Family issues in invasive electrophysiology - career paths of female and male EP fellows in Germany

Abstract Introduction Female doctors are underrepresented in invasive electrophysiology (EP) for multiple reasons. Despite an increasing focus on the topic, it is unclear what aspects are predominant and how they should be adressed to support women in EP. Methods We conducted a survey on career paths of current or former EP fellows in Germany to elucidate how gender and family affected their careers. The survey consisted of 11 questions on current work and family status, 20 on status before parenthood and the impact of children on career and 7 on the impact of pregnancy. 231 fellows (24% female) were invited. Results 110 participants completed the survey, 30% female and 70% male, mean age 39±5 and 42±5 years (p=0.012). Women and men had children in 68% and 84%, respectively (p=0.045). Before parenthood, both genders were at similar starting points in terms of working position, clinical experience, research activity and career goals. Of the 87% women and 86% men with a former career goal of invasive EP, 80% and 96% were active in invasive EP at the time of the survey, respectively (p=0.021). Women were in lower-level positions, had done fewer procedures, were less active in research and had achieved fewer degrees and qualifications. Women had fewer children and were less satisfied with their work. The associations were independent of age. Women reported to have changed their career paths after parenthood more often than men (p=0.004). Reasons were mainly changes in personal priorities, followed by lack of flexibility at work and at home. In contrast to men, women reported to cover the majority of childcare at home. Most women and men with children felt supported by their family, but did not feel supported by their employer in terms of work-family conflicts. 82% of employers offered some sort of daycare for children, but only 21% of women and 52% of men stated these were satisfactory. 13% of women and 3% of men received support by dedicated grants or programs. During pregnancy, 70% of women were unable to continue to follow their career. The most common reason was restrictions by their employer. 65% of women were not allowed to continue with invasive procedures, although 91% stated they wanted to. 74% were not allowed to work with radiation, alghough 78% wanted to. Only 22% stated there was a dedicated policy or program for pregnant interventionalists. Conclusion Women had to change their career paths more often than men after parenthood but reassuringly the majority was still able to continue with an invasive EP career. Despite a similar starting point of both genders before parenthood, women were able to accomplish fewer professional achievements and were less satisfied with their work. A fundamental reason seems to be the distribution of childcare at home, but also a lack of flexibility and support by employers as well as working restrictions during pregnancy. These points should be adressed to further support women in EP.