New child care offerings put oncology meetings at the forefront of work-life balance
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Taking time from work and personal obligations to attend professional meetings can be a hassle, but it is that much and more for working moms in the medical profession.
These meetings are valuable for their ability to keep physicians up to date on the latest practice standards, provide networking opportunities and promote career advancement. However, many women who balance two full-time positions as mother and physician have found it difficult to attend these meetings because of the complicated arrangements associated with child care and, until recently, they had little on-site support to encourage their participation.
Miriam A. Knoll, MD, radiation oncologist at John Theurer Cancer Center at Hackensack University Medical Center, and colleagues conducted a survey to assess the degree to which parenting issues affected the attendance of early-career female oncologists. The results, published last year in a research letter in JAMA Oncology, showed that among the 248 early-career oncologists (43.5% women) who responded, women had attended significantly fewer conferences than men during the past year (median, 2 vs. 3; P = .004). Moreover, women were almost twice as likely as their male colleagues to note a child care conflict as the primary factor for not attending a meeting (30.6% vs. 17.1%; P = .01).
When asked about the significance of these meetings for career advancement, both male and female respondents overwhelmingly agreed they were important opportunities for presenting research, networking and continuing education.
“Our findings extend prior research in other settings to support visible, innovative actions by oncology meeting organizers, including women’s networking centers and facilitation of child care services, as steps to ensure full participation of all those who might contribute or benefit at conferences,” Knoll and colleagues wrote.
With this call to action in mind, Healio spoke with some of the survey’s authors about the challenges facing moms as they seek to develop their careers in hematology and oncology and what services are available to help physicians and researchers who are also parents achieve their professional goals.
The unconscious bias of motherhood
Knoll, a mother of four, attended her first ASCO Annual Meeting in 2016 and subsequently wrote a blog about her experience on her ASCO Connection blog detailing the difficulties parents often face in making child care arrangements to attend large scientific meetings.
Knoll conducted an informal poll of a hematology and oncology women physicians’ group on Facebook, asking its members what the largest factor was in deciding whether to attend ASCO 2016. Among the 60 respondents, the No. 1 factor was child care, followed by practice coverage.
Knoll said it was the first time she could recall the question being discussed publicly, and added that it shows the impact of child care considerations on early-career investigators.
“Arranging for child care is something I have been doing since the onset of my career because I had two children while in medical school,” Knoll told Healio. “There is very little open support, because by acknowledging that we have children, women face a professional penalty for appearing to be less committed to our profession.”
It’s a cultural phenomenon that Knoll calls “the unconscious bias of motherhood,” and it’s something she has been dealing with since medical school.
“It can sometimes be shocking to women who are starting their careers,” she said.
Knoll said it’s important to recognize this unconscious bias and how it prevents women in the field of oncology from attending conferences, presenting their research and potentially advancing their careers.
“Ignoring this issue won’t make it go away. It’s important to acknowledge the barriers early-career attendings face so that we can support them and help them be successful,” Knoll said. “Women shouldn’t have to wait until their children are grown or put off having them altogether to embark upon a successful career in medicine.”
After the blog post, Reshma Jagsi, MD, DPhil, deputy chair of the department of radiation oncology at University of Michigan, reached out to Knoll about conducting a more formal study of the topic.
“Even though over half of all those entering medical school in the U.S. today are women, women continue to constitute only a small minority of those at senior ranks and those holding leadership positions,” Jagsi told Healio.
There are several possible explanations for the deficit of women in leadership roles, Jagsi said. Among them is society's continued expectation for “a gendered division of domestic labor” in which women perform the majority of domestic tasks, including parenting.
“We wanted to focus on oncologists and also evaluate whether these challenges were affecting women's ability to participate in national conferences, which are important opportunities for mentorship, networking, research dissemination, education and leadership development,” Jagsi said.
A developing success story
Jagsi also is a mother, “the proud mother of two kids — a 13-year-old girl and a 10-year-old boy.” Her husband is an academic whose job, like hers, requires a fair amount of international travel.
“I travel a great deal for work, including professional society meetings and also visiting professorships and invited lectures at other institutions,” Jagsi told Healio. “I absolutely weigh my responsibilities at home when I make the decision about whether I can attend another meeting, even when I'm offered a keynote talk or other valuable professional opportunity.”
The couple’s parental responsibilities and their hectic schedules often present conflicts with professional opportunities, Jagsi said.
“We work it out through a patchwork of help from the nanny, my mother, and other friends and family. But it is not easy,” she said.
ASCO did not provide child care at its annual meeting when Knoll wrote her initial blog.
“This blog post sparked the discussion,” Knoll recalled, and the organization provided a list of offsite child care resources on its meetings website in 2018. In 2019, it offered free onsite child care at Chicago’s McCormick Place, where the annual meeting was held.
“Many physicians juggle work and family responsibilities that can make it challenging to pursue educational and career development opportunities. We all know people who have had to make difficult choices and trade-offs as a result,” Monica Bertagnolli, MD, FACS, FASCO, chair of ASCO’s board of directors, told Healio.
Bertagnolli, who presided over last year’s ASCO Annual Meeting, said the organization wants to make it possible for all interested professionals to attend its meetings, and the new child care offering is part of that effort.
“To help create a more family-friendly meeting environment, we updated our policies and enhanced our facility offerings to include free child care at the ASCO Annual Meeting,” she said. “I’m very pleased we were able to offer these accommodations this year and hope they made, and will continue to make, a difference for our attendees in future years.”
Jagsi said the move by ASCO was extremely popular and a concrete example of how a professional organization can help address the logistical obstacles facing women and potential roadblocks to career advancement.
“Ensuring access to attendance at society meetings is critical if our profession is to continue to thrive,” Jagsi told Healio.
“By starting to offer child care at conferences, organizations like ASCO are expressing their support for working parents and are providing a more inclusive environment for attendees to advance their careers,” Knoll added.
ASCO is not alone in identifying child care needs as a problem requiring a solution for early-career women among its members.
“ASH has provided child care at its annual meeting for over 10 years,” Bill Reed, FASAE, CMP, chief event strategy officer at ASH, told Healio. “The overarching goal is inclusion.”
Last year’s ASH Annual Meeting and Exposition marked the first time the organization offered free child care to its attendees.
“We want to make the best science accessible to all, including to hematologists who are parents,” he said. “The need for child care should not be a barrier for hematologists who want to attend.”
Reed noted that offering child care was not only an egalitarian move, but a sound business one, as well.
“Being as welcoming as possible has played a role in the overall growth of our attendance,” Reed said. “ASH has received feedback that we are leading the way in addressing the needs of working parents.”
American Association for Cancer Research also provides subsidized onsite child care at its annual meeting. AACR has provided this service for the past 6 years through KiddieCorp, a national provider of onsite child care at conventions and meetings.
Jagsi said she hopes more professional societies will identify opportunities to facilitate work-life integration for their members.
“We are at our strongest when we have access to the full talent pool, including the men and women who, in our study, identified a lack of on-site child care as a barrier to their engagement in professional society meetings,” she said. “Collective intelligence is improved by having diverse perspectives represented in a group.”
With more than 3 years having passed since her initial blog post about the barriers working mothers face in attending professional meetings, Knoll reflected on her efforts and the study she conducted with Jagsi, and asserted that they have yielded positive results.
“Absolutely this is a success story, there is no question about that,” Knoll said. “It is possible to give women the tools they need to succeed and do it in a supportive way that does not assign any blame. We’ve been able to uncover a problem, come up with solutions and make concrete changes in real time. The time has come to make these changes and to make them now, not at some point in the future.” – by Drew Amorosi
References:
Knoll MA. In the Hillary Clinton era, is there a glass ceiling at ASCO's Annual Meeting? June 30, 2016. Available at: https://connection.asco.org/blogs/hillary-clinton-era-there-glass-ceiling-ascos-annual-meeting. Accessed Jan. 15, 2020.
Knoll MA, et at. JAMA Oncol. 2019;doi:10.1001/jamaoncol.2019.1864.
For more information:
Monica Bertagnolli, MD, FACS, FASCO, can be reached at American Society of Clinical Oncology, 2318 Mill Road, Suite 800, Alexandria, VA 22314.
Reshma Jagsi, MD, DPhil, can be reached at University Hospital, 1500 E. Medical Center Drive, UHB2C490, Ann Arbor, MI 48109; email: rjagsi@med.umich.edu.
Miriam A. Knoll, MD, can be reached at John Theurer Cancer Center at Hackensack University Medical Center, 92 2nd St., Hackensack, NJ 07601; email: miriam.knoll@hackensackmeridian.org.
Bill Reed, FASAE, CMP, can be reached at American Society of Hematology, 2021 L St. NW, Suite 900, Washington, DC 20036; email: breed@hematology.org.
Disclosures: Bertagnolli reports institutional research funding from AbbVie, Agenus, Astellas Pharma, AstraZeneca, Bayer Health, Baxalta, Breast Cancer Research Foundation, Bristol-Myers Squibb, Celgene, Complion, Eisai, Eli Lilly, Exelixis, Genentech, GHI Pharma, Gilead Sciences, GlaxoSmithKline, Incyte, Janssen, Jazz Pharmaceuticals, Leidos, Lexicon, Merck, Matrex, Mayo Clinic, Massachusetts General Hospital, Millennium Pharmaceuticals, Novartis, Patient-Centered Outcomes Research Institute (PCORI), Pfizer, Pharmacyclics, Robert Wood Johnson Foundation, Sagerock Advisors, Sanofi, Taiho Pharmaceutical, Takeda, Tesaro, and Teva. Jagsi reports stock options as compensation for her advisory board role with Equity Quotient, a company that evaluates culture in health care companies; personal fees from Amgen and Vizient; and grants from Blue Cross-Blue Shield of Michigan for the Michigan Radiation Oncology Quality Consortium, the Doris Duke Foundation, Greenwall Foundation, Komen Foundation and NIH. Knoll reports a consultant role with Bristol-Myers Squibb. Reed reports no relevant financial disclosures.
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