“It's impossible to do it all”: a cross-sectional observational study of pediatric faculty parents during the COVID-19 pandemic

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused systemic changes to schooling, childcare, and the workplace, uniquely impacting the lives of physicians and parents, especially women. Experiences of those filling multiple roles as pediatric faculty parents remain largely undocumented. Methods: In September 2020, we emailed a survey invitation to pediatric faculty (n=275) at a tertiary-care children's hospital in an early pandemic epicenter and collected cross-sectional observational data from those who responded within 1 month. Survey items included age, gender, and parenting status of children <18 years. Our primary outcome was difficulty meeting work commitments due to family demands. Response categories were dichotomized: 'not at all/a little' vs. 'sometimes/always'. We assessed bivariate associations of age, gender, and parent status with our outcome and entered significantly associated variables plus gender into a logistic regression model. We asked parents three open-ended items about work/life challenges and mitigation strategies, using thematic analysis to code and identify themes in the data. Results: Of 110 survey respondents, 66% were women; 46% were parents; 57% were ≤ age 50 years; 40% reported elevated difficulty. Age and parent status were independently associated with elevated difficulty. After adjusting for age and gender, parents had higher odds [odds ratio (OR): 5.48, 95% confidence interval (CI): 1.9-16.1] of elevated difficulty than non-parents. Three themes emerged from open-ended items: (I) challenges of new and expanded roles; (II) variety of sources of support; (III) finding relief in flexible work arrangements. Conclusions: We found that pediatric faculty parents experienced difficulties that align with a sociological construct termed as 'role conflict', defined as distress occurring from filling multiple social roles with conflicting demands. Institutional policies that provide flexible work opportunities, may help to support faculty holistically and reduce role conflict.