Paternity Leave’s Incision on Gender Disparities in Academic Surgery

20 Jun 2023

Title: Paternity Leave’s Incision on Gender Disparities in Academic Surgery
Authors: Mayte Bryce-Alberti1,2, Rohini Dutta1,3
Author’s Affiliations:

  1. Program in Global Surgery and Social Change, Harvard Medical School; Boston, MA, USA
  2. Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
  3. Mary Horigan Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA, USA

Keywords: Gender Equity, Work-Life Balance, Surgery
Corresponding Author Contact Information: Mayte Bryce-Alberti. Program of Global Surgery and Social Change, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115. Email: mayte.bryce.a@upch.pe.


Academic surgery demands a significant amount of training and time commitment, with many surgeons pursuing postgraduate degrees and protected research time, in addition to completing medical school and surgical residency. The gender pay gap and disparities in surgery training can be attributed in part to the disproportionate burden of childcare responsibilities placed on women, which coincides with their fertile years and presents significant challenges for them in meeting the extensive training requirements. (1,2) 

The “Mommy Tax” and the “Daddy Bonus”

Studies from other professions have consistently demonstrated that women and men are equally competitive in salary and working hours until the first child’s birth. Henceforth, women are the ones who bear the brunt of the “mommy tax” – the impact on income that results from leaving a job to take care of family responsibilities. In contrast, fathers benefit from the “daddy bonus” effect – the significant increase in income due to a perceived greater work commitment, stability, and deservingness without the actual burden of active childcare, compared to women and childless men.  (3) Consequently, negotiations for more flexible hours, part-time jobs, and reduced workloads are disproportionately undertaken by women, putting them at a significant disadvantage when competing for promotions and higher pay. (4) In the academic surgical field, better-paid maternity leave policies, flexible work arrangements, and supportive workplace cultures are increasingly being implemented. (2,5) 

Initiatives in Academic Surgery

While such initiatives are well-intentioned and necessary, they continue to place the burden of childcare on women by perpetuating the age-old notion that they should be the primary caregivers at home. To keep pace with successful initiatives from businesses and governments, a cross-continentally proven solution is the introduction of paid paternity leave. This policy has produced positive socioeconomic outcomes for men and women alike (6,7) by reducing the “mommy tax” through promoting and compensating shared parental responsibilities. 

The Benefits of Paid Paternity Leave

Examples where this policy was implemented include the governmental laws of Japan (52 weeks), South Korea (52 weeks), and Iceland (20 weeks), as well as in private companies such as Netflix (52 weeks), Gates Foundation (52 weeks), and Morgan Stanley (16 weeks). When enacted in conjunction with fair and adequate maternity leave policies, paid paternity leave when mandated by academic healthcare institutions allows women surgeons to remain in the workforce after childbirth, increasing their active participation and retention. This ultimately leads to reduced recruitment costs, a boost in staff loyalty and morale, and increased competitiveness. These policies benefit the profession by ensuring that we retain our best surgeons, regardless of their gender.

References:

  1. Rangel EL, Castillo-Angeles M, Easter SR, Atkinson RB, Gosain A, Hu YY, Cooper Z, Dey T, Kim E. Incidence of Infertility and Pregnancy Complications in US Female Surgeons. JAMA Surg. 2021 Oct 1;156(10):905-915. doi: 10.1001/jamasurg.2021.3301. Erratum in: JAMA Surg. 2021 Oct 1;156(10):991.
  2. McKinsey Global Institute. How advancing women’s equality can add $12 trillion to global growth [Internet]. McKinsey & Company; September 2015 [cited 2023 May 17]. Available from: https://www.mckinsey.com/~/media/mckinsey/industries/public%20and%20social%20sector/our%20insights/how%20advancing%20womens%20equality%20can%20add%2012%20trillion%20to%20global%20growth/mgi%20power%20of%20parity_executive%20summary_september%202015.pdf
  3. CUNY Academic Works. The Condition of Latinos in Education: A Factbook [Internet]. City University of New York; [cited 2023 May 17]. Available from: https://academicworks.cuny.edu/cgi/viewcontent.cgi?article=1034&context=clacls_pubs
  4. Acai A, Steyn C, Reid SE, Sonnadara RR. A solution to gender inequity in surgery? Better caregiving policies. Can J Surg. 2018 Feb;61(1):6-7. 
  5. Morrison LJ, Abbott AG, Mack Z, Schneider P, Hiemstra LA. What Are the Challenges Related to Family Planning, Pregnancy, and Parenthood Faced by Women in Orthopaedic Surgery? A Systematic Review. Clin Orthop Relat Res. 2023 Feb 27. 
  6. OECD. Parental Leave Systems in OECD Countries: Current Reforms and Challenges [Internet]. Organisation for Economic Co-operation and Development; [cited 2023 May 17]. Available from: https://www.oecd.org/els/soc/PF2_1_Parental_leave_systems.pdf
  7. The New York Times. Parental Leave Policies Around the World [Internet]. The New York Times; [cited 2023 May 17]. Available from: https://www.nytimes.com/interactive/2015/your-money/parental-leave-policies.html



Dr. Mayte Bryce-Alberti earned her MD from Universidad Peruana Cayetano Heredia, Lima, Peru. As a Research Collaborator at the Program in Global Surgery and Social Change, she has dedicated her time to projects focused on Rwanda and the Pan American region. Her work involves strengthening health systems, surgical education, and improving access to minimally invasive surgery in low resource settings. She is an active member of the program’s Anti-Racism Curriculum team, organizing discussions, webinars, and capacity-building sessions for program members. She will be applying for the NRMP Match 2024 to train as a general surgeon.



Dr. Rohini Dutta earned her MBBS from Christian Medical College and Hospital, Ludhiana, India. A recipient of the Women of the Future Award India in 2021,  she is committed to a lifetime of empowering women through the provision of high-quality healthcare and strengthening its provision through socially conscious frugal solutions and policies. As a Global Women’s Health Fellow at the Brigham and Women’s Hospital where she is developing an educational mHealth tool for high-risk pregnant women undergoing cesarean delivery in Uganda to enhance their birth preparedness. She is currently an MPH Candidate in Global Health at the Harvard T.H. Chan School of Public Health and is applying for the NRMP Match 2024 to train as an obstetrician-gynecologist.

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