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[Tension between being a Physician and Mother: A Qualitative Interview Study on Structural Barriers to Re-entry into
Sandra Decker1, Jan Gehrmann1,2, Frederike Kneissl1
1Institut für Allgemeinmedizin und Versorgungsforschung, Department Clinical Medicine, TUM School of Medicine and Health, Technische Universität München, München, Deutschland.
Background:
The increasing proportion of female physicians, combined with the emerging shortage of medical professionals, makes the reconciliation of family responsibilities and medical work a central issue for healthcare systems. Returning to work after maternity leave poses substantial structural and organisational challenges for female physicians.
Objective:
This study examines factors that facilitate or hinder the return to clinical work of female physicians with children, as well as existing opportunities to improve compatibility of family and professional life.
Methods:
Twenty semi-structured, guideline-based interviews were conducted with female physicians working in inpatient and outpatient settings. Data were analysed using Mayring's structuring content analysis.
Results:
Four key factors were found to shape the re-entry experience: (1) institutional conditions, such as the availability and suitability of childcare; (2) organisational structures, particularly flexible working hours and duty schedules; (3) team and leadership culture, including appreciation, integration, and understanding of family responsibilities; and (4) regulations governing residency training, especially regarding crediting of training periods, duration of training, and disadvantages in rotation or position allocation. A lack of structured re-entry processes and uncertainties regarding legal frameworks further increase the burden. Many physicians report role conflicts, mental strain, and doubts about long-term compatibility, which may lead to delayed re-entry, changes in specialty, or considerations of leaving clinical practice.
Conclusion:
The findings demonstrate that work-family compatibility in medicine is primarily a structural challenge that requires structural solutions. Family-friendly working models, reliable childcare, supportive leadership cultures, and flexible training regulations are essential levers to facilitate re-entry and sustainably counteract the shortage of physicians.
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