Ahead of Mother's Day this weekend, Secretary of the AMA Victoria Private Practice Subdivision Associate Professor Vinay Rane has penned a column reflecting on the evolving challenges facing women in the medical profession and the reforms needed to address those challenges.
Mother's Day, and the Arithmetic of Training
As Mother's Day approaches, amid the predictable rush of brunch bookings and florists doing their best work, my thoughts have drifted elsewhere, toward the women I trained alongside, and what it has required of them to reach the same professional destination.
Medicine has always demanded endurance. The hours are long, the examinations exacting, and the service obligations rarely confined to what is formally rostered. We accept this as the price of admission. What receives far less candid attention is how unevenly that burden is distributed.
For women in training, particularly those who choose to have children, the equation becomes far more complex. Maternity leave exists in policy, but the lived experience is often something quite different. Stepping away is rarely a clean break. Training pathways are rigid, progression can stall, and there remains a persistent sense that time away must be justified rather than simply taken. Many return earlier than they would otherwise wish, not because they are ready, but because the system does not easily accommodate absence.
That tension is amplified by a shift we have not adequately confronted. Our trainees are older than they once were. The rise of postgraduate pathways, increasingly competitive entry, and prolonged training programs have compressed the window in which decisions about parenthood are made. What was once sequential has become concurrent. Career and family now demand attention at the same time, and too often the structure of training forces a choice between the two.
The financial dimension compounds this. College fees, registration, indemnity, and insurance continue unabated. These are not trivial expenses, and they do not adjust in recognition of reduced income. For a period already characterised by vulnerability, the burden is considerable.
Overlaying all of this is a more difficult truth. The demands of training and the demands of motherhood do not negotiate with one another. Each asserts its claim fully. The result is a constant recalibration, accompanied for many by a persistent sense of maternal guilt, a feeling that one is falling short in one domain regardless of how much is given to the other.
Within departments, expectations have not always evolved to reflect this reality. Women on leave are frequently asked to maintain involvement in audit, departmental meetings, and administrative responsibilities. Tasks that would ordinarily sit within funded clinical time migrate into what is ostensibly protected leave. This is seldom the result of ill intent. More often it reflects systems that have not been redesigned with sufficient care. Nevertheless, the cumulative effect is difficult to ignore.
I reflect as well on my own experience as a trainee, and not without a degree of discomfort. I was treated generously, at times indulgently, by a workforce largely composed of women across nursing, midwifery, and administrative roles. I was supported, encouraged, and, if I am honest, afforded latitude that I did not always earn. It is increasingly clear to me that my female colleagues were not extended the same margin. Expectations were sharper, tolerance narrower, and errors less easily absorbed.
There was, too, a difference in how ambition was interpreted. In young men it was often read as leadership potential, something to be fostered and promoted. In young women, the same traits could attract far less generous interpretations, recast as abrasiveness or a lack of collegiality. I benefited from a culture that did not distribute its goodwill evenly.
The profession has changed in visible ways. Women now constitute a substantial and growing proportion of medical graduates, and their presence across specialties continues to expand. This is to be welcomed. Representation, however, is only one part of the story. Structural and cultural reform must follow.
The question that presents itself is whether our hospitals have adapted with sufficient pace. Have we created an environment in which it is genuinely possible to work, to parent, and to sustain a sense of self that is not perpetually under strain? Or have we simply increased the number of women navigating a system that was never designed with them in mind?
Mother's Day offers an opportunity for reflection. Not only on the role of mothers, but on the structures within which they are asked to function, and whether those structures are fit for purpose.
