Women Physicians in Transition Learning to Navigate the Pipeline from Early to Mid-Career: Protocol for a Qualitative Study
Authors: Leung Tiffany I , Wang Karen H , Lin Tammy L , Gin Geneen T , Pendharkar Sima S , Chen Chwen-Yuen Angie 
Published: May 2022

Background
Women physicians face unique obstacles while progressing through their careers, navigating career advancement and seeking balance between professional and personal responsibilities. Systemic changes, along with individual and institutional changes, are needed to overcome obstacles perpetuating physician gender inequities. Developing a deeper understanding of women physicians’ experiences during important transition points could reveal both barriers and opportunities for recruitment, retention, and promotion, and inform best practices developed based on these experiences.

Objective
The aim is to learn from the experiences and perspectives of women physicians as they transition from early to mid-career, then develop best practices that can serve to support women physicians as they advance through their careers.

Methods
Semistructured interviews were conducted with women physicians in the United States in 2020 and 2021. Eligibility criteria included self-identification as a woman who is in the process of transitioning or who recently transitioned from early to mid-career stage. Purposeful sampling facilitated identification of participants who represented diversity in career pathway, practice setting, specialty, and race/ethnicity. Each participant was offered compensation for their participation. Interviews were audio-recorded and professionally transcribed. Interview questions were open-ended, exploring participants' perceptions of this transition. Qualitative thematic analysis will be performed. We will use an open coding and grounded theory approach on interview transcripts.

Results
The Ethics Review Committee of the Faculty of Health, Medicine, and Life Sciences at Maastricht University approved the study; Stanford University expedited review approved the study; and the University of California, San Diego certified the study as exempt from review. Twelve in-depth interviews of 50-100 minutes in duration were completed. Preliminary analyses indicate one key theme is a tension resulting from finite time divided between demands from a physician career and demands from family needs. In turn, this results in constant boundary control between these life domains that are inextricable and seemingly competing against each other within a finite space; family needs impinge on planned career goals, if the boundary between them is not carefully managed. To remedy this, women sought resources to help them redistribute home responsibilities, freeing themselves to have more time, especially for children. Women similarly sought resources to help with career advancement, although not with regard to time directly, but to first address foundational knowledge gaps about career milestones and how to achieve them.

Conclusions
Preliminary results provide initial insights about how women identify or activate a career shift and how they marshaled resources and support to navigate barriers they faced. Further analyses are continuing as of March 2022 and are expected to be completed by June 2022. The dissemination plan includes peer-reviewed open-access journal publication of the results and presentation at the annual meeting of the American Medical Association’s Women Physicians Section.