The right answers to the wrong questions

“SO WHEN ARE you planning to have children?”

a.) While I may wish to have children at some time in the future, I would never interrupt my training as work is my first priority and it would be inconvenient for all involved.

b.) I’ll be getting pregnant ASAP after locking down this contract. It’s just a gateway to paid maternity leave.

c.) I’ve actually chosen not to have children. Will that reflect positively or negatively on me?

d.) I’m sorry, it sounded like you were asking me a question that has no relevance to my knowledge, skill or merit for employment in this role. Next question.

There is unprecedented competition for access to specialty training programs, with an excess of medical graduates battling their way through an ever-tighter bottleneck. Yet any edge achieved on merit may be blunted for just over 50% of doctors-in-training (DITs) who dare to enter an interview room with a uterus, especially if there is a wedding band accompanying it.

I have noticed that career advice chats have two distinct trajectories. For me, regardless of what training I’ve said I am interested in, I am given well-meaning advice that I should consider how easy it will be to work part-time when, not if, I have children. It implies not only an assumption about my future gravidity, but my future priorities – to cut back on work to focus on childcare. Yet my male colleagues don’t tend to receive such advice. Instead, their conversations focus on networking opportunities, skills acquisition and prospects for more dollars in the bank.

In 1966, married women were no longer barred from working, and in 1984, the Sex Discrimination Act made it unlawful to discriminate against a person because of their sex, relationship status, family responsibilities, pregnancy or potential pregnancy, or breastfeeding. Yet as much as we might like to deny it, these biases are ingrained in our society, and in the culture of medicine.

Recently, a colleague told me that during an interview for a specialty college she was asked whether she was planning to have children. After picking my jaw up off the floor, I emailed DIT members asking if they had similar experiences, and I received the first 10 responses within the first hour.

Here are some of the responses:

“I wanted to get onto a specialist training program and was told that ‘as a mother’ I stood no chance of ever making it.”

“I was 12 weeks pregnant at my interview. The first question was, ‘So I believe you are with child at the moment? How are you planning on working in this role?’ I cannot remember much else from this interview as I was completely thrown by his question and felt embarrassed, victimised and unsure what to say or do.”

“I was told when enquiring about a position that the department doesn’t tend to employ women so I probably wouldn’t have much of a chance at getting the job.”

“I was told jokingly, ‘You better not get pregnant’ – and when I did, I became completely ignored. All talk of research and PhD went away.”

“At two interviews I was asked about my family life ‘to help the practice with planning’.”

“A friend was told she would not have her contract renewed because the LHD did not want to set a precedent of people taking maternity leave.”

“During a job interview for a full-time position I was asked about my family. When I said that I have two young children, I was asked, ‘Do you miss them?’ I replied, ‘Yes’ and was then asked, ‘Why don’t you work part-time?’ I found this line of questioning very out-dated and upsetting. I doubt this same sequence of questioning would have occurred if I had been male.”

I doubt it would have either. I asked a group of around 30 DITs and while a majority of females said potential employers had enquired about their family plans at some point in a recruitment process, formally or informally, no male had been.

All these experiences are indicative of the prevailing mentality in medicine that parental leave and flexible training are the singular dominion of women. Training posts for the Colleges of Physicians and Obstetrics and Gynaecology seem to have the dubious honour of being at the root of most of the anecdotes I received, and also appeared the most blatant in their practises. Pre-interviews for basic physician training jobs also seem to be particularly compromised.

Perhaps even more upsetting than inappropriate interview questions, is the response from above. Many trainees have been told by directors of training, mentors or peers that while these kinds of questions shouldn’t be asked, to accept they probably will be, especially to women who wear a wedding ring – so best take that off, and if they do ask then just lie. Give the “right” answer to the wrong question – for those unsure, it’s (a) in the little quiz at the start of this article.

Why aren’t we calling this practice out instead? It’s fraught for trainees – I asked the same room of DITs above how many of them would feel comfortable reporting discriminatory questions – only two of 30 said they didn’t think there would be negative consequences, such as not getting on your program. Fear and disempowerment is driving silence and submission.

Now one could argue with some validity that asking about plans for pregnancy contravenes no laws, but rather the laws prohibit the answers to these questions from factoring into a decision about hiring. What if you need to ask to plan your workforce, but wouldn’t let the answer bias your decision?

Frankly, if the answer to the question is not going to factor into your hiring decision, why is it being asked at an interview? As with clinical practice, you don’t do the investigation if it isn’t going to change your management.
This is not to say that parental leave doesn’t impose an upfront cost and inconvenience. Of course it does. But if that’s a challenge for your department, don’t put pressure on female trainees not to have babies, join us instead in advocating for system change – a centralised funding source, and equitable provision of parental leave regardless of gender or sexuality so every candidate is equally ‘risky’ to hire. If you don’t have enough senior trainees to staff your department if someone goes on leave, create bigger networks so there is more flex in the system when it needs to accommodate life. Work hard to encourage those who do take leave to return to work when they are ready, by supporting part-time or other flexible work practices. Not just because it’s the right and lawful thing to do, but because it’s financially beneficial in the long run, and will ensure the best candidates for your Colleges, departments and patients, for decades to come.

The Federal Workplace Gender Equality Act 2012 has replaced the Equal Opportunity for Women in the Workplace Act 1999, in recognition that equal opportunity is not just a women’s issue. Yes, many of us will have babies. But amazingly most of those babies will have two parents, and it’s possible for the one who didn’t give birth and breastfeed them to do pretty much everything else they need to be happy and healthy little humans.

In our recent NSW Hospital Health Check Survey, respondents were asked about their views on part-time or other flexible working arrangements. Only 6% of females and 2% of males had applied for flexible work arrangements in the last year. However a further 50% of women and 29% of men said they would consider it in the future or had applied in the past.

We need to recognise that dads can be equal contributors to parenting. And we need them to if women are going to be able to participate to the extent they want, and that our community needs, if we want the best possible healthcare delivered by the best possible doctors.

How to do this? Now you’re asking the right questions.