'I didn't see my children awake for seven days': the painful pursuit of work-life balance for doctors

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By Erin Dean

As a new Doctors.net.uk survey shows that most doctors with young children struggle to find suitable childcare, several describe the at-times impossible juggle and what it has meant for their careers and life at home.

During a recent working week, general surgery registrar Ms Radhika Chadha didn’t get to see her toddler or four-year-old awake at all.

“I didn't see my children for seven days straight on my ward-based week,” said the Association of Surgeons in Training representative for Oxford. “I would leave before they woke up and go into their bedroom and give them a kiss when I got home and they were already asleep. You know that ultimately you accept the career path you’ve chosen, but it's pretty demoralising. It's upsetting.”

She and her partner, who is also a doctor, moved a few years ago to be closer to family for childcare support, but this has left her with a 90-minute commute each way to work. On a normal day she is up at 5.30am and out of the door at 6am.

Many doctors say they experience stress and guilt – both for leaving children for long periods of time and having to leaving work to look after their children

“My days are really long, so it has a huge impact on not only work-life balance, but just my health generally and having the energy to be around my kids when I am there. There's a sort of ripple effect in terms of the impact.”

Chadha’s experience is echoed in the findings of the exclusive new Doctors.net.uk survey examining the considerable pressures of being a clinician with young children. Eight in 10 of the more than 1,100 respondents said they struggle to find childcare that fits their working hours.

Doctors reported the financial and logistical difficulties of finding childcare that covered long and erratic rotas, early starts and late finishes. There were widespread feelings of stress and guilt that went with both leaving children for long periods of time and with leaving work.

Resident doctors also flagged that being moved around frequently either took them away from childcare arrangements and family or left them with extremely long drives.

The Doctors.net.uk survey results add to a growing body of evidence. In a 2024 BMJ survey of nearly 600 doctors, for instance, nine out of 10 doctors said they couldn’t find suitable childcare for their demanding schedules. Nearly 70% said that concerns about childcare had influenced when and how many children they plan to have.

For Chadha, making things work has meant moving to an 80% full-time role and recruiting a nanny. This combination has had a hugely positive impact on family life, but it now means that her earnings go entirely to pay for childcare.

She says that understanding and flexibility for parents in surgery is starting to improve, but more change is needed. “There are still significant systemic barriers,” she says. “I couldn't sustain this at full time work.”

Scheduling strain

Recently published research underscores how, even though more women are in competitive and demanding professional roles than ever before, they continue to provide or coordinate the majority of childcare and household management.

Perhaps that persistent juggle helps explain why the majority of doctors who responded to the Doctors.net.uk survey are women: 67% women compared to 32% men. A consistent theme for both sexes, however, was the unrelenting strain around scheduling.

“Childcare does not fit with medical rotas,” one doctor said. “Without family support it is impossible to work full time.”

Another described how inflexible working patterns were reshaping career decisions: “Shift work and on-call commitments make standard childcare impossible. It has forced me to reconsider how much I can realistically work.”

Changing specialty, job and other career switches due to childcare pressures were common in the survey.

Parents also commented on the difficulties of rotations in training, which often coincides with the years that women will have children.

In a 2023 report on the impact of parental responsibilities on surgical careers by the Nuffield Trust, two-thirds of respondents suggested that their parental plans and experiences had affected their likelihood of achieving their career goals, undertaking additional activities to their role or taking on leadership roles.

Dr Victoria Zaslona, a specialist forensic psychiatrist, says she would be unable to rejoin training as a mother. “Originally I came in to being a SAS [specialty, associate specialist, specialist] doctor for other reasons, but being a mother has definitely kept me being one,” she says.

Some surgeons still perceive [prioritising time with your children] as a lack of commitment to your training, to your career path

“There is more flexibility – I'm more able to choose where I go and stay there for a longer period of time so that I don't get moved around. I’m able to choose a job where I'm not doing on calls or I can choose a certain pattern of on calls.”

She says it offers the consistency that supports parenthood. “I work with the same team, so there's less kind of emotional turmoil of being dragged around from different places.”

Pressure from colleagues

As well as the logistical difficulties that doctors face balancing family life, many also say they are affected by longstanding pressures and expectations within the culture of medicine. Many doctors describe difficult experiences with colleagues as they juggle their different commitments.

“There are those who are supportive, and I would say that they're perhaps some of the newer generation of surgeons,” says Chadha. “But some of the older generations, they still perceive it as a lack of commitment to your training, to your career path. There's no doubt that I've encountered the odd negative attitude or microaggression because a colleague perceives me as being less dedicated.”

For Dr Isabel Harford (not her real name), as she was recently preparing for an interview for her first consultant post, one colleague told her that the only thing going against her were her “absences”.

She says the colleague was referring to the three days that she had to take off work over a number of months when her young children were unwell. The now consultant physician in Scotland had split the time that needed to be taken off with her pharmacist husband.

“It was suggested that I ‘stop being absent’ in order to increase my chances of getting the job,” she says. “As we have no family locally, we have no choice but to take time off ourselves if the children are unwell. The clinical lead once pulled a face when I told him I had to leave to take my poorly one year old to the GP – she had a temperature of 40C and needed antibiotics for tonsillitis.”

On one occasion a colleague refused to cover a clinic for her when one of her two children was unwell. “I had to leave my child with her dad, screaming for me, in order to go to clinic which was extremely traumatic,” she says.

Harford didn’t get the job. But she did recently secure a consultant’s post and has found that gives her more control over her time than as a doctor in training.

Additional needs

Meanwhile mum-of-three GP Dr Jenny Modi echoed a number of survey respondents when she says that working got incredibly difficult when one of her children started struggling at school.

Her youngest son, now 11, who has autism, attention deficit hyperactivity disorder and pathological demand avoidance (PDA), started refusing to go to school. He has now not been able to access mainstream school for nearly two years.

It just seems impossible to be respected in your career once you have children. Being a mother is expected to be second

“This brings a new set of childcare issues and bit by bit I have had to reduce my hours of work down to just one day per week,” she says. “This is not where I thought I would be.”

She is part of Facebook group through the Physician Mums Group UK with about 80 doctor mums whose children have PDA and “many of us are struggling to work”, Modi says.

The phase when her son sometimes didn’t want to go to school, was one of “the most stressful of my life”, she says.

Harford says that there needs to be cultural change for parents within medicine.

“It just seems impossible to be respected in your career once you have children and being a mother is expected to be second,” she says. “Taking time off for caring duties is looked down on, and it’s not right.”

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