Work-Life Conflict among Female Doctors and their Career Development

I. ABSTRACT

This research analyses the contemporary phenomena of work and family issues of working women and then their impact on the career development. Issues of both work and family are seen to fuel each other as well as driving trends in career development. The career development is shown to occur partly as a consequence of the work and family life satisfaction. To understand about the career development the tradition explain status of women, patriarchy and family system, issues of work life conflict. Considering the nature, aim and purpose of the study, researchers selected the Sheikh Zaid hospital and Shalimar Hospital as research site. The tool for data collection was in-depth interview, for which researchers have developed a comprehensive interview guide. Taking into consideration the nature of this study, the in-depth qualitative interviews were conducted with the female doctors to know their view point about their work and family issues both. Tough routines of female doctors in hospitals and their family life negatively affect their career development. The study concludes by recommending the new aspects for research and family friendly policies by Government for working women.

II. INTRODUCTION

According to the U.S. Bureau of Labor Statistics (1998), 76 percent of married women with children ages six to seventeen years old are in the labor force, and 64 percent of women with children under age six work outside the home. Women now represent 46.2 percent of the workforce, up from 29 percent in 1950, and they will comprise approximately 48 percent of the workforce by 2005 (Bureau of Labor Statistics, 1998). Postsecondary educational attainment among women has been climbing since the 1960s. In 1994 women outnumbered men among the recipients of postsecondary degrees at every level except doctoral. Women now account for 55 percent of bachelor's degrees, 53 percent of master's degrees, and nearly 40 percent of doctorates. Historically educational attainment has been a predictor of increased labor force participation (National Center for Education Statistics, 1997; U.S. Department of Labor, 1994).

A survey of working adults conducted by the New York Times reports that 83 percent of working mothers experience conflict between work demands and the desire to be with family (Galinsky, Johnson and Friedman, 1993). Further, nearly 40 percent of women surveyed reported that their job interferes with family life. Over 30 percent of women have tried to cope with this stress by declining a new job, promotion, or transfer because it would have meant less family time (Galinsky, Johnson and Friedman, 1993). Constant interference of family with work responsibilities can hinder women's career progression, decrease satisfaction with work, interfere with concentration on the job, increase absenteeism, and perhaps eventually lead to turnover (Parasuraman and Greenhaus, 1997).

The 1973 constitution, prepared by the Bhutto regime (1972-1977), gave women more rights. Relevant clauses of 1973 constitution are as follow:

Article 34

Steps shall be taken to ensure full participation of women in all sphere of national life.

The roles of women are significant in any nation's development. Women work in many fields and these working women, the laborers, the career girls, the high academic achievers, the productive citizens are greatly contributing to the economy through her skills in Pakistan. But the low status of the women is one of the many factors in Pakistani which interfere with the achievement of development goal (Aziz, Sociocultural, religious and political aspects of status of women in Pakistan, 1998). Mainly their work contribution and work is mostly underrated, underreported and hardly celebrated. This undermines her identity as a laborer, skilled worker and a professional.

In past, perception about the working women is not so much positive but as the globalization culture spread out and covers the whole world. It almost changed the whole culture of the working environment all over the world. A few decades ago the number of working women was very few and they were reluctant to work outside the house. People also used to think that the appropriate position of the women is inside the house, but now the trend is changing. All the countries and nations are now realizing the importance of working women in their economy.

2.1 Statement of the Problem

Work life conflict is complex phenomena that have far reaching effects on career development. At one extreme, women's participation in workforce is increasing and has great impact on economy of any country. At the other extreme it is cause of much issue in work and family. Women's participation in workforce also undermined traditional livelihoods of female, changed the traditional social system of a family.

It is believed that to take advantage of the opportunities of employment and manage household and job responsibilities, people and countries had to make reforms and policies to address the issues of married working women. But with the increasing number of women in workforce emerges a growing demand for wide family friendly employment policies for women.

This study aims to explore the impact of work life conflict and work and family issues on working women for their career enhancement and how dynamics changed for this research work is concerned with the complex nature of problems of female doctors. Moreover, the study is conducted to analyze the response of doctors from two different hospitals to explore their work life conflict and their major confronts faced in addressing these issue for their career development.

2.2 Sociological Significance of the Study

Work life conflict is an important problem to focus in today's time where participation of women in workforce increased. Work life conflict and time management among different roles is an important issue for working women and it effects their career development. The aim of this thesis is to explore the issues of work and family issues of working women and their impact on career development in Pakistan with particular emphasis on the hospitals. Taking Sheikh Zaid Hospital and Shalimar Hospital, the interview is conducted to analyze work and family issues of female doctors both married and unmarried that effect their career. After an intensive literature review, it became clear that there is major room for further studies into this area in the specific context of Pakistan. Although there have been a lot of studies conducted by social scientist to exploring the issues of working women but, social scientists have hardly investigated the work and family issues of female doctors specifically married and unmarried. Also there was no sufficient literature in this area, pointing towards lack of researches in this domain. This study will help to understand these gaps and will also provide a foot hold for further studies on this topic in future and it can also be generalized at societal level to inform civil society about the changing trends of participation of women in workforce and their status and its impact on socio-cultural dynamics of our society.

2.3 Research Questions

The research questions is formulated as follows,

1. What is the nature of work life conflict that young Pakistani doctors are facing in contemporary Pakistan?

2. How the professional life of young Pakistani doctors influence different other aspects of their lives including family, marriage?

III. LITERATURE REVIEW

The literature review emphasis on Socioeconomic status of women which is worse because of low literacy rate, lack of educational services, awareness, and poor economic situation, lack of skills and self-doubting environment of the society for working women. Men have more decision-making power than the women regarding family, choice of selecting male partners and household expenditure. Education has been of fundamental importance to the development of human society. Traditionally, it is understood that women are limited to their homes and men are the breadwinners of the family. In this situation, education can play a vital role in enhancing the status of women and placing them on an equal balance with their male counterparts and it also increases women's ability to lock employment in the formal sector. Women workers face different challenges in the workplace like gender based discrimination, harassment, domestic restriction, work and family issues and unequal pay. Better governance, proper implementation of laws and policies, and balanced progress of all sections and areas of society would obviously reduce the problems faced by the members of society, including women.

3.1 Status of Women in Pakistani Society

Society all through the world consists of two sexes (male and female). Though their roles are not uniform right through the world, but at rest they have to play their productive role in the society. In

Underdeveloped world, the strength need activities, most likely a male trait is not strictly allocated to males. In fact, activities such as burden bearing and water carrying are done more by female than by males (Begum, 2002).

The status of women in each society is a complex phenomenon. To denote the status of women, various scholars have used different concepts in literature such as female autonomy by Dyson and Moore (1983), women's right by Dixon (1975), patriarchy by Cain et al (1979) and men's situational advantage by Caldwell (1981) (Aziz, sociocultural, religious and political aspects of the status of women in Pakistan, 1998). The aspects of female status and roles that are interest to social policy makers are the ability of women to plan their reproductive behavior and their capacity to limit their fertility to a preferred number of children [Syed (1978), p. 409].

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The 1973 constitution, prepared by the Bhutto regime (1972-1977), gave women more rights. Relevant clauses of 1973 constitution are as follow:

Article 25

1. All citizens are equal before law and are entitled to the equal protection of law.

2. There shall be no discrimination on the basis of sex alone.

Article 27

No citizen otherwise qualified for appointment in the service of Pakistan shall be discriminated against in respect of any such appointment on the ground only of race, religion, caste, sex, residence or place of birth.

Steps shall be taken to ensure full participation of women in all sphere of national life.

Article 35

The state shall protect marriage shall protect marriage, the family, the mother and the child. [Hafeez (1981, 15-16)].

The Ideology- "No nation can rise to the height of glory unless their women are side by side with them...It is crime against humanity that our women are shut up with in the four walls of the houses as prisoners. There is no sanction anywhere for the deplorable condition in which our women have to live."... (Quaid-e-Azam Muhammad Ali Jinnah, Father of the Nation) (Bhattacharya).

The Reality- "Pakistan was made only for the powerful and for the men. It was not made for weak and poor women like me. What is worth and what is status of women in Pakistan? (Bhattacharya).

3.2 Gender relationships

Gender refers to the social roles and status difference between women and men in a society. These roles are determined by the social, cultural and economic organizations of a society and the prevailing religious, moral and legal norms. 'Sex' is a biological term while "gender" a psychological and socio-cultural one (Anderson 1988).

Nobody is superior or inferior on the basis of gender as said "The sole basis for superiority of any person over another is piety and righteousness not gender, color, or nationality" (Quran 49:13) (Bukhari, 2013).

Gender discrimination is prevalent in Pakistani society but causes of gender discrimination are usually misunderstood. Usually this discrimination is influenced by cultural norms and traditions, religion, region. Human beings belong to two sexes. Both genders are different biologically and socially, in their needs, fields of responsibilities. Physically a female is made to make family, relations, serve and trained human beings gently and male is made for hardships to construct, bear workload and struggle for earning. Both are equal in basic human rights but gentleness of woman need to be secure by strength of man. Both are made for different purposes so they cannot be utilizing in same manners (Bukhari, 2013).

3.3 Women Education and Employment

Women's empowerment and gender equality are key objectives for the United Nations (UN) and other humanitarian organizations. The United Nations Educational, Scientific and Cultural Organization (UNESCO) names gender equality as one of two global priorities (UNESCO 2009). Key events in the international dialogue relating to women's empowerment and gender equality are the Beijing Declaration and Platform for Action (United Nations 1996), the United Nations' Millennium Declaration (United Nations 2000a) and the subsequently formulated Millennium Development Goals (MDGs), with targets for achieving specific levels of improvements by 2015 (United Nations 2001; United Nations Development Programmed 2008; World Bank 2003) (Courtneyb S. M., 2009).

IV. METHODOLOGY

The sociological research is exploring the notion of work and family issues and their impact on women's career development. This study has tended to rely on qualitative methods in order to explain the issues, problems and strategies of work life conflict among working women. To explore the work family conflict in females young doctors both married and unmarried, it is important to look at each of these problems and issues and examine how actors suffer from these problems. Moreover this study looks at the choices and reasons underpinning the methodological framework and the data collection methods employed in the research. Therefore, this begins with the explanation of qualitative research model, its epistemological stance, and adoption of an interpretive approach for the data collection. The discourse then proceeds towards the research design and the case study comparative research and provides the rationale for adopting this approach. The following section construe the data collection methods used in this research. The sampling strategy is discussed together with the data sources. The scheme for entering the research sites and conducting field work includes the processes of negotiation, rapport building, and disclosure and effective use of gate keeping is also mentioned. After that, the researcher explains the reasons for selecting in-depth semi structured interviews, as a tool of data collection, are examined alongside the structure of interview guides. Following this discussion, ethical consideration i.e. informed consent, privacy, anonymity, and confidentiality of the participants are also part of the present study. The researcher's filed work experiences are also expounding. Towards the end, the procedure for transcribing and analyzing the data are discussed.

4.1 The Qualitative Research Model and Epistemological Position

Major social science approaches, positivist and interpretivist, have their roots embedded in two areas of philosophy which are ontology and epistemology. Ontology deals with "what exist" and asks what reality is but epistemology is concerned with the creation of knowledge. Both of these approaches provides a different outlook to observe, measure and understand the social reality (Neuman, 2000). The positivist paradigm emphasized on objective measurement of social issue and it forms the foundation for quantitative studies in social sciences (Charmaz, 2006). Taking into account the conception of positivism, it is difficult to analyze the dynamics of work life conflict among young female doctors in Pakistan. That is why, the present study position itself within the qualitative approach to social sciences that seeks to understand the meaningful social action, socially constructed meaning and value relativism (Neuman, 2000). This particular outlook of looking at society is known as the interpretive approach and qualitative research is primarily situated in the interpretive school of thought (Manson, 2002).

This research begins with observation and proceeds with the search for pattern in what researcher have observed. So, present research placed itself in inductive research rather than deductive in which researcher derive hypothesis and then tested through observation. The present research theory is generated from data in a reflexive manner. The research begins with little knowledge of ideas under study, so the conceptualization and operationalization of the concepts occurred during the data collection and analysis phase.

4.2 Purposive sampling

Playing with the corners of the triangle of a specific gender, work and family issues of working women the themes under-study have heterogeneous, complex and divers opinion in explanation of different working women (Macionis, 2001). Interviewing only women from both hospitals i.e. Shaikh Zaid hospital and Shalimar hospital helped the researcher not only to know about the theme and phenomena under-study but also made researcher capable to know the divers viewpoints of respondents with reference to their age, cast and occupation in general. Proper consideration was given to the view and experiences of all respondents involved in study and different meaning which they attach to particular issues and experiences.

Qualitative research is conducted in a micro-setting by qualitative researcher who is not interested in broader generalization in greater extended (Usman, 2011). Thus they are not indulged in detailed procedures of selecting a representative sample using the probability sampling techniques so as to come out with general explanation about larger population like quantitative researchers (Usman, 2011). So they select their sample by using non-probability sampling techniques with aim and intention to understand the context of particular study in depth and detail (Marashal, 1996; Neuman, 2000).

4.3 Ethical Considerations

There are some ethical considerations that a researcher has to follow during the interaction with research participants. The fundamental ethical principle is to obtain permission from respondents and inform them about what they are being asked to participate in (Neuman, 2000).

Therefore, the informed consent was obtained from the participants by informing them about the purposes and specifics of the study. The date and time for interview was decided in accordance with respondents' will. The respondents were made fully aware about the study and its purposes by the researcher at the beginning of the interview. They were also informed about the expected duration of an interview and that they were free to withdraw at any stage without giving a reason. It was decided to ask the participants to sign a consent form as well.

4.4 Data Analysis

Data analysis reflects both variation and homogeneity through critical synthesis. The interpretive structure is used to make sense of interview data in terms of intentions of the respondents by systematically analyzing the data and summarizing the description, to provide a coherent organizing framework.

4.5 Nature of Work Life Conflict-Married

This topic analyses the nature of work life conflicts among married women. The responses of married working women about the work life conflict are analyzed here. Reactions to nature of work life conflict differ according to the experiences and role of the doctors interviewed. This section looks at how the socialization of children, household responsibilities, relation with husbands and in laws and social relations are affected with the work of the married working women's.

4.5.1 Socialization of children

Socialization, as defined by Hartley and Hartley (In HSU 1972:470), is "learning to be a member of a group." It is difficult to develop a more precise definition, because each society has its own conception of socialization. The nature of the learning process in each society is based on two criteria: the inherent abilities of children and cultural ideas about children (Goodman 1970). In order to make each child a useful member of his culture, socialization must foster ideas about cultural values and expectations and a desire to conform to these values and expectations (Davis, 1975).

Mothers are often considered the primary agent for socializing children, especially when the children are very young. In contrast, little attention has been paid to the fact that mothers are also socialized into becoming good mothers. Those mothers who have preschool children and try to hold outside jobs must prove that they are indeed "good mothers" despite their outside employment (Mariko, 1989).

Another respondent talked about the relation between mother and a child, which is as:

There is so much interaction between a mother and child's socialization. Mothers are so much responsible for their socialization. Children's should not dependent on husbands and on in-laws; it is a mother duty to socialize them. I give so much time to my children's (Dr. Ayesha, 25, married).

4.6 Education

Mothers who return to work after their baby is born risk causing serious damage to the child's prospects in later life. Such children are more likely to do worse at school, become unemployed and to suffer mental stress than youngsters whose mothers stay at home to bring them up. According to the study, the impact of having a full-time working mother on a child's education is similar to growing up in a single-parent family. If a mother returns to work, the child is 20 per-cents less likely to get an A-level. Researcher has also rejected the idea that a child is helped if the father stays at home, showing that his absence has little effect on the child's educational success (Doughty, 2015).

4.7 Relationship with husbands

Another respondent has a same feedback about his husband such as

My husband is an educated man so he thought and understand that an educated or doctor woman shouldn't stay at home after such a tough study. So my husband is $100\mathrm{\%}$ favorable to my job. And my dependence on my husband is very much. I totally depend on him for everything (Dr. Hafsa, 28, married).

All the working women have those relations in which their husbands are very much favorable and cooperative to them. But it doesn't mean that these working women don't depend upon their husbands. They are dependent on them for every purpose. In majority responses it has been noticed that all the husbands of working women consider that their educated wives should do job outside after such a difficult study. But due to their jobs their relation with their husbands affect so much because they can't give them adequate time due to their day and night duties.

4.8 Relationship with in laws

Only one exceptional case reveals that in laws don't bother when the household responsibilities can't be fulfilled. It can be only possible if the mother in law is also a working woman, only in this condition she can understands the situation of her daughter in law. But in many other majority cases it is noticed that in laws bothers when these responsibilities aren't fulfilled. Although they are favorable to the job of their daughter in law but at the same time they don't give her any margin in these responsibilities.

4.9 Social Relations

When the working women do the professional work, they become so much busy in their tough working routine that they can't interact with other people of society. Even they can't attend the socially occurred events, so their social interactions are affected so much due to their work life. As one of the respondents said that

Social interactions become very much less. We haven't enough time to attend the social events. We have more night duties as a doctor so social events are so much effected. We are stuffed every time. Due to our tough routines, even we forget our own special events gradually (Dr, Sameena, 28, Married).

In Pakistani society women's work is frowned upon; men are considered the rightful breadwinners and women's sphere is restricted to the household. Only certain occupations are viewed as "desirable" and "respectable" for women. Teaching and practicing medicine are viewed favorably but not factory work or domestic service. Thus enhanced status is associated with higher status jobs only. So, profession of doctors considers a respectable profession. In our society before the changing the trend of increase in women participation in workforce, consider that women who worked were more likely to be widowed or separated or facing stringent financial needs in the household. Very few women worked out of choice, and the majority stated that they would give up work if their financial situation improved. As we know work participation of women is also generally examined as important indicator of status of women. Women's labor force participation in Pakistanis not necessarily associated with enhanced status.

Both married and unmarried female doctors adopt these strategies to cope with work life conflict, time management, set priorities in work and family that effect their career development.

V. RECOMMENDATIONS

There are some recommendations for future research that one should keep in mind. If we notice then we see that the married working women have more issues regarding their work life conflict and career development as compared to the unmarried working women, so for future research it is recommended that to keep focus on the married working women. For the future research work on the work life conflict of working women need to work on other fields of work and employment. Our research explore the issues of female doctors especially gynecologists but there are also many areas of medical science need focus. A flexible work structure, including the number of hours worked and how work is scheduled, is one of the most important types of support that employers can provide for employees with family responsibilities. The growing literature on work-family conflict undoubtedly reflects the belief that work and family lives are interdependent. The myth of separate worlds of work and family is surely eroding. Considerably more research testing more complete models of work-family conflict is required. Basic to any additional research is the development of reliable scales for the assessment of work-family conflict. Government should make the family friendly policies which allow modification to time schedule can assist working women in managing their work and family demands reducing the strain of multiple roles. For example, in France an apparently generous system of parental leave after the birth of second child is limited in its effectiveness because parents fear the consequences of an absence from the labor market in a context of high unemployment (Fagnani, 1995). In Sweden, direct attempts are being made by the state who encourage more men to take a parental leave rights by the introduction of one month of parental leaves solely for fathers, and not normally transferable to the mother (Lewis, 1997).

There also need to do research to explore the effectiveness of policies about employment of working women by government. There is need for future research to explore the strategies for overcoming work life conflict and career development issues.