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Most of us are familiar with "work-life" conflict, but we may be surprised to hear that workers in certain professions actually report "work-work" conflict. The average day for an academic medical faculty member at Stanford’s School of Medicine, for example, may include preparing a grant application, meeting with coworkers, advising students, and grading papers for a medical course—all of which compete with lab work and clinical care. Faculty at the School of Medicine, or SoM, fit these competing responsibilities into work weeks that regularly total 65+ hours. Add to these the typical work-life conflicts of balancing career, family, and personal interests, and it's no wonder that a recent faculty survey listed work-life balance as a top concern.
Relief may be on its way, however—in the form of a new program called Academic Biomedical Career Customization (ABCC), a pilot of which will be in full swing by the end of January. ABCC combines two innovative flexibility programs, customized to fit the needs of SoM faculty. First, it prompts faculty to create customized career plans, encouraging them to address work-life issues by varying their workloads and responsibilities over the course of their careers. Second, it includes a "time banking" system, where faculty earn credits they can cash in for help with certain tasks at work or at home.
The ABCC program was co-created by Dr. Hannah Valantine, Senior Associate Dean for Diversity and Faculty Development at the SoM and Dr. Christy Sandborg, Vice President of Medical Affairs at Lucile Packard Children’s Hospital. Dr. Caroline Simard, Associate Director for the SoM Office of Diversity and Leadership, is implementing the ABCC pilot. Dr. Jennifer Raymond, Associate Professor of Neurobiology, is Associate Dean for Faculty Career Flexibility and has been working on the design and implementation of ABCC. She is spearheading the adaptation of the program to basic science fields and clinical faculty.
The ABCC team is confident that their program will redefine the way work and careers are conceptualized in the medical school and, in turn, alleviate faculty’s time pressures.
The gendered nature of work conflicts
Given that academic medical faculty regularly work 60 hours a week or more, work-life and work-work conflicts are issues facing all physician-scientists. However, female faculty experience both types of conflict at even higher rates than their male peers.
Work-life and work-work conflicts are issues facing all physician-scientists.
Despite changes in family roles in recent decades, women are still likely to have greater responsibility for tasks related to home and children than their male partners, increasing their experience of work-life conflict.
According to Raymond, women in academic medicine also experience more work-work conflict than men. In a career where pay and promotion decisions are based on research productivity and clinical care, research shows that women faculty do a disproportionate share of teaching and service work. For example, research shows that women associate professors spend, on average, eight hours more per week teaching, serving on committees, and mentoring students and postdocs than their male colleagues. This gendered division of workplace labor, says Raymond, leads to one of the top problems facing the academic medical community: the retention of female physician-scientists.
Flexibility policies—What works in academic medicine and what doesn’t
Valantine and Sandborg knew from the start that designing and implementing a program to help academic medical faculty balance their competing demands would be a challenge. In fact, results from a 2009 study showed that few SoM faculty made use of the flexibility policies already available to them.
The ideal solution balances the need to provide relief from work-life and work-work conflicts with faculty’s adherence to a professional culture.
Valantine and Sandborg found that Stanford’s previous flexibility options have been underutilized by faculty because they are misaligned with academic culture—a culture that valorizes long work hours and productivity, career advancement, and individual accomplishments. (Indeed, a recent study of faculty revealed that many worried that using a flexibility policy signaled to their coworkers and supervisors that they were uncommitted to their careers.) The ideal solution, Valantine believes, is one that balances the need to provide relief from work-life and work-work conflicts with faculty’s adherence to this professional culture.
The ABCs of ABCC—Customized career plans for work-life balance
ABCC helps faculty address work-life balance by encouraging them to vary their workloads and responsibilities over the course of their careers to meet their evolving individual priorities.
Valantine and Sandborg found inspiration for ABCC in an innovative program implemented at the consulting firm Deloitte LLC, called Mass Career Customization (MCC). MCC’s premise is that career progression should be thought of as a “lattice” rather than a ladder. On the career lattice, employees accelerate or decelerate their careers at any point in time, without stepping off the path to career advancement. MCC changes the way employers and employees think about career growth and success, from a cookie cutter approach to one where variation is the norm.
Like the Deloitte model, ABCC encourages the faculty to modify their job responsibilities (research, teaching, clinical care, and service), accelerating their careers when possible and decelerating when family and personal responsibilities are greatest. How exactly does the faculty do this? First, faculty participate in career coaching to help identify their short and long-term goals, and to recognize points in their career where they may have increased family or personal responsibilities (for example, child or eldercare). Then faculty, along with their department chairs or division chiefs, create customized career plans, deciding whether they will “scale up” or “scale down” along four dimensions of work: pace (rate to promotion), workload (part-time versus full-time), location/schedule (restricted versus not-restricted), and role (individual contributor or member of leadership). Finally, the faculty identify the flexibility policies that will allow them to achieve their career goals.
Time banking offers innovative approach to alleviating both kinds of work conflict
ABCC also fundamentally alters the way faculty are rewarded for the work they do. The program includes a “banking” system in which the faculty earn credits for taking on additional teaching and service responsibilities. Using an online program, faculty track their hours spent on non-research related activities, like teaching classes or serving on university committees. As the time accumulates, they earn credits which they can use to help alleviate either work-life or work-work conflict. For example, faculty can cash in their credits for help with grant writing, for a meal delivery service, or even to hire a housecleaner. Thus, work activities that require faculty-level input but take time away from research (teaching, service) earn help with other activities that compete with research and can be done by someone other than faculty (cooking, housecleaning, editing a grant application). Raymond explains that faculty “reinvest the credits in their own career advancement and work-life fit.”
Work activities that require faculty-level input but take time away from research (teaching, service) earn help with other activities that compete with research and can be done by someone other than faculty (cooking, housecleaning, editing a grant application).
Some people may object that credits for meal delivery or housecleaning are an unnecessary luxury. Simard has a different perspective, citing research conducted by former Clayman Institute Director Londa Schiebinger. By freeing up faculty to do the work for which they were trained and are most qualified to do, Simard explains, faculty will be more productive—a win-win for faculty and the SoM.
Raymond is hopeful that this aspect of the program will help reverse gender inequities in academic medicine as well. By revaluing faculty’s work responsibilities, female faculty will receive some benefits for the extra teaching and administrative work they do, as will male faculty who take on these same types of duties.
Tracking ABCC’s effects
The ABCC pilot will be fully implemented by the end of this month. Moving forward, Simard will examine how the program affects faculty’s satisfaction with work-life integration, their research productivity, perceptions of career advancement and development, and Stanford hospital patients’ satisfaction with the SoM doctors. She is confident that the ABCC framework will help faculty better balance their competing demands and help them feel more satisfied with their work and home lives.
Dr. Hannah Valantine is a cardiologist, Professor, and Senior Associate Dean for Diversity and Faculty Development at Stanford’s School of Medicine. Valantine joined the Stanford community in 1985 and has since risen to the rank of full professor. Valantine moved into her role at the Office of Diversity and Leadership in 2005. She was a 2009-10 Faculty Research Fellow at the Clayman Institute.
Dr. Christy Sandborg is a pediatric rheumatologist and Professor. In 2012, she became the Vice President of Medical Affairs at Stanford’s Lucile Packard Children’s Hospital. Sandborg’s scholarly interests include developing programs to facilitate career training and research opportunities for the next generation of academic pediatricians. More recently, Sandborg has focused on developing new models of care for children with the most complex rheumatic chronic illnesses.
Dr. Jennifer Raymond is an Associate Professor of Neurobiology and the Associate Dean for Faculty Career Flexibility. Her research focuses on the neural mechanisms of learning, using a combination of behavioral, neurophysiological, and computational approaches. Dr. Raymond was a 2011-12 participant in the Clayman Institute's Voice & Influence Program.
Dr. Caroline Simard is now the Director of Research at the Clayman Institute for Gender Research. She was the Associate Director for Diversity and Leadership at Stanford’s School of Medicine. She received her Ph.D. from Stanford before going to work at The Center for Social Innovation of the Stanford Graduate School of Business and then The Anita Borg Institute for Women and Technology. Simard’s work addresses women and minorities’ under-representation in Science, Technology, Engineering, and Math (STEM) fields and business.
Lindsey B. Trimble received her Ph.D. in Sociology from Washington State University. She is a Postdoctoral Fellow at Stanford’s Clayman Institute for Gender Research, where she studies social networks and labor market inequality.
