For many women in surgery, building a career that establishes a leadership ascent framework while maintaining a semblance of work-life balance can be particularly challenging. Yesterday, Elizabeth R. Benjamin, MD, PhD, FACS, and Jamie Jones Coleman, MD, FACS, led a Town Hall session, Women in Surgery: Leadership and Work-Life Integration, to discuss productive methods and approaches to advance one’s career.

Throughout the discussion, the audience posed questions focused on the challenges of making time for family and other obligations outside of work while pursuing career-driven ambitions.

“I think that one of the biggest things for me was really setting boundaries and being honest with myself about what I want in both places,” said Dr. Benjamin, professor of surgery, trauma/surgical critical care at Emory University School of Medicine in Atlanta, Georgia, and trauma medical director at Grady Memorial Hospital in Atlanta. Dr. Coleman is the vice-chair of wellness and associate professor of surgery at the University of Louisville School of Medicine in Kentucky.

Women starting their careers as surgeons can find themselves overwhelmed with opportunities that might feel more like obligations, according to Dr. Benjamin, who has a young daughter. Residents are encouraged to be a “triple threat” by pursuing research and teaching along with their clinical duties.

“When I look at myself in the mirror, I know what I’m good at and what I like to do,” Dr. Benjamin said. “It’s not all of those things.”

She urged attendees to combat these unrealistic expectations by identifying what they enjoy about work and what they hope to do in the future. Once those priorities are defined, it becomes easier to say ‘yes’ to opportunities that are in service of one’s goals and to say ‘no’ to superfluous commitments.

Women who leverage these strategies throughout their careers can still feel like they’re not doing enough at home, particularly those with children. The moderators and attendees commented on the difficulties of raising young children who wish their mothers would stay home more. Several attendees noted that despite their demanding full-time careers, they still felt pressured to attend every soccer game for their children or bake cookies for the school bake sale.

“Mom guilt can always hit you, but it will continue to hit you until you reconcile the fact that you’re a better mother because you are a surgeon,” said Dr. Coleman, who has two young sons.

Dr. Coleman has adopted an optimistic perspective on what it means to be a working mother. Being a surgeon has taught her sons a valuable lesson about women’s roles in the family and society, she said.

Residents and women early in their careers often feel that starting a family is something they need to avoid or put off until they’re more tenured clinicians. An array of Town Hall participants, along with Drs. Benjamin and Coleman, shared stories of how they were made to feel like they would be causing a problem for their employer if they became pregnant.

Dr. Benjamin urged attendees to be direct with their employers and draw clear boundaries around their needs and desires for life outside of work. This communication should be factual, not aggressive or combative, Dr. Benjamin clarified. Dr. Coleman also emphasized the importance of building support systems with other colleagues to deal with these issues collectively.

“You’ve got to find people who understand your life,” Dr. Coleman said.