In just a few weeks, I am presenting a poster at the Association of American Medical College’s (AAMC) Physician Workforce Research Conference – perhaps a bit of an unusual meeting for a cytopathologist to attend. But in addition to cytology, I have a considerable interest in the healthcare workforce and in particular, on how generational and gender differences and career flexibility can contribute to recruitment and retention. This is a topic that is pertinent to cytology and laboratory careers, too. In fact, a large number of fields are showing interest in career flexibility. For many years, the Alfred P. Sloan Foundation has provided grants to promote workplace flexibility in a variety of industries, including academia and the private sector. A flexibility competition for medical schools sponsored by Sloan Foundation is currently in progress. Additionally, a UC Davis colleague and I are co-PIs on a NIH grant to study attitudes, awareness and use of career flexibility policies and how this can influence careers in academic biomedical science, especially those of women.
The work that I am presenting at the upcoming AAMC conference focuses on academic biomedical careers, but I believe that our findings are also pertinent to the entire spectrum of healthcare professionals, including those outside of academia. It therefore occurred to me that it might be worth sharing our findings in this blog and prompting ASC members to think about this issue, too. There is growing concern about the national dearth of healthcare professionals of all types. The AAMC is predicting a physician shortage, including pathologists, and there is already a shortage of clinical lab scientists. Maldistribution of healthcare professionals further aggravates these shortages. The closure of many cytotechnology schools in recent years will likely create growing cytotechnologist shortages and enhance the geographic maldistribution of cytotechnologists that already exists – a phenomenon we are already experiencing in California and the West where there are very few cytotechnology training programs. Though new screening guidelines and technology may change the number of cytotechnologists required to meet national needs and some of the work that they do, a need for cytotechnologists is still anticipated. Further impacting the cytology workforce – both pathologists and cytotechnologists — is the observation by many that the younger generation is choosing to work differently, and that they place a higher value on family, career flexibility, and work-life balance than their predecessors. This is likely due to the different roles each gender is assuming at work and at home. The Families and Work Institute (FWI) reports that more young men are assuming household and childcare duties than their counterparts 30 years ago, and more women want jobs with responsibilities similar to men11. Balancing these demanding work and family roles is creating new stresses and conflicts for both genders.
Making your laboratory a place where talented individuals want to come – and where they want to stay – to grow their careers will therefore be increasingly important. A workplace that provides sufficient flexibility can have a competitive advantage in attracting and retaining talent since employees can more easily fulfill their aspirations related to work and family. Opportunities for flexible or non-traditional work hours, distance technologies to support work from afar, and generous leave policies for births, adoptions, illness of loved ones, and care of elderly parents can all make a big difference in employees’ ability to manage their personal and professional lives. UC Davis’ faculty policies have been present since 1988 and were updated to better address medical school needs in 2004. Policies to support flexibility also exist for UC Davis staff. In a recent survey of our faculty, we found a high level of support for career flexibility policies among all generations and genders, which surprised us since many of the policies address childbirth and childcare that don’t frequently pertain to individuals over age 50, particularly men. We believe this high level of support represents genuine concern for younger colleagues based on the older generation’s own challenging experiences during the early part of their own careers. Notably, a very large percentage of older survey respondents, once again including a high percentage of older men, reported that they did not take as much time off for family or personal needs as they felt they needed. These older respondents are likely reflecting on their own experience and feeling regret, and are therefore interested in supporting those that follow them. Similar attitudes may explain the large majority of respondents who agreed that having family-friendly work-life balance policies increased their career satisfaction, even if they didn’t anticipate using these themselves.
Despite UC Davis’s long-standing policies, we discovered that few individuals are utilizing them. The survey demonstrated a variety of perceived barriers and biases, including fear of being seen as “slackers”, and concern about over-burdening colleagues, particularly among women. One of our goals is to get the word out that colleagues support policies and consider these to be important for recruitment and retention. Interestingly, a significant percentage of survey respondents – including young men and older women — indicated that their satisfaction regarding flexibility policies was high because they anticipated needing these in the future. Flexibility policies are therefore not just a young woman’s issue to accommodate working mothers; these policies are seen as important to everyone and can be a strategic tool.
Interventions to address barriers to policy use, enhance respect for flexibility, and diminish bias, are the next steps in our NIH-funded study to improve career flexibility at UC Davis. These include enhancing communication via newsletters, grand rounds, and workshops to get the word out that colleagues of all generations and genders value, support, and need flexibility. My colleagues and I are also making special efforts to reach young men and older women since these groups experience more work-family conflict and lower career satisfaction, according to our study and others. We are re-surveying over a three year period to evaluate change in knowledge, awareness, and policy use and to assess effects on barriers, satisfaction, academic reviews and advancements.
I hope that my work at UC Davis has sparked some interest in supporting career flexibility and work-life integration in your own workplace, too. As a working mom who raised two daughters over the course of my own career, I know well the challenges of balancing career and family responsibilities. I now try to balance my career obligations with my obligations as a daughter helping to care for my aging parents. You may have similar experiences, too. As the premier organization in cytopathology, perhaps the ASC should play a bigger role in supporting members to address career issues like this, both on the individual and laboratory level. We have a wonderful, rewarding, and important profession and we need to ensure that talented individuals want to join us. There are many facets to recruitment and retention – but are we, as a profession, currently considering all angles to optimize our success? Is this something that the ASC should pay more attention to? The ASC Executive Board will be holding their strategic planning meeting at the beginning of May, and we want to ensure that we consider topics that are important to our members when developing a plan for the society. Please share your comments in this blog, by e-mail, or in discussion boards soon to be posted. We look forward to making the ASC the society that you want it to be.
Lydia Pleotis Howell MD, ASC President
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