COVID has obliterated Work-Life Balance and exposed Gender Inequalities

13 May 2020

By Pam Choi

The COVID era has brought forth unprecedented times. Schools are closed, and clinics/elective cases are canceled. As a result,  many of our schedules have changed. We were still taking the same amount of call, but we were not coming into the hospital as frequently.

“My workout schedule is great.” My male surgery colleague exclaimed. I looked at him blankly. We were the same level. He was a father with 2 young children. But his wife was still home from maternity leave, and his mother-in-law and au pair were also still with them.

I, on the hand, had put on some weight during this time.

At baseline, professional women still do more household work than professional men. But COVID has skewed the entire work-life balance and destroyed the childcare equilibrium we had had in place before, making the gender inequalities even more apparent.

To be fair, my husband, who is a software engineer and works from home, has taken the brunt of home-schooling activities. When I am at work in the hospital, which is still most of the time, he is the one who is struggling to figure out how to work and teach/entertain our son at the same time. As such, we had generally agreed that when I was “working from home”, I would try to help out and take care of our son. But ultimately, even when I am at home, I also still have work to do.

This is how I work from home. I still get up at 0500 because that is the only time I have to myself to work until 0700. In the last few days, I’ve submitted an abstract, finished a case report, a Grand Rounds presentation, and worked on some surgical Committee tasks. But I am also trying to teach 2-digit addition subtraction, the difference between noun and verb, and keep our 6-year old from climbing the walls. 

Even at this very moment, I am “working from home.” But I’m also doing laundry, trying to finish a manuscript, trying to finish this AWS blog essay, and also trying to get my son to sit down and finish his math problems. Frankly, I feel like I’m doing a terrible job at everything (except for the laundry- at least I know how to do that). The quality of my work has suffered. And my son and I have had more arguments now than we’ve ever had before. I’ve literally just sent him to his room because he was trying to draw on the table.

Overall, it’s not a great feeling.

“Self care” is easy to say, harder to do. But why does it seem all that much easier for my male colleagues to do?

As I had said before, these times are unprecedented. The situation is unique- such that we haven’t outsourced some of the household work or childcare/teaching as we would typically do if not for the Pandemic. It’s not really anybody’s fault, per se. It’s just exposing the gender inequalities that were there all along.

Pam Choi (@pmchoi) graduated medical school at the University of Rochester and completed general surgery residency at Washington University in St Louis. While in St Louis, she met her awesome husband, Nick, and had their son, Calvin. After residency, she was the ship surgeon for an aircraft carrier as an active duty Navy officer. She is presently the senior pediatric surgery fellow at Children’s Mercy Hospital in Kansas City. In her free time, she enjoys eating, conquering Escape Rooms, and visiting National Parks with her family.


Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

8 Replies to “COVID has obliterated Work-Life Balance and exposed Gender Inequalities”

  1. I fully agree. I am a PGY5 general surgery resident. I readily admit my husband does more primary child care than I do solely due to the fact that he is physically at home more. But my working from home versus his working from home are drastically different. I have to study for boards, prepare for cases I am lucky enough to be doing now, try to work on research. It is nearly impossible for me to do these things at home. When I hear discussions from male colleagues, I do not hear the same struggles, in part because they have additional help (nannies/au pairs/babysitters/family) and we were day care dependent, and partly I believe because the gender role of “mom is home” is not the same thing as “dad is home.” Dad seems to have legitimate work to do. Mom is just ignoring her kid somehow.

    I don’t know how to make this better. But I can tell you that you are not alone.

  2. Women need to learn to outsource. We have the resources to outsource.
    We do not need to do this all ourselves. Neither do our husbands.

    I am a colorectal surgeon, I have an extremely busy oncology practice. Thankfully it maintained at approximately 60% throughout this pandemic. 40% extra time for me. I have a husband who is 17 years older than me. Is a creative genius but currently not contributing financially secondary to a very bad divorce (financially & otherwise) and due to the fact that he should be retiring and enjoying life.
    We have two children. 4&9 years old.

    I do not homeschool my 9 yr old. He also does not.
    We have a full time live in nanny, a personal assistant (who also lives with us and does the homeschooling with my challenging 9 yr old son) and 2-5 additional young people from different countries who work in our home giving us 25 hrs of free work for room and board.
    They are called workaways. Look up workaway.info.

    My husband and I also don’t make dinner, do the laundry, wash the dishes or clean the house.

    We do what we want to do; what we think is good for our children. We try to spend quality time with them and have set up our lives so that we can do what we love and not feel overwhelmed by laundry. It’s not perfect, but it allows me to work more than my male colleagues. Which I choose to do because I love my work and am well compensated for it (no gender inequality there). I also have been increasing my workouts and doing between 7-12 hours of Pilates a week since this pandemic.
    My 4 year old daughter now asks me a series of questions before bed. Are you working tomorrow? Are you on call? When are you doing Pilates?

    Why can’t busy women have additional help? Certainly more difficult for residents. I truly feel for surgical residents and couldn’t have had children during residency. You are truly amazing. It does get better. Apparently children with mothers who work are more successful later in life.

    As female surgeons there definitely are gender inequalities, but we need to find solutions to these inequalities.

    I truly believe they exist.

  3. I disagree with this. I’m a surgeon and I decided not to have kids because of the challenges inherent in balancing being a surgeon and a parent. My father was a doctor and wasn’t home much when I was growing up. He was ok with that. I would struggle with it. Whether you’re a mother or a father, you decide how much of a parenting role you take on just as your spouse does. If you don’t get help, the imbalance you perceive in a motherly versus a fatherly role is created by the collective parenting model you have made with your spouse. Blaming men for prioritizing their other interests because you haven’t isn’t fair. We’re all responsible for creating gender roles. I totally don’t buy into the whole ‘baby needs Mommy more than Daddy’ mentality. Women probably are more to blame than men for creating and perpetuating that idea which in itself can be viewed as sexist. The most successful doctor families I’ve seen have a lot of help. The job is demanding. Without help you’re left to juggle too much and both work and home life suffer. COVID or not, sounds like you need more help. When you’re one step away from chaos, you don’t have a big enough safety net in place. Don’t blame it on gender inequality. We have enough legitimate battles to fight in that arena that don’t revolve around not having adequate child care when you decide to have a career. That’s on you. I’ve watched friends and colleagues struggle. The ones who have been happy at home and work have multiple people helping them raise their children. It won’t get better when you’re out of residency so start recruiting now.

  4. It absolutely takes a village. Also please understand that the village is critical through most, if not all, of high school also. High school is where your child is more independent but also definitely needs to know that they are not expected to figure out everything on their own. It was crucial during high school for my daughter to know that I understood many of her challenges and that I (and her sitter until age 16) was available to help her.
    With regards to the gender biases of work expectations at home, I submit that men do what they want to do first because we/the world let them. We all know as surgeons that we cannot get away with what the men get away with at work. But we also know how to seek help.

  5. “ There are only 24 hrs in a day. Choose wisely “ This is what I was told in fellowship over a decade ago – and I agree. I am a orthopedic hand surgeon with three kids. It takes a village. And a great spouse. And a lot of realizing things will get done – maybe just not exactly the way you wanted them to. Be good to your kids; be good to your spouse and be good to yourself. If all else fails dump the laundry on the couch and let everyone forge for themselves. When all else fails ask for help – my boys and husband are way more capable than I have given them credit for.

  6. I went to medical school as an older student (38) with 2 children, then 10 and 8. I then did a 5 year residency and became an orthopaedic surgeon. I am now retired but—I couldn’t have done what I did, particularly the 2 years of pre-med classes that were at 6P (dinner hour) with then 6 and 8 year old children with busy after school programs without the support, encouragement and major help from my husband. He learned to cook so everybody could eat and took over a lot of responsibilities that I had done before. We did have someone else in the apartment 5 days a week during the day so my husband could work also—and pay for my education—but there is no way that I would have been able to do what I did without him. A lot depends on how you and your husband discuss everything and make the necessary arrangements. I do agree that some things just seem to be the woman’s responsibility to do but it doesn’t have to be overwhelming. My children also learned not to disturb me when I was in pre-med and medical school if I was studying.

  7. I was train in two countries and never witnessed gender equality simply because men and we men are so different. But I do agree, COVID did show these differences more sharply. I am a trauma/critical care surgeon and a single mom of 14 years old boy. My nanny who helped me in none-COVID times left me, some of my neighbors start treating me as a plaque since I am working in ICU including COVID patients. At the end of the day, I realized that I am much stronger than I expected. But I wish I did not have to find this out.

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