemic.
Importance How the COVID-19 pandemic has affected academic medicine faculty's work-life balance is unknown.
Objective To assess the association of perceived work-life conflict with academic medicine faculty intention to leave, reducing employment to part time, or declining leadership opportunities before and since the COVID-19 pandemic.
Design, Settings, and Participants An anonymous online survey of medical, graduate, and health professions school faculty was conducted at a single large, urban academic medical center between September 1 and September 25, 2020.
Main Outcomes and Measures Self-assessed intention to leave, reducing employment to part time, or turning down leadership opportunities because of work-life conflict before and since the COVID-19 pandemic.
Results Of the 1186 of 3088 (38%) of faculty members who answered the survey, 649 (55%) were women and 682 (58%) were White individuals. Respondents were representative of the overall faculty demographic characteristics except for an overrepresentation of female faculty respondents and underrepresentation of Asian faculty respondents compared with all faculty (female faculty: 649 [55%] vs 1368 [44%]; Asian faculty: 259 [22%] vs 963 [31%]). After the start of the COVID-19 pandemic, faculty were more likely to consider leaving or reducing employment to part time compared with before the pandemic (leaving: 225 [23%] vs 133 [14%]; P < .001; reduce hours: 281 [29%] vs 206 [22%]; P < .001). Women were more likely than men to reduce employment to part time before the COVID-19 pandemic (153 [28%] vs 44 [12%]; P < .001) and to consider both leaving or reducing employment to part time since the COVID-19 pandemic (leaving: 154 [28%] vs 56 [15%]; P < .001; reduce employment: 215 [40%] vs 49 [13%]; P < .001). Faculty with children were more likely to consider leaving and reducing employment since the COVID-19 pandemic compared with before the pandemic (leaving: 159 [29%] vs 93 [17%]; P < .001; reduce employment: 213 [40%] vs 130 [24%]; P < .001). Women with children compared with women without children were also more likely to consider leaving since the COVID-19 pandemic than before (113 [35%] vs 39 [17%]; P < .001). Working parent faculty and women were more likely to decline leadership opportunities both before (faculty with children vs without children: 297 [32%] vs 84 [9%]; P < .001; women vs men: 206 [29%] vs 47 [13%]; P < .001) and since the COVID-19 pandemic (faculty with children vs faculty without children: 316 [34%] vs 93 [10 %]; P < .001; women vs men: 148 [28%] vs 51 [14%]; P < .001).
Conclusions and Relevance In this survey study, the perceived stressors associated with work-life integration were higher in women than men, were highest in women with children, and have been exacerbated by the COVID-19 pandemic. The association of both gender and parenting with increased perceived work-life stress may disproportionately decrease the long-term retention and promotion of junior and midcareer women faculty.
The COVID-19 pandemic has altered the ways we live and work with far-reaching impacts on all sectors of society. In the United States, 9.8 million jobs were lost between February and December 2020.1 This job loss has disproportionately affected women, who accounted for 46% of the prepandemic workforce but have experienced 54% of pandemic-related job losses.2 Structural inequalities further affect parents who have significantly increased their time spent on household and childcare duties by an additional 27 hours per week.1 This change has disproportionately affected mothers of young children, who have experienced a 4- to 5-fold decrease in work hours than working fathers since the pandemic.3
The COVID-19 pandemic has not spared the field of medicine, magnifying both the unique and universal stressors faced by physicians and medical scientists. Even before the pandemic, the US health care system had put a great deal of stress on health care workers through systems of high workload, high administrative burdens, inefficiency, emphasis on high productivity, and a culture of constant availability.4,5 Gender differences in pay parity, promotion, and work distribution have unevenly affected female physicians, leading more female physicians to reduce their working hours to part time or leave the field of medicine entirely.6 In academic medicine, women were already underrepresented in senior leadership positions before the pandemic. Although women make up 41% of all full-time academic medical school faculty, they account for 18% of academic chairs, 18% of deans, and 25% of full professors.7 The COVID-19 pandemic threatens to cause a regressive effect on the positive trends in gender equity and success in academic medicine unless action is taken.
To better understand how the COVID-19 pandemic is associated with faculty work-life conflict within our large urban academic medical institution, we conducted a campus-wide faculty survey to evaluate the perceived stress of the pandemic and maintaining work-life balance has affected faculty intention to leave, consideration of reducing their employment to part time and turning down leadership opportunities.
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