Does this get any easier?Work-life strategies

Lauren Ferrante, M.D., M.H.S.

Assistant Professor of Medicine

Section of Pulmonary, Critical Care, and Sleep Medicine

Yale School of Medicine

@LFerranteMD

I have nothing to disclose.

Within the last 12 months I have not had any type of financial arrangement or affiliation with commercial interests related to the

content of this continuing education activity that requires disclosure.

DISCLOSURE

Funding: Beeson award NIH/NIA (K76 AG057023)

I do not have all the answers, but hopefully some of this will be helpful

DISCLOSURE #2

Work Life

Life

Life

Life

“Work-life balance” implies that work

and life are always at odds

Reality: you are adding another gear to life and they all have to work together

Important work and life milestones often happen in fellowship

and the early faculty years

Start clinical PCCM

fellowship. Start data

collection for 1st study

1.5 months later -Master’s program & Geriatrics Research

fellowships begin (while still in clinical

fellowship)

Started writing my 1st paper while working on 2nd project

-Pulmonary Boards

- 3 grant applications

- 1st publication Graduation

First

faculty job

• In 2017, for the 1st time, the majority of first-year medical students in the U.S.

were women

• Nearly half of all physicians are married to other physicians

• Most of what I am about to discuss applies to all dual-professional households

where one partner is a physicianFerrante and Mody, JAMA 2019

Dyrbre, J Am Coll Surg 2010

Relman AS, NEJM 1989

Professional Challenges

• Mismatch in career stages

• Moving often required for residency, fellowship, first job

• The “couples’ match” only works if in same career stage – but it works

• NRMP 2018: 1082 couples matched (95.8% success rate; remainder of applicant pool with a similar, 96.1% success rate)

• Timing of the hiring process

• Dual-academic, one academic/one private

• Academic physicians may feel pressure to move for promotionGirod et al, J Am Coll Surg 2011

2018 Main Residency Match, NRMP, accessed 5/10/19

Personal Challenges

• Fellowship/early faculty – often peak childbearing years

• Balancing childcare and work-related duties: may disproportionately affect one partner, with potential implications for gender equity

• NIH K-awardees 2006-2009: Women with children spent more time on domestic activities than their male counterparts & were more likely to take time off for childcare

• Making “professional adjustments” and taking time off for sick childcare also found in a survey using census data and a study of surgeons, respectively

Jolly, Ann Intern Med 2014

Ly, Ann Intern Med 2018

Dyrbye, J Am Coll Surg 2010

What institutional and individual strategies might help improve work-life integration?

Institutional Strategies

• Parental leave policies that are equal for men and women• And ideally more generous than the usual 6-8 weeks

• And that “prorate” clinical service requirements to account for parental leave

• Onsite childcare with extended hours

• Sick childcare• Many lost work hours, and almost never addressed

• “Tandem recruiting” for dual-academic couples

Putnam et al, Acad Med 2018

Girod et al, J Am Coll Surg 2011

Individual strategy: Be organized

Have a system for:1. Scheduling work & family obligations in your calendar –

including spending time with your partner2. Aligning call schedules3. Deadlines4. Emails5. Reviewing literature (i.e. Web of Science alerts EndNote

sync works well)6. Important paperwork related to home and children

Perlman et al, Acad Med 2015

Individual Strategy: Set priorities

• Learn to say “no” graciously

oWomen and underrepresented minorities may have to do this more often (aka the minority tax)

• Don’t get distracted by email!

• Figure out your/your family’s priorities & schedule accordingly

oEx. Our family eats dinner together every night, even if it means we eat at 7/7:30pm

oEx. No work at home during certain hours (e.g. dinner-bedtime)

Saying “no” and setting priorities

can be challenging

Individual strategy: Ask for (& maybe pay for) help

• Childcare assistance

• Outsource simple but time-consuming domestic tasks (e.g. housecleaning) if financially feasible

• Maintain open communication with your partner about goals, challenges, and deadlines

• At work: a near-peer support system is invaluable

Perlman, Acad Med 2015

Ferrante and Mody, JAMA 2019

Questions/Comments?Strategies to share?

Informal poll of work-life strategies/thoughts from the past day at CCCF:

• Scheduling time with your spouse as a calendar appointment

• Scheduling your own wellness priority (real examples included running, watching football, playing golf, reading books)

• Starting a “chocolate drawer” in your ICU where you can go if you’re having a rough day (~Sunnybrook faculty)