“My Better Half”: Partner Experiences of Women Cardiothoracic Surgeons

Abstract

Background

The demands of cardiothoracic surgery often affect personal relationships, with those of partners vulnerable to numerous challenges. We aimed to characterize the personal relationship experiences of women cardiothoracic surgeons.

Methods

We designed a survey gathering information on relationship dynamics from partners of women cardiothoracic surgeons. The survey was loaded into an internet-based platform, and links were disseminated to members of the Women in Thoracic Surgery, who subsequently distributed the survey to their partners and spouses. Questions explored avenues through which the women’s surgical careers had affected their partners and relationships.

Results

The survey was completed by 32 individuals, and relationship roles included 28 (87.5%) spouses and 4 (12.5%) nonmarital partners. Among respondents, 64.3% (17 of 27) reported that the cardiothoracic surgeon’s dedication to her job inspired the partner to be more understanding, whereas 55.6% (15 of 27) noted challenges in maintaining healthy work-life balance. Irregular and demanding work hours resulted in missed important events (44.4%; 12 of 27), reduced quality time together (55.6%; 15 of 27), and increased relationship tension (48.1%; 13 of 27). Notably, 66.7% (18 of 27) reported that their partners’ surgical careers did not affect their decision to have children. When comparing experiences across relationship durations, there were no meaningful differences in the distribution of the responses.

Conclusions

Our findings highlight challenges encountered by partners of women cardiothoracic surgeons across all stages of their careers and relationships. Elucidating these dynamics enables us to better support those interested in the field and within our community.

In Short.

• ▪Among respondents, reported challenges included work-life balance, stress, and time constraints limiting togetherness and event attendance.
• ▪Reported benefits included access to medical care, financial stability, travel experiences, and sentiments of pride and understanding.
• ▪Challenges and benefits appeared stable over time, whereas achievement of family goals, such as childbearing, were affected among a notable though minority proportion of respondents.

The demands of cardiothoracic (CT) surgery can be immense. The complexity of procedures and diseases, the potential for adverse events, the extensive training duration, and ultimately long workdays introduce daily stressors to the lives of those practicing this specialty. Such experiences can lead to substantial discontent, anxiety, fatigue, and burnout. More so, these demands also often affect personal relationships, with those of partners under the greatest pressure and vulnerable to numerous trials and tests.

There exists a paucity of data on the topic of personal relationships in surgery. The limited published studies on the topic have explored partnerships of surgeons, most often from the surgeons’ perspective.¹ These investigations highlight challenges in work-life balance and home conflict. Literature related to the impact on home life in CT surgery is particularly sparse, and it focuses on the profession as a whole, notably represented predominantly by men.^2,3 Although some of the relevant issues are universal, women CT surgeons face unique challenges both at work and at home.

Women CT surgeons have distinct experiences from their men counterparts in the clinical environment. This has been demonstrated in representation, both generally within the field and when considering promotion and productivity.⁴ Despite what is available, the nuanced relationships of women CT surgeons outside of work remain underexplored.

We aimed to characterize the personal relationship experiences of women CT surgeons. We hypothesized that by elucidating areas of greatest challenge, we would identify opportunities for interventions to better support those interested in the specialty and our community. Further, we hoped to identify and disseminate underreported relationship benefits, to offer reassurance to women interested in the specialty and their loved ones.

Material and Methods

A survey was developed with the aim of characterizing various aspects of the relationships of women CT surgeon relationships with their family members. Survey questions were designed by content experts with extensive experience in survey-based research after detailed review of previous literature in this arena. Question items specifically gathered data pertaining to the nature and duration of the relationship, other members of the household, and aspects of family planning, as well as career impact on work-life integration, financial caveats, and attendance at personal and work-related events (Supplemental Table).

The question items were piloted among an initial sample cohort and refined with feedback before finalizing the survey content. The survey was loaded into an internet-based application (Qualtrics), and links were disseminated to members of the Women in Thoracic Surgery, who subsequently distributed the survey to their own partners. This was done to attempt to obtain a more diverse response population. Aspects of relationships related to motherhood and parenting have been published previously.⁵ For this investigation, questions related to partnerships were analyzed.

Question stems were followed by multiple-choice answers using 5-point Likert scales, and responses were organized as dichotomous variables for statistical analysis. Results were anonymized, analyzed in aggregate, and reported descriptively to ensure confidentiality. Question-level denominators were provided on the basis of items completed. χ² tests were used to assess for association. Analysis was performed using RStudio software version 1.4.1106. An Institutional Review Board waiver of approval was obtained (#2022-0426, August 3, 2022).

Results

Of 32 respondents, 28 (87.5%) identified as spouses and 4 (12.5%) as nonmarital partners. Relationship durations were reported as follows: <5 years, 12.5% (n = 4); 5 to 10 years, 25% (n = 8); 10 to 15 years, 21.9% (n = 7); 15 to 20 years, 12.5% (n = 4); >20 years, 28.1% (n = 9) (Table).

Table.

Survey Respondents’ Relationships With Cardiothoracic Surgeons

Relationship Status and Duration	n (%)
Relationship status
Unmarried partner	4 (12.5)
Spouse	28 (87.5)
Duration of relationship, y
<5	4 (12.5)
5-10	8 (25)
10-15	7 (21.9)
15-20	4 (12.5)
>20	9 (28.1)

Notably, 43.8% (14 of 32) of respondents reported that the woman CT surgeon’s career fostered a sense of pride and accomplishment for them personally. Nearly two-thirds (64.3%; 17 of 27) reported that the CT surgeon’s dedication to her job inspired him or her to be more understanding in interpersonal interactions (Figure 1).

Figure 1.

Survey responses: benefits. (CT, cardiothoracic.)

Regarding challenges, 55.6% (15 of 27) reported that their relationships experienced trouble maintaining a healthy work-life balance. Substantial proportions of respondents indicated that irregular work hours reduced quality time together (55.6%; 15 of 27), that job-related stress created relationship tension (48.1%; 13 of 27), and that these factors resulted in missed important events (44.4%; 12 of 27). Despite these obstacles, two-thirds (66.7%;18 of 27) of respondents reported that their partners’ jobs did not affect their decision to have children (Figure 2). Interestingly, 37.5% (12 of 32) of couples were parents, but there were not meaningful differences in responses among those with and without children.

Figure 2.

Survey responses: challenges. (CT, cardiothoracic.)

Several favorable advantages arising from relationships with women CT surgeons were characterized, with 41.4% (12 of 29) of partners indicating that traveling to conferences had broadened their horizons, 82.1% (23 of 28) appreciating financial stability, and 85.2% (23 of 27) benefiting from expanded access to medical advice (Figure 1).

When comparing experiences across relationship durations (<15 years vs ≥15 years), there were no meaningful differences in the distribution of the responses, thus indicating relative stability of strain over time. Interestingly, there was a trend toward more positive perspectives among those who had been partnered for more than 15 years (Figure 3). This consistency in experiences also held true when comparing <10 years with ≥10 years.

Figure 3.

Experiences stratified by relationship duration. (CT, cardiothoracic.)

Comment

We demonstrated that among women CT surgeons, the demands of the profession substantially affect partnerships, and we highlighted both challenges and benefits reported across all stages of relationships.

Our findings corroborate those of previous investigations. Ungerleider and colleagues² recently published the results of a survey from significant others of CT surgeons as related to burnout. Among respondents, 63.3% did not feel that the typical schedule left enough time for personal and family needs, with only 22.6% reporting emotionally connection to their partners and 48.3% reporting spending a healthy amount of time together. Relatedly, 27% did not feel that their families achieved work-life balance; nonetheless, 43.2% would want their partner to choose CT surgery again. Participants in that study overwhelmingly comprised men surgeons’ wives, and investigators did not delineate gender-stratified experiences.

Outside of CT surgery, foundational work by Dyrbye and colleagues,^3,6 who surveyed American surgeons, found that marital conflict was a major contributor to burnout, leading to significant career changes, including attrition. Women surgeons in that study were more likely than men to report work-home conflict, thus underscoring the relevance of our findings.

Regarding challenges, our study confirms and quantifies the impact of many anecdotal reports as well as previous publications, by highlighting difficulty with work-life balance, quality time, and work stress affecting relationships. Pertinent benefits that certainly contribute to relationship duration and health included feelings of pride, understanding, and security of both family finances and medical access. In addition, two-thirds of respondents noted that their partners’ careers did not affect their decision to have children. This finding is encouraging because it highlights that personal goals are being attained among these challenges while also identifying serious issues affecting 1 in 3 families that merit support. Finally, when evaluating these responses on the basis of relationship length, only the sense of pride and accomplishment was more pronounced in the longer-duration group. Otherwise, themes were consistent over time. This finding differs from previous work but may be unique to the partner experience of women CT surgeons.

Our study is distinct because of the focus on women CT surgeons and their respective partners. Women CT surgeons face unique challenges at work, including but not limited to representation, compensation, and promotion.⁷ More so, these challenges extend to home life, including child care and parenting, with women surgeons frequently absorbing much of the workload associated with domestic tasks.⁸ As documentation of workplace stressors disparately affecting women CT surgeons has grown in recent years, elucidation of the impact on personal relationships adds to our body of knowledge as we work to better understand how to support all members of our current and future workforce. Both The Society of Thoracic Surgeons and the American Association of Thoracic Surgeons have established workforces and committees on wellness, exploring topics such as work-life balance and physical ailments. We hope that this work may act as a starting point for these organizations to focus further on the needs of our surgeons.

There are several limitations to our study. Given that the foundation of our data collection was survey based, these findings are inherently limited by its methodology, including selection bias for those more likely to complete a voluntary questionnaire. Relatedly, those who responded were in partnerships with the women CT surgeons, thus excluding a group who was divorced or separated. Specific limitations in this context include an inability to determine response rate because this survey was distributed through intermediary CT surgeon partners of the respondents. Similarly, we are unable to know the proportion of the population that our study fully represents. Future studies should include a diversification of types of partnership and experiences.

The demands of CT surgery often affect personal relationships, with those of partners particularly vulnerable. Our findings highlight challenges and benefits encountered by partners of women CT surgeons across all stages of their careers and relationships. Elucidating the dynamics arising from a woman's career in CT surgery enables us to better provide insight and support for those interested in the field and within our community.