Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Don’t make me choose between motherhood and my career

Anonymous
Physician
August 22, 2019
2K Shares
Share
Tweet
Share

A debate highlighting gender discrimination in medicine currently rages within the pediatric hospitalist medicine community.

The debate centers on the board certification process for “grandfathering” for the new pediatric hospitalist subspecialty which effectively excludes women on the basis of motherhood.

For those not familiar with “grandfathering in,” this is the process by which a new subspecialty may grant board certification to physicians who have been practicing in the specialty. The alternative option for obtaining board certification in pediatric hospitalist medicine (PHM) is completing a two-year fellowship. For physicians already practicing PHM, completing a fellowship means completing training for a job they already perform and may even teach to PHM fellows. “Grandfathering” is time-limited — in the case of pediatric hospitalist medicine, four years of uninterrupted practice must occur between 2015 to 2023 in order to qualify. Unfortunately, only within the last month has the American Board of Pediatrics (ABP) made it clear that maternity leave will be considered a practice gap, rendering an applicant ineligible for “grandfathering.”

Pregnant pediatric hospitalists and those who have recently had children are terrified and angry that their career plans, which many have been working towards for half their lifetimes, are now being crushed by an arbitrary rule that discriminates on the basis of motherhood. Many who were denied on the basis of motherhood submitted appeals (which were reviewed by a group of pediatric hospitalists who refuses to be identified) and also denied.

Because physicians completing training are usually in their 30s, women in pediatric hospitalist medicine are now being forced to choose between having a family or completing four years of uninterrupted practice to become board certified in pediatric hospitalist medicine. This is a distinctly different process than any other part of training (medical school, residency, fellowship) where there are allowances for time off to have a baby.

Some physicians within PHM incorrectly insist that board certification isn’t necessary to practice, but job postings, interviews, and even insurance companies are already asking about board eligibility.

Current pediatric subspecialties (cardiology, infectious disease, gastroenterology, and the relatively newer subspecialty of pediatric emergency medicine) also increasingly require board certification in the subspecialty in order to practice. One rationale for board certification in pediatric hospitalist medicine was to ensure that pediatric hospitalists had the same opportunities for leadership as physicians in other subspecialties. With the current gender gap in both leadership positions and pay within medicine, what does this say about the ABP’s commitment to women in leadership?

Ironically, this exclusion is occurring at the hands of a specialty that advocates for the health of children and families.

The problem reaches deeper than the specialty of pediatric hospitalist medicine. The process for grandfathering in other subspecialties has also included a requirement for continuous practice, although it is unclear whether maternity leave was allowed. Requiring continuous practice for board certification inherently contains a gender bias. Biases are often unconscious, and rules are often built around the unconscious assumptions of the rule-makers. In the 1970s, the law was that a woman could not open a credit card in her name or work overtime because of the assumption that women stay home with the children, and men work.

The assumptions, in this case, are that pediatric hospitalists are not women of child-bearing years and that maternity leave constitutes an unnatural and unnecessary break from clinical practice.

These rules may reflect outdated ABMS rules on grandfathering in new subspecialties. If that is the case, this is a call to action for the house of medicine to change its rules to reflect the current climate of the medical era, a climate in which over half of medical students are now female.

From a historical perspective, though the women’s rights movement changed the day-to-day roles that women played in society, the laws in the 1970s reflected the climate of a generation prior. Changing those laws, by Ruth Bader Ginsburg and others, meant first convincing people that bias against women existed and then convincing people that the laws or rules needed to reflect the current state of society.

“The court should never be influenced by the weather of the day, but inevitably, they will be influenced by the climate of the era.”
– Paul Freund

The climate of this new era of medicine is one in which more female physicians than men are entering practice. The rules or “laws” were made in a different era or made by physicians who practiced in a different era, one in which there was never any consideration for maternity leave because the physicians were all men. The climate of medicine has changed — it is time for the rules to change with it.

The author is an anonymous physician.

Image credit: Shutterstock.com

Prev

Who should advocate for older patients in the hospital?

August 22, 2019 Kevin 0
…
Next

Tell your patients these family health tips when they're headed to a theme park

August 22, 2019 Kevin 0
…

Tagged as: Hospital-Based Medicine, Pediatrics, Practice Management

Post navigation

< Previous Post
Who should advocate for older patients in the hospital?
Next Post >
Tell your patients these family health tips when they're headed to a theme park

More by Anonymous

  • Do residents deserve the title of physician?

    Anonymous
  • Breaking down barriers: How technology is improving diabetes management in underserved communities

    Anonymous
  • The patient who became my soulmate

    Anonymous

Related Posts

  • How social media can help or hurt your health care career

    Health eCareers
  • After the pandemic, would I choose medicine again?

    Sarah Becker
  • Pursuing a career as a physician: A reminder why

    Sangrag Ganguli
  • Medical schools should improve long-term career counseling

    Akhilesh Pathipati, MD
  • Facing the pressure to choose a specialty

    Jamie Katuna
  • 3 steps to gain expertise early in your medical career

    Stephanie Wellington, MD

More in Physician

  • Dr. Glaucomflecken for president!

    Aaron Morgenstein, MD & Amy Bissada, DO & Corinne Sundar Rao, MD
  • What is driving physicians to the edge of despair?

    Edward T. Creagan, MD
  • Do residents deserve the title of physician?

    Anonymous
  • When an MBA degree meets medicine: an eye-opening experience

    Arthur Lazarus, MD, MBA
  • The hidden gems of health care: Unlocking the potential of narrative medicine

    Dr. Najat Fadlallah
  • The dark side of immortality: What if we could live forever?

    Ketan Desai, MD, PhD
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • Breaking the stigma: Addressing the struggles of physicians

      Jean Antonucci, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • The pros and cons of using ChatGPT for your health care needs

      Liudmila Schafer, MD | Tech
    • Dr. Glaucomflecken for president!

      Aaron Morgenstein, MD & Amy Bissada, DO & Corinne Sundar Rao, MD | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Do residents deserve the title of physician?

      Anonymous | Physician
    • A new era of collaboration between AI and health care professionals

      Harvey Castro, MD, MBA | Tech
    • When an MBA degree meets medicine: an eye-opening experience

      Arthur Lazarus, MD, MBA | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Coffee and Heart Function; Ionizing Radiation and CVD
  • Health Inequity Should Be Labeled as a 'Never Event'
  • Healing the Damaged Nurse-Physician Dynamic
  • Doc Moms, Mind the Gap -- $3M Earning Difference by Sex
  • Clinical Note Writing App Powered by GPT-4 Set to Debut This Year

Meeting Coverage

  • Switch to IL-23 Blocker Yields Deep Responses in Recalcitrant Plaque Psoriasis
  • Biomarkers of Response With Enfortumab Vedotin in Advanced Urothelial Cancer
  • At-Home Topical Therapy for Molluscum Contagiosum Gets High Marks
  • Outlook for Itchy Prurigo Nodularis Continues to Improve With IL-31 Antagonist
  • AAAAI President Shares Highlights From the 2023 Meeting
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • Breaking the stigma: Addressing the struggles of physicians

      Jean Antonucci, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • The pros and cons of using ChatGPT for your health care needs

      Liudmila Schafer, MD | Tech
    • Dr. Glaucomflecken for president!

      Aaron Morgenstein, MD & Amy Bissada, DO & Corinne Sundar Rao, MD | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Do residents deserve the title of physician?

      Anonymous | Physician
    • A new era of collaboration between AI and health care professionals

      Harvey Castro, MD, MBA | Tech
    • When an MBA degree meets medicine: an eye-opening experience

      Arthur Lazarus, MD, MBA | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Don’t make me choose between motherhood and my career
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...