The View To the Top, When You Are At the Bottom—Finding Flexibility in the Workplace of Academic Medicine and Other Rigidly Evolved Work Settings!

The academic medicine mountain is a steep climb, but the view from the top is worth the climb if you have certain goals for your professional medical life. Research, teaching and service gives you the opportunity to have impact well beyond the important, but necessarily limited, one on one physician-patient relationship. Heady stuff, but the difficult path is worth the effort. (Academic medicine does not have a monopoly on inflexibility, so think how this applies to your own challenging work place.)

An academic in medicine wants to help thousands or maybe millions of patients by teaching the next generation well. Adding to the fund of knowledge that drives what other doctors do for their patients, again reaching untold and unseen numbers. Driving policies and programs which shape the future direction of medical care. Exciting? You bet! But when you are in your early 30’s and have spent 8-11 years in the rigidly scheduled pursuit of the goal of “becoming a doctor,” these are tough to imagine as you think about having families and lives beyond the world of medicine, a very demanding world, not just for women but for everyone.

And medical school and training are almost always conducted within the rigidly scheduled academic medical centers, so you come to believe that you, too, must become rigid and unyielding to be successful in this setting.

Wrong. Only “they” (the dinosaurs who know only one way to the top) don’t know it yet. And it will not become apparent unless we (women and men who see life and work differently) demand new models. There are only so many ways a person can bend to “adapt” to these settings, which are of course, not limited to academic medicine. Institutional flexibility is critical. Academic departments need to think (and act) out of the box.

Two important facts: 1). Women are now >50% of the graduating medical school classes and 2) Both men and women of this new generation seek a balance in work and other life’s pursuits. For a multitude of reasons, everyone is seeking more flexibility. Flexibility to have families, to have spouses with work outside the home, or to have time for other life’s pursuits.

So any academic department that wants to excel and attract the best and the brightest to sustain their mission is going to have to find better ways to integrate future academicians. The changing demographics of medicine for women will be a force, when women play their advantages well. (Yes, I know that women who negotiate are less likely to get hired, but this is the part before the negotiations).

So here is the how—look for flexibility in the system you are about to enter. And if it is not there, be prepared to look elsewhere or create it yourself.

First, research your options well. Before you sign up, look around and see what kind of flexibility is built into their system. Here are some examples. Is there a parental leave, for both men and women, to have children, care for sick parents or others? What does it look like and is it on paper, or are there others who have utilized this option? Find out about the personal, make sure there is a personal.

Is everyone on a rigid schedule? Or are there opportunities to create schedules that will work with your goals and theirs? Does the OR have to start at 7:30 am? Does your patient schedule need to begin at 8 am? Does every meeting of the faculty have to be at 5 pm? The answer clearly is no, but have they discovered that yet? Productivity, effectiveness and efficiency are not synonymous or even consistent with rigidly defined time commitments.

Is the governance a shared task? Is the boss, the boss or is everyone’s voice heard? Are new ideas given their fair consideration? Is there a culture of change? What does it look like?

Sound pie in the sky? Maybe in some places it is. But in many, women are challenging the status quo, and doing it successfully. Ask the questions, again and again. And sooner or later, the guys (and in medicine it is overwhelmingly the guys) will get the idea that they are going to have to change if they want to attract the best and the brightest to their departments.

Up next: Personal flexibility options for the budding academic.