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Barriers to Career Flexibility in Academic Medicine: A Qualitative Analysis of Reasons for the Underutilization of Family-Friendly Policies, and Implications for Institutional Change and Department Chair Leadership

Shauman Kimberlee PhD; Howell, Lydia P. MD; Paterniti, Debora A. PhD; Beckett, Laurel A. PhD; Villablanca, Amparo C. MD
doi: 10.1097/ACM.0000000000001877
Research Report: PDF Only


Academic medical and biomedical professionals need workplace flexibility to manage the demands of work and family roles and meet their commitments to both, but often fail to use the very programs and benefits that provide flexibility. This study investigated the reasons for faculty underutilization of work–life programs.


As part of a National Institutes of Health–funded study, in 2010 the authors investigated attitudes of clinical and/or research biomedical faculty at the University of California, Davis, toward work–life policies, and the rationale behind their individual decisions regarding use of flexibility policies. The analysis used verbatim responses from 213 of 472 faculty (448 unstructured comments) to a series of open-ended survey questions. Questions elicited faculty members’ self-reports of policy use, attitudes, and evaluations of the policies, and their perceptions of barriers that limited full benefit utilization. Data were coded and analyzed using a grounded theory approach.


Faculty described how their utilization of workplace flexibility benefits was inhibited by organizational influences: the absence of reliable information about program eligibility and benefits, workplace norms and cultures that stigmatized program participation, influence of uninformed/unsupportive department heads, and concerns about how participation might burden coworkers, damage collegial relationships, or adversely affect workflow and grant funding.


Understanding underuse of work–life programs is essential to maximize employee productivity and satisfaction, minimize turnover, and provide equal opportunities for career advancement to all faculty. The findings are discussed in relation to specific policy recommendations, implications for institutional change, and department chair leadership.

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Funding/Support: This work was supported by National Institutes of Health award GM 088336—in partnership with the Office of Women’s Health Research—with the goal of supporting “Research on Causal Factors and Interventions That Promote and Support the Careers of Women in Biomedical and Behavioral Science and Engineering.” The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of General Medical Sciences or the National Institutes of Health. This publication was also made possible by the Frances Lazda Endowment in Women’s Cardiovascular Medicine to one of the authors (A.C.V.).

Other disclosures: None reported.

Ethical approval: UC Davis Institutional Review Board approval.

Previous presentations: This work was presented in part in poster format at the November 2010, 2011, and 2012 annual meetings of the Association of American Medical Colleges held in Washington, DC; Denver, Colorado; and San Francisco, California, respectively.

Correspondence should be addressed to Amparo C. Villablanca, University of California, Davis, Division of Cardiovascular Medicine, 1 Shields Ave., TB 172, Davis, CA 95616; telephone: (530) 752-0718; e-mail:

© 2018 by the Association of American Medical Colleges