Radiology's family-friendly image comes under scrutiny

Good pay, defined hours, potential for flexible working--the case for radiology as a family-friendly specialty seems undeniable on paper. In practice, however, radiology's growing female workforce faces considerable hurdles combining motherhood with a medical career.

Around 50% of all students entering medical school this year will be women. In some countries, the percentage will be as high as 70%. The prospect of a relatively predictable working week makes radiology an attractive option to those hoping to combine work with parenthood in a few years' time. But if the reality fails to meet expectations, then women who enter radiology may opt straight out again, leaving departments with significant gaps in staff.

Departments need to face up to the shifting balance between the sexes and initiate change to working patterns that will benefit all radiologists, men and women, according to Dr. Helen Carty, a former professor of pediatric radiology at the Royal Liverpool Children's Hospital in Alder Hey, U.K.

Workforce planning can undoubtedly become difficult when several staff members become pregnant or take maternity leave. Solutions must be sought that do not cause friction within the team, she told delegates at the European Congress of Radiology 2008 session, "Women in radiology: how to maximise their input."

"This is not about cherry-picking--taking the best parts of the job but not being prepared to give anything," she said. "A healthy work-life balance matters to all of us."

Highly trained radiologists are in demand worldwide, according to Dr. Birgit Ertl-Wagner, a radiologist at the Institute of Clinical Radiology, University of Munich, in Germany at the same session. So it is especially unfortunate that women are leaving the profession when they are really ready to contribute, having just finished their training.

A mother of two young children, Ertl-Wagner has managed to continue her own career in radiology thanks to a supportive department head, a teleradiology link to her home, good childcare, and sheer hard work.

"It is possible to have children and a career in radiology, but you have to stay flexible," she said. "You can find solutions to most problems. My advice to other women would be to get as much help as you need and as you feel comfortable with."

Not all women radiologists with children have access to this type of support, though. In Eastern Europe, where salaries are typically far lower or working hours limited by law, women may find themselves juggling an additional part-time job in addition to radiological work. Good childcare may simply be unaffordable.

Just 17% of female Polish radiologists who responded to a survey on work and family life identified flexible working as a way of improving their work-life balance. Relief from night duties was requested by 11% and teleradiology by 10%. An overwhelming 70% of respondents suggested that an increase in salary would be the most beneficial solution.

"The women who responded to the survey said that they found it difficult to do professional work and have a professional career after having a baby," said Dr. Katarzyna Gruszcynska, a radiologist at the Medical University of Silesia in Katowice, who conducted the survey. "They were left with limited financial resources to buy books and attend educational courses. Approximately 28% had to prolong their training period."

In Poland, women on maternity leave receive 100% of their salary for 18 to 28 weeks, two of which can be taken before delivery. After 14 weeks, some of this leave can be taken by the father. In contrast, radiologists in Sweden who go on maternity leave receive 80% of their salary for nine months. In Germany, this same 80% salary arrangement is available for 12 months. Russian radiologists benefit from 18 months maternity leave, though the pay rate is much lower (40% of salary).

Flexible arrangements may not necessarily provide the work-life balance that working mothers--and fathers--are looking for. A study of working conditions in Europe from 2000 found that high-functioning workers, such as top executives, often ended up working overly long hours even if they had flexible timetables, according to Dr. Clare Roche, a radiologist at University College Hospital in Galway, Ireland.

"That also holds true for radiologists today, who are finding the working day getting stretched and stretched all the time," she said.Women pursuing careers in academic radiology may find that their commitment is questioned if they switch to part-time work after having children, said Dr. Isabella Björkman-Burtscher, an associate professor of radiology at Lund University Hospital in Sweden. She called for the radiology community to respond to the need for flexibility and accommodate different career styles.

"Can you be a good parent and a good academic radiologist? I think you can, yes, but it is hard," she said.

-By Paula Gould