ARTICLE IN PRESS

Social Science & Medicine 57 (2003) 13271341

Women doctors in Norway: the challenging balance between

career and family life
Elisabeth Gjerberg*
Work Research Institute, P.b. 6954 St. Olavs Ploss, N-0130 Oslo, Norway

Abstract
In most Western countries, women doctors are still underrepresented in the higher positions in the medical hierarchy
and in the most prestigious specialities. A crucial question is whether family responsibilities affect female and male
career differently. The article examines how Norwegian physicians balance their work and family responsibilities and
demonstrates differences in the way doctors combine work and family obligations, between women and compared with
men. Among women doctors, the probability of becoming a specialist decreased with an increasing number of children.
Moreover, postponing the birth of the rst child increased the probability of completing hospital specialities. Although
more women than men work part-time, this was the case only for a small proportion of women doctors. Transition
from full-time to part-time work is primarily an accommodating strategy to family responsibilities, however strongly
inuenced by variations in the opportunity structure of different specialities. The ndings further demonstrate that
being married to another doctor had a positive impact on the career, especially for women doctors.
r 2003 Elsevier Ltd. All rights reserved.
Keywords: Medical profession; Woman doctors; Norway

Introduction
The medical profession has commonly been characterised by long working hours and obligations to put
patient welfare above personal needs and family
responsibilities. In the past, many women doctors have
tackled this by choosing not to marry or have children,
or they have limited their career commitment (Drachman, 1986; Uhlenberg & Cooney, 1990; Gjerberg &
Hofoss, 1995). In male doctors, combining professional
and family life has always been taken for granted, very
often because of a traditional gendered division of
labour. The demanding characteristics of medical work
still exist, although varying between specialities. However, in Norway, like most Western countries, the
medical workforce is changing. Today, 34% of professionally active Norwegian doctors are women, most of
them without the traditional ground crew that male
*Tel.: +47-23-36-92-00; fax: +47-22-56-89-18.
E-mail address: elisabeth.gjerberg@a-wri.no (E. Gjerberg).

doctors usually had in wives taking care of child rearing

and household duties. How do modern women doctors
manage the challenges in combining family life and a
medical careerwhat kind of adjustments are they
making?
In spite of the increasing proportion of women in
medicine during the last decades, women doctors in
Norway are still underrepresented in the higher positions in the medical hierarchy (Kvrner, Aasland, &
Botten, 1999) and in the most prestigious specialities
(Gjerberg, 2001, 2002). The same pattern is found in
most Western countries (Lorber, 1993; Riska &
Wegar, 1993). Thus, it may well be asked whether
family responsibilities still affect female and male
medical careers differently. Moreover, depending on
individual preferences and variations in the opportunity
structure of different specialities, it is likely that women
doctors are using different adjustment strategies in
order to combine family and career commitments.
At one extremity, renouncing children to full her
career aspirations, and at the other, compromising, by

0277-9536/03/$ - see front matter r 2003 Elsevier Ltd. All rights reserved.
doi:10.1016/S0277-9536(02)00513-0

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E. Gjerberg / Social Science & Medicine 57 (2003) 13271341

choosing a eld with relatively few working hours and

few hours on call. Others may have refused to
compromise and have had highly successful medical
careers as well as partners and children.
In the medical literature, increasing attention has been
given to how women doctors balance their work and
family commitments. A comparison of career and family
characteristics in male and female doctors has demonstrated signicant gender differences in the family/work
interface. Allen (1988, 1994) found that many British
women doctors reported children as being a constraint
on their career, and only a small proportion of women
with children worked full-time. An earlier study of
Norwegian doctors found that most women doctors
compromised when they choose the eld and position
they worked in, mainly because of concern for their
families (Lindahl & Killi, 1984).
This article is based on a study of Norwegian doctors
who entered the labour market in 19801983. The results
show that although family responsibilities still affect the
medical career of women and men differently, women
doctors of today do not choose between a career and a
family life. They want to eat their cake and have it.
However, there are great variations in how they do it. I
argue that at least a part of the systematic variations in
the familycareer combination lies in the nature of
different specialities. The organisational contexts of
different specialities make some careerfamily combinations more or less likely for the women involved.
The Norwegian context
Compared with earlier generations, young women in
Norway, as in most Western countries, have developed a
dual strategy towards employment and children, combining career and responsibility for children and family
(Chafetz & Hagan, 1996; Ellingster & R^nsen, 1996).
Since the 1970s, family events such as marriage and
childbirth have had increasingly less effect on womens
participation in the labour market. From 1972 to 1997,
the employment rates among Norwegian mothers with
children aged less than 16 increased from 43% to 82%
(CBS, 1998). The Norwegian authorities have actively
developed workfamily policies with the aim of promoting gender-equality. Gender-equality policies and family
policies have been intertwined, reected in various
arrangements that have facilitated womens entry into
the labour market, for example state-sponsored day-care
centres, the right to paid leave in order to care for sick
children and the right to paid parental leave. Parental
leave in connection with child birth was signicantly
extended in the 1980s and 1990s. Since 1993, the leave
has covered 52 weeks with 80% wage compensation or
42 weeks with full compensation, of which the father is
entitled to four weeks. However, the increase in
Norwegian womens employment rates has not resulted

in integration in the labour market on equal terms. On

the contrary, Norway has one of the most segregated
labour markets in Europe (Hansen, 1995), and is ranked
as the fth most gender-segregated labour market in the
OECD (OECD, 2000). First, men and women are
distributed unequally over occupations and secondly,
men and women tend to have jobs at different levels of
the occupational hierarchy. Moreover, Norway is found
to have one of the highest incidences of part-time work
among employed women (OECD, 2001). In 2000,1 43%
of Norwegian women worked part-time (CBS, 2001).
However, there are large variations in work hours
depending on the mothers educational levels. Full-time
work is the dominant practice of highly educated
mothers, even when the children are small (Ellingster,
Noack, & R^nsen, 1997).
During the last few decades, the Norwegian medical
workforce has changed profoundly, as a result of both
the increasing proportion of women doctors and the
increasing proportion of male doctors with partners
with a separate career. Like other men, male doctors are
expected to be under increasing pressure to assume a
larger share of the responsibility for home maintenance
and child rearing. Men and women doctors educated in
the last few decades of the 20th century may thus be
expected to have the same opportunities for combining
career and family life, although most of them had their
children in a period when family policies supported
working women to a lesser degree. The present paper
examines how Norwegian doctors, educated during a
period characterised by egalitarian attitudes to gender
roles and gender behaviour, tackle the challenges
between work and family responsibilities.
This paper addresses three questions: First, are
women doctors careers more affected by family
responsibilities than those of male doctors? I have
chosen to examine some specic areas of the medical
career that may be inuenced by family responsibilities:
Do women doctors with children specialise more seldom
than male colleagues in the same situation? And among
those who specialise: do women doctors with children
spend more time on specialist training than male
colleagues with similar attributes and women doctors
without children? Further, does having children or the
number of children inuence the type of speciality
chosen? For example, is it possible for women doctors
with family responsibilities to make a career in hospitalbased specialities like surgery and internal medicine? If
so, do they have to make some adjustments to manage
the challenges, for example by having fewer children
than other women doctors?
1
According to OECD (2001), only 40% of the Norwegian
women work full-time. The difference in part-time proportion
between CBS and OECD is due to different denitions of what
is full-time work.

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The second question is what variations are there in the

career paths of women in different specialities? For
example, how prevalent is the use of part-time work in
different medical specialities and how can variations in
present and previous employment status be explained?
Thirdly, parallel to the increasing number of women
in medicine, there have been an increasing number of
two doctor marriages (Johnson, Johnson, & Liese, 1991;
Beiser & Roberts, 1993). Earlier studies of dual-doctor
couples both in Britain (Johnson, Johnson, & Liese,
1992) and in Norway (Arnesen, Myraker, Steinsholt,
Thesen, & rbeck, 1974; Steinsholt, Rygh, & Thesen,
1990) have found that the husbands career development
takes priority over the wifes. However, there is no
consistent evidence that dual-doctor marriages differ
from other dual-career couples in their impact on the
career development of women doctors. For example, do
women doctors married to another doctor more seldom
specialise, spend more time on specialising, or work
part-time more often than other women doctors?
To answer these questions, I will rst give a brief
presentation of the theoretical perspectives of this paper,
followed by a presentation of a study of Norwegian
doctors who qualied at the start of the 1980s. The study
provides data on both present and previous employment
histories. The last part of the paper presents the results
and analyses them within a context of the medical career
structure and womens employment patterns in Norway.

Theoretical perspectives
There are a number of ways of combining labour
force and domestic commitments, depending on a
complex interdependence of individual preferences,
family relations and work. Several studies on womens
employment pattern in Norway (Skrede & S^rensen,
1983; Ellingster et al., 1997) and in USA and Germany
(Drobnic, Blossfelt, & Rohwer, 1999) have demonstrated that the employment status varies as life
progresses, inuenced by marital status, number of
children and age of the youngest child. When explaining
womens employment patterns, different types of models
have been offered: individual and structural. Individualoriented explanations describe womens employment
pattern as a result of individual choice of education and
career, either as a result of social emotional values based
on socialisation, or an economic rational judgement of
the priority they want to put on work in relation to
domestic commitments. For example, the high proportion of women doctors in specialities like psychiatry,
paediatrics and gynaecology is explained as a function of
gender-based interests (Bergquist et al., 1985). According to the other type of individual-oriented models,
based on human capital theories, womens employment
patterns are seen as a reection of their investments in

1329

education and career. Occupational choices are thus

based on rational decisions on how they want to
combine career and family commitments in the future
(Becker, 1985; Hakim, 1991, 1998).
Chafetz and Hagan (1996) suggest that most professional women are confronted with two sets of prevailing
social norms when they seek employment: on the one
hand, traditional familial relationships, and on the
other, individual fullment and success in the labour
force. In a modied version of rational choice theory,
they argue that an increasing number of married women
will attempt to satisce, that is, most women want to
reach a reasonable level in respect of both career and a
successful familial life, rather than maximising one or
the other. For example, women doctors who judge the
opportunity structure of hospital-based specialities to be
incompatible with their priorities of taking care of a
family will probably more often choose a speciality that
enables them to cope better with the workfamily
interface. Contrary to individual-oriented explanations,
structural models see womens employment pattern in
the light of the structural context of work and society,
for example emphasising structural opportunities and
barriers in the work organisation (Reskin & Roos,
1990). In studies of women in medicine, structural
changes in health care, the career structure of the
various specialities, as well as male exclusionary
practices, have been used to explain the employment
pattern of women doctors (Riska & Wegar, 1993;
Crompton, Le Feuvre, & Birkelund, 1999; Gjerberg,
2001, 2002).
Some researchers have applied an integrated model,
emphasising the complex interdependence between
individual preferences, family relations and work
(Ellingster, 1995; Crompton & Harris, 1998; Crompton, 1999). Recent research has also emphasised the
need for including welfare state characteristics, arguing
that womens employment patterns are shaped in the
intersection between family, work and state (Esping
Andersen, 1990; Crompton, 1999; Ellingster 1999).
Although the impact of the public welfare arrangements
is not explicitly examined in this paper, it represents an
important framework within which Norwegian doctors
make their choices. The historical period in which
families live may thus have a major effect on how
women choose to combine career and family lives. For
example, parental leave was signicantly shorter when
most of the doctors in this study had their children in the
rst part of the 1980s than it is today.
Historically, medicine has been regarded as a masculine profession, using men as standard. Long and
irregular working hours, being on call, and geographical
mobility have not made medical career particularly
compatible with family life. However, in their study of
women doctors and bankers in four countries, Crompton and Harris (1998) found that, more often than bank

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E. Gjerberg / Social Science & Medicine 57 (2003) 13271341

managers, women doctors had been able to organise

their career around their family lives. The authors
explained the differences in balancing family and work
via a comprehensive model, taking into account the
impact of the occupational structure, as well as prevailing social norms and individual preferences. They argue
that differences in how women doctors and bankers
arrange their work and domestic lives are at least partly
due to systematic differences between medicine and
banking. Characteristics of professional versus managerial occupations are thus reected in the family and
employment patterns of doctors and bankers.
However, as Crompton and Harris (1998) point out,
different branches of medicine offer different possibilities for combining employment with family life. The
doctors in the study of Crompton and Harris (1998)
were all general practitioners. In Norway, as in many
other countries, there are clear distinctions between the
career structure of different specialities.2 Training in
most hospital-based specialities requires long working
hours, being on call, and having geographical mobility.
Until recently, working part-time to become a specialist
has either not been available or very unusual. Primary
health care has, at least in cities, more controllable hours
and is more likely to facilitate part-time work. It has also
been possible to complete specialist training by working
part-time. It is thus of interest to examine how
organisational structures and practices, as represented
by different types of specialities, affect the work/family
interface of doctors.

Response to mailing
Of the 1805 authorised as doctors in 19801983, 86 were
untraceable. The effective study cohort therefore comprised 1719 doctors, of whom 74.5% were men and 25.5%
were women. Completed questionnaires were received
from 1142 doctors, representing a response rate of 67
(64% of the men and 73% of the women answered the
questionnaire). The article is based on an analysis of the
material from 1104 persons, 308 women, and 796 men.3
Methods
Descriptive statistics were used to characterise the
population. In order to analyse how characteristics of
the family and work domain affected four different
aspects of the medical career, both linear and logistic
regression were used. In analysing the work-time
adjustments, i.e. transitions from full-time to part-time
work throughout the career, logistic regression was used,
applying a similar technique to that described by Wei,
Lin, and Weissfeld (1989). Both trajectories and transitions were examined.4 The analysis unit, instead of being
the individual doctor, then becomes each job in the time
period covered by the investigation. Every job was
ascribed a set of variables, some of which may change
over time. An example of time-dependent variables was
having small children or not. Other variables are
constant, for instance gender.
Variables

Methods and data

Sample and procedure
The population in this survey included all the doctors
authorised to practice medicine in Norway in the years
19801983. A questionnaire was sent to the study
population in December 1996. The questionnaire
requested demographic information, employment details
dating back to their rst job as a doctor, reasons for
choice of speciality, actual career, and actual employment status (part-time /full-time).
2
In 2001, Norway had 4.5 million people and about 16,500
active doctors. The health services consist of publicly owned
hospitals and doctors on a salary. Primary-care doctors work
on a fee-for-service basis. About 60% of active doctors work in
hospital medicine and 25% in primary health care, and about
60% of all doctors o70 years of age are specialists. The
majority of the specialties relate to health services in institutions. In primary health care, the specialities are general
practice, community medicine, and occupational medicine.
Training as a specialist requires a minimum of 45 years
training in ones main subject, and usually one more years
training in a subsidiary subject (NMA, 1993).

Four career aspects were analysed:

(1) Specialist status (to specialise or not).
(2) Type of speciality chosen: Of 43 medical specialities, there are 30 main categories. When nothing else is
mentioned, the rst main speciality achieved is used.5
The speciality variable was then reclassied into two
categories: (a) hospital-based specialities typically entailing irregular work and nights on duty, and (b)
primary care specialities with more regular working
hours and scheduled duties (although they may include
3
16 doctors who passed their nal exam before 1970 were
excluded from further analysis. In addition, 22 persons who had
not answered the questions describing past and present
occupations were excluded from further analysis. The choice
of the exam year, 1970, as a limit for being included in the
investigation is partly pragmatic. Doctors educated before 1970
have a much longer working history and will therefore be less
comparable with the majority.
4
I would like to thank statistician Petter Mowinckel for his
help with these analyses.
5
In addition to the 30 main specialities, there are 13 subspecialities. A specialist in gastroenterological surgery was thus
recorded as a specialist in general surgery, because gastroenterological surgery is a subspeciality under general surgery.

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long working hours): general practice, community

medicine, occupational medicine, psychiatry, and laboratory medicine.6
(3) Time spent on completing specialisation,
(4) Employment status: Two aspects of employment
status are of interest: First, working hours in their
present job (full-time or part-time). Secondly, based on
work-history data, their employment status throughout
their whole career was analysed. The distinction between
part-time and full-time work was based on regular
working hours, excluding hours on call or extra
duties. Part-time means less than 31 h per week.
The explanatory variables were the characteristics of
the family and the work domain. The characteristics of
the family domain were: marital status, spouses
employment status, number of children, and age at
birth of rst child. The work-domain characteristics
were type of speciality and work place.
Most questions were structured, but an open-ended
question on their experience of combining work and
family was included. The answers to the open-ended
question were analysed by qualitative methods; themes
and concepts were systematised. The themes were
related both to the practical adjustments the doctors
have made, for example working part-time, and their
emotional experiences on how they had experienced
combining work and family life. Excerpts from these
answers that were considered to be representative
are used in the text to illustrate the major ndings in
the quantitative analyses.

Results
Who are the doctors?
Marital status7: Signicantly more women than men
had never married or were separated/divorced (Table 1).
6
I have chosen to include psychiatry and laboratory
medicine (pathology, physiology etc.) in the category primary
care specialities, because many of those working in these elds
are employed outside hospitals. For example, about 4050% of
specialists in psychiatry work outside hospitals, either in private
practice or in outpatient clinics. In Norway, specialist training
in psychiatry takes place both inside and outside hospitals.
7
The questionnaire did not differentiate between married
and cohabitant. The term married is used to cover both
categories. The Act of same-gender partnership was passed in
1993. The intention in the questionnaire was that doctors living
in a same-gender partnership should indicate this by ticking off
in the square labelled married/cohabitants. The fact that it
was not possible to analyse the material with regard to
heterosexual and homosexual relationships could be interpreted
as a heterosexual bias. However, to simplify the text, I have
chosen to refer to the woman doctors partner as if she were
living together with a partner of opposite sex.

1331

The higher proportion of unmarried or divorced women

doctors agrees with earlier studies, both in Norway
(Gjerberg & Hofoss, 1995) and in other countries
(Uhlenberg & Cooney, 1990; Allen, 1994; Dumelow,
Littlejohns, & Grifths, 2000). Comparing the overall
Norwegian population at the same age (4554 years),
more doctors than others were married/cohabiting: 89%
and 78%, respectively.
Number of children: The higher proportion of childless
women doctors agrees with the result of an earlier study
of Norwegian doctors (Gjerberg & Hofoss, 1995), and
with recent studies in Britain (Tait & Platt, 1995;
Dumelow, Littlejohns, & Grifths, 2000). When women
doctors are compared with other Norwegian women
with higher education, the proportion of childless
women doctors is far below average (Lappega( rd,
1999). The women doctors had an average of 2.3
children, the male doctors 2.6. The results show no
difference between non-specialists and specialists or
between specialists of different kinds as regards the
presence or absence of children, though there is a
difference in the number of children. Among female
non-specialists, and women doctors in primary-care
specialities, the average number of children was 2.6
(median 3), while among women in hospital-based
specialities, the average number of children was 2.2
(median 2). Similar differences were not found among
men (Gjerberg, 2002).
Age at birth of the first child: The median age at the
birth of the rst child in our study population
corresponds to the overall population. Of women born
in 1950, the median age of primipara was 20.6 years in
women with short education, compared with 28.4 years
in those with the highest education (Lappeg(ard, 1999).
However, while the median age at the birth of the rst
child was 30.5 years in women doctors in hospital-based
specialities like surgery and internal medicine, compared
with 28 years in women doctors in primary care
specialities, no speciality-dependent age differences were
found in their male colleagues (Gjerberg, 2002).
Educational level and work situation of spouses/
cohabitants: A far higher proportion of female than
male doctors were married to spouses educated at
university level (Table 1). Corresponding gender differences have been found in a study of doctors in
Netherlands (Keizer, 1997). They match the well-known
social pattern of women usually marrying men of a
similar or higher education level, while men more often
choose women who are less educated than themselves
(Lorber, 1984). However, this pattern may also be a
consequence of the type of people they meet at work.
More women than men had spouses who were
employed outside the home, and spouses of male doctors
far more often worked part-time than spouses of women
doctors. Moreover, answers to the open-ended question
on their experience of combining work and family

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E. Gjerberg / Social Science & Medicine 57 (2003) 13271341

Table 1
Personal characteristics of questionnaire
authorised as doctors 19801983 (percentages)

respondents

Female

Male

Age (median)
Marital status
Single
Married/cohabiting
Divorced/separated/widow

43
N 308
7.5
81.5
11.0

44
N 796
2.9
91.7
5.4

Educational level of spousea

High school or less
College
University
Ph.D.
Other

N 249
4.8
5.6
73.9
13.3
2.4

N 715
13.3
49.5
33.7
3.1
0.4

Married to another physicianb

N 227
39.6

N 600
16.8

Number of children
No children
12 children
3 or more children

N 307
8.5
46.6
45.0

N 794
4.5
41.9
53.5

Age at birth of rst child (median)

28

28

Specialist status I
Specialist
Not specialist

N 308
83.4
16.6

N 796
86.2
13.8

Specialist status II
Not specialist or primary-care
specialities
Hospital-based specialities

N 308
73.4

N 796
68.0

26.6

32.0

8.0

8.0

Number of years to complete

specialist training (median)
Current employment status
More than full-time
Full-time
Part-time

N 301
34.9
45.8
19.3

N 790
56.7
35.8
7.5

Age at which rst speciality was

achieved (median)

38.0

37.0

Age of youngest child (median)

11.0

10.0

Employment status of spouse

Employment outside home
Homemaker
Student
Other

N 250
96.4
0.4
1.2
2.0

N 714
86.6
7.6
3.1
2.8

Employment status of spouse

(those employed outside home)
Full-time
Part-time

N 238

N 610

97.9
2.1

56.0
44.0

Less than 2% did not answer the question about employment status of his/her spouse. Of those with employed partners,
about 6% have not answered what kind of work their partners
have.
b
The percentage of doctors married to another doctor are
based on those who were married.

obligations indicated that this had also been the case

throughout their career:
It is going well, but the development of my career
has depended on my wife being a full-time homemaker at times. (Man, specialist in oncology)
It is all right as my wife has used her right to full
parental leave and is working part-time. (Man,
specialist in general practice)
These quotations illustrate not only that, more often
than women doctors, male doctors have had spouses
taking care of child-rearing and household duties, but
also that the development of their career is regarded as
dependent on such arrangements.
In short, a comparison of doctors with the general
Norwegian population shows that fewer doctors
were single or divorced than in the total population.
More females than male doctors were childless, but on
average both women and men had more children than
the comparable general population. Also, while about
half the spouses of male doctors were working part-time
or were full-time homemakers, almost all the spouses of
women doctors were working full time.
Speciality status
About 85% of all doctors were specialists (Table 1). In
order to study the impact of family characteristics on
specialisation, a multivariate logistic regression analysis
was performed. The results show that the doctors
gender and being married to another doctor inuenced
the probability of specialising (Table 2). My hypothesis
was, however, that womens decision to specialise might
be more inuenced by family characteristics than mens.
Separate analyses for women and men were carried out.
In women doctors, the probability of becoming a
specialist decreased with an increasing number of
children. This agrees with the answers from the nonspecialist women doctors: Asked to explain why they
had chosen not to specialise, about 70% emphasised
difculties in combining a career with responsibilities for
children. Moreover, women doctors who were married
to a male doctor were signicantly more likely to
become a specialist than other women. In men, neither
of the relations in the model was signicant. However, in
men as well as in women, it was positive to have a
spouse who worked as a doctor, although the effect was
not signicant (p 0:07).
Type of speciality
Looking at all doctors, about 27% of female vs. 32%
of male doctors had chosen to specialise in a hospitalbased speciality. However, the most prestigious specialities within hospital medicine, like surgery and internal

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1333

Table 2
Logistic regression (the effect on specialisation (to specialise or not) of sex, number of children, age at birth of the rst child, married to
a physician or not; respondents authorised as doctors 19801983)
Variable (reference category)

Gender (women)
Age at birth of rst child
Number of children
Married to another doctor
(no 1; yes 2)
Constant
n

All doctors (N 1061)

Women (N 288)

Men (N 773)

(SE)

(SE)

(SE)

0.4091
0.0058
0.1248
0.9576n

(0.1943)
(0.0233)
(0.0982)
(0.2906)

0.0533
0.6390n
1.3162n

(0.0500)
(0.1906)
(0.4453)

0.0239
0.0866
0.6980

(0.0265)
(0.1219)
(0.3843)

1.0901

(0.8422)

4.4978n

(1.7147)

0.8401

(0.9126)

Signicant at a 5% level.

Table 3
Logistic regression (the effect on specialisation in hospital-based specialities vs. primary care of sex, number of children, age at birth of
the rst child, married to a doctor or not; respondents authorised as doctors 19801983)
Variable (reference category)

Gender (women)
Age at birth of rst child
Number of children
Married to another doctor (no 1; yes 2)
Constant
n

All doctors N 1040

Women N 281

Men N 759

(SE)

(SE)

(SE)

0.240
0.070n
0.024
0.0324
3.325n

(0.161)
(0.017)
(0.080)
(0.1870)
(0.660)

0.167n
0.079
0.253
5.719n

(0.043)
(0.177)
(0.308)
(1.499)

0.047
0.079
0.6980
2.308n

(0.019)
(0.090)
(0.3843)
(0.687)

Signicant at a 5% level.

medicine, only recruited 9% of the female compared

with 19% of the male doctors (Gjerberg, 2002). In order
to analyse the inuence of family characteristics on what
speciality they had chosen (hospital-based specialities
vs. primary care specialities), a multivariate analysis
was carried out. Only age at birth of the rst child was
signicantly related to choice of speciality (Table 3).
Since there could be an interaction between gender and
family characteristics, women and men were analysed
separately. In men, neither of the relations in the model
was statistically signicant. In women, postponing the
birth of the rst child increased the probability of
specialising in hospital-based medicine.
The respondents were also asked how important
family responsibilities had been in their choice of
speciality. First, more women than men reported that
care of children and possibilities of combining work
and responsibilities for children and family had been of
great importance in their choice of speciality (51% vs.
23%, and 51% vs. 30%, respectively).
For the sake of my family, I stopped working as a
paediatrician in a hospital after 56 years. (Female
doctor, who changed from paediatric to general
practice, married, three children).
However, both men and women in hospital-based
specialities answered less often than those working in

primary care that these factors had been of importance

in their choice of work.
Numbers of years taken to complete specialist training
An estimation of the time spent on achieving specialist
status can either be based on the year in which the
doctor was authorised, or on the point in time that the
doctor considered that specialist training started. The
rst alternative was chosen in the present study, as the
doctors self-reports were found not to be sufciently
valid in an earlier study (Gjerberg & Aasland, 1999). A
multivariate analysis was carried out in three stages. At
the rst stage, it was only the doctors gender that had a
signicant effect (po0:01): women doctors spent slightly
more time completing specialist training than their male
colleagues, but the model only explained 2% of the
variation (Table 4A). Assuming that characteristics of
the family domain might have a greater effect on the
length of time spent on specialist training in women than
in men, the two genders were analysed separately. The
older the women were when they had their rst child,
and the more children women doctors had, the more
time they spent completing specialisation, adjusted for
the other variables in the model. Further, it took a
shorter time to become a specialist when specialising in
hospital-based specialities. The model explained about

1334
Table 4
Linear regression. The effect of sex, number of children, age at birth of rst child, being married to another doctor or not and type of speciality on length of time to complete
specialist training
(A) All doctors
Women N 325

Men N 658

(SE)

(SE)

(SE)

0.613*
0.013
0.313
0.070

(0.214)
(0.024)
(0.235)
(0.192)

0.097n
0.063
0.791n

(0.051)
(0.364)
(0.385)

-0.002
0.521
0.146

(0.026)
(0.303)
(0.221)

8.535n
R2 0:02

(0.865)

6.768n
R2 0:072

(0.965)

8.134n
R2 0:005

(0.930)

(B) Women doctors

Variable

Age at birth of rst child

Number of children
Married to another doctor
Constant
n

Signicant at a 5% level.

Women in primary care (N 160)

Women in hospital-based specialities (N 75)

(SE)

(SE)

(0.070)
(0.273)
(0.443)
(2.269)

0.049
0.373
1.313n
11.128n
R2 0:09

(0.067)
(0.164)
(0.558)
(2.750)

0.159
1.396n
0.527
0.961
R2 0:16

ARTICLE IN PRESS

Gender (women)
Age of birth of rst child
Married to another physician (no 1; yes 2)
Type of speciality (Primary care 1
Hospital-based specialties 2)
Constant

All doctors N 893

E. Gjerberg / Social Science & Medicine 57 (2003) 13271341

Variable (reference category)

ARTICLE IN PRESS
E. Gjerberg / Social Science & Medicine 57 (2003) 13271341

7% of the variation. In men, none of the variables in the

model inuenced the time they spent completing
specialist training.
The effects of family characteristics might depend
on which specialities the doctors chose. Separate
analyses for men and women in hospital-based and
primary-care specialities, respectively, were carried
out (Table 4B). The more children female specialists in
primary-care specialities had, and the older they were
when they had their rst child, the more time they spent
completing specialist training. To be married to a male
doctor did not inuence the time these women spent
completing their speciality. The model explained 16% of
the variations. In contrast, the time women doctors
spent on completing specialist training in hospital-based
specialities was not inuenced either by how many
children they had or by their age at the birth of the rst
child. On the other hand, in these women, having a
husband who also was a doctor had a positive effect.
Female specialists in hospital-based specialities married
to another doctor completed their specialist training in a
shorter time than other women doctors. In men, none of
the variables in the model inuenced the time they spent
becoming a specialist.
In short, women and men were fairly similar as
regards the degree of specialisation and the time spent
on specialisation, but an increasing number of children
diminished the likelihood of women becoming specialists. This was not the case in men. Moreover, an
increasing number of children prolonged the time
women in primary-care specialties spent on specialist
training. However, this was not the case either in women
in hospital-based specialities or in men. On the other
hand, being married to another doctor positively
inuenced the career of women doctors in hospitalbased specialities, in that they completed specialist
training in a shorter time.
Employment status
Most doctors worked full-time in their present job,
although signicantly more female than male respondents reported part-time work in their main employment
(Table 1). However, some of those who reported
working part-time had deliberately chosen this in order
to have more than one job. For example, working 60
80% in general practice combined with 2040% in
community medicine is an arrangement that has been
quite common in Norway during the last few decades.
This result agrees with previous studies: The typical
part-time working doctor is not really working parttime, but is combining two or more jobs (Hofoss &
Gjerberg, 1994). When adjusting for those working parttime in combination with another job, about 6% were
categorised as real part-time workers, about 14% of
the women, and 3% of the men.

1335

What is the explanation of the variation in employment

status?
In order to examine the effect of different family
characteristics on the actual employment status, a
logistic regression was carried out (Table 5). The
subsequent analysis was based on actual working-time,
i.e. those who were combining two or more part-time
jobs were counted as full-time workers. Assuming that it
might be the age of children rather than the number of
children that inuenced choosing part-time or full-time
in their present job, the variable children aged 05
years was included in the model, which also comprised
explanatory variables such as the doctors gender and
type of speciality. The probability of working full-time
was higher in men than in women. Moreover, doctors
working in hospital-based specialities were more prone
to work full-time than those working outside hospitals,
and the likelihood of working full-time decreased when
they had children younger than six years old. When
analysing men and women separately, the assumption of
an interaction between gender and other variables in the
model was conrmed. In women, the probability of
working full-time decreased if they had small children.
This was, however, not the case for women in hospitalbased specialities; they were more prone to work fulltime irrespective of whether they had small children or
not. In men, it was only being married to another doctor
that inuenced their employment status: male doctors
married to female doctors more often worked part-time
than other male colleagues.
Respondents who did not work full-time in their main
employment were asked to explain why. Looking at the
real part-timers, women more often than men
emphasised that problems in combining full-time work
with their responsibility of children had inuenced their
choice of working part-time, the gures being 56% and
25%, respectively. This was illustrated by answers to the
open-ended question on how they had managed the
workfamily balance:
I have deliberately chosen jobs with no on-call rotas
and with the possibility of working part-time. Thus,
the workfamily combination has been tolerable
(Female doctor, married with three children,
working in occupational medicine most of her
career).
Employment status during the career
Analysing the employment status throughout their
career, I rst looked at the jobs they had in January each
year from 1983 to 1996. Not surprisingly, more women
than men had worked part-time throughout their career.
Working part-time had been most common in general
practice and community medicine, especially among

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1336

E. Gjerberg / Social Science & Medicine 57 (2003) 13271341

Table 5
Logistic regression (the effect of gender, having children aged 06 years, and type of speciality on employment status in present job;
working full-time or more 1; working part-time 0)
Variable (reference category)

All doctors (N 819)

Women (N 221)

Men (N 598)

(SE)

(SE)

(0.315)
(0.340)
(0.321)
(0.406)
(0.695)

1.194n
0.099
1.468n
0.3298

0.463
0.407
(0.583)
(0.5982)

0.269 (0.538)
1.102n (0.491)
0.646 (0.573)
2.672n (0.6196)

Gender (women)
1.610*
Children 05 years (no 0; yes 1)
0.809*
Married to another doctor (no 1; yes 2)
0.308
Type of speciality (primary care 1; hospital-based specialities 2) 1.051*
Constant
0.822
n

(SE)

Signicant at a 5% level.

Table 6
Doctors employment status during their career (per cent) (based on the total number of jobs in different specialities. Doctors
authorised 19801983)
Women

General practice and community medicine

Gynaecology and obstetrics
Surgery
Internal medicine
Psychiatry

Number
of jobs

Full-time

Part-time

81.1
97.6
98.1
96.3
97.1

19.0
2.4
1.9
3.7
2.9

women. However, as doctors may have changed

employment in the course of the year, it was also
necessary to look at the total number of jobs. Thus a
survival analysis was used, using each job as the
analysing unit (Table 6). About one-fth of the womens
jobs in general practice and community medicine had
been part-time throughout their career compared with a
very small proportion of jobs in other specialities.
Transitions from full-time to part-time work
To examine the effect of different family and work
characteristics on the probability of changing from fulltime to part-time work, a survival analysis was carried
out (Table 7). As it was primarily women doctors who
worked part-time, male doctors were excluded from the
analysis. The coefcients in the table show the effect of
each variable on the probability of changing employment status. As expected, women doctors who had given
birth to children within a year before the transition were
more prone to change from full-time to part-time work
than other women. Caring responsibilities are a prime
cause of moving into part-time work. This is also
demonstrated by the fact that an increasing number of
children increased the probability of changing to parttime work. While marital status had no effect in itself,
being married to another doctor increased the probability of changing from full-time to part-time work. In

705
124
214
427
312

Men

Number
of jobs

Full-time

Part-time

96.6
100.0
99.2
99.5
97.3

3.4

0.8
0.5
2.2

2404
130
896
1126
503

general, being a specialist decreased the probability of

changing to part-time work. However, this was not the
case with specialists in general practicethese doctors
more often changed to part-time work than other
doctors.
In short, women doctors more often work part-time
than their male colleagues, but to a lesser degree
than other Norwegian women educated at college or
university level. Part-time work seems to be an
accommodating strategy to balance work and
family responsibilities, most often seen in women
doctors working in general practice and community
medicine.

Discussion
Like most Norwegian women educated at the beginning of the 1980s, women doctors do not choose
between a career and children, they have it both ways.
Only a small proportion have adjusted their personal or
family lives to benet from a continuous full-time career
by remaining single/divorced and childless. However,
there are still persisting differences between women and
men in how family responsibilities affect their medical
career. Career patterns differ not only between women
and men, but also between women in different types of
specialities. Although most women doctors in this study

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E. Gjerberg / Social Science & Medicine 57 (2003) 13271341
Table 7
The effect of family and work characteristics on the probability
of changing from full-time to part-time work (women doctors)
Variables

OR

CI

Age
Children l year or younger
Number of children
Marital status
Married to another doctor
Specialist
Type of speciality
General practice
Internal medicine
General surgery
Psychiatry

0.81
1.89
1.36
0.83
1.82
0.54

0.451.47
1.312.71
1.081.72
0.401.71
1.122.96
0.360.82

4.39
1.43
0.49
0.95

2.019.57
0.464.47
0.073.18
0.233.96

combined parenthood and career, there were substantial

differences in the way they did this.
The last decades profound changes in the patterns of
womens employment and family life may explain why
most women doctors choose to combine work and
family obligations. The transition from a traditional to a
modern dual-career family is closely connected with
different processes of social change since the 1960s.
Women doctors in this study were educated at a time
when public policies made conditions increasingly
favourable for combining parenthood and paid work,
in line with the ideology of equal division of domestic
duties between women and men. At the same time, there
were marked changes in health care. In the 1960s and the
early 1970s, there was a great expansion of hospitals,
and thus a great increase in job opportunities. Parallel to
this, increasing concern was expressed about problems
in primary health care. Both general practice and
community health care were in need of strengthening
(Parliamentary Report No. 85, 19701971, Parliamentary Report No. 45, 19721973). From the end of the
1970s and during the 1980s, the number of new positions
in primary health care increased substantially, the
working conditions improved, and the level of pay
increased, making it more protable to work as general
practitioner than before. Moreover, the status of both
general practice and community medicine increased.
During the period 19681975, university institutes for
general practice medicine were established, and in 1983
the Norwegian College of General Practice was founded.
The health reform policies in primary health services
culminated in the Municipal Health Services Act of 1982
and in the recognition of general practice and community medicine as separate specialities in 1984/1985.
Thus, the doctors in this study who started their
career at the beginning of the 1980s were facing health
services in the process of changing, affecting individual
preferences, working opportunities, and ideology.

1337

The further discussion of patterns of family and work

life outlined in this study is limited to three main topics:
(1) The gendered balance between family and career, (2)
the variations in the work-family interface of women
doctors, and (3) the inuence on the career of being
married to another doctor.
The gendered balance between family obligations and
medical work
To understand why the career seems to be more
hampered by family responsibilities in women than men,
one has to look at specic features of the familywork
relationship. By examining the characteristics of the
spouses of those who are married, I found that about
half the spouses of male doctors were working part-time
or were not employed outside the home. Answers to the
open-ended questions on their experience of the work
family balance throughout the career also indicated that
several male doctors had spouses who had either been
full-time homemakers at times or had worked part-time
for several years. Thus, the results indicate that many
male doctors have not fully shared the domestic and
caring responsibilities at home. Their choice of speciality
and career has not been limited by family obligations to
the same extent as their female colleagues.
Although we have no information on how much time
the doctors spent on caring and domestic activities in
this study, there is no reason to believe that this has
changed during recent years. Data from a survey among
Norwegian doctors conducted in 1993 shows that
women doctors did much more housework than male
doctors. Women doctors worked shorter hours in paid
work, but on average they worked more hours (in total)
per week than male colleagues (Hofoss & Gjerberg,
1994).
It is well known that women doctors who have or
expect to have children consider current or future family
obligations when choosing a jobor a speciality
(Bergquist et al., 1985; Martin, Arnold, & Parker,
1988; Allen, 1994). This also seemed to be the case in
this study. Although retrospective questions about
motives have some limitations, several answers indicated
that, more often than men, women had considered
family obligations when choosing a speciality. Thus,
male doctors might have felt freer to choose specialities
involving being on call and working long hours than
women doctors who do not have a partner taking the
main responsibilities for domestic duties.
Several doctors explicitly used the term adjustment
in their accounts of how they had managed to balance
work and family. On the one hand, this term implied
that the family had organised their life to t in with the
doctors job, for example by having a wife who worked
part-time or was a full-time homemaker. Other doctors
had adjusted their work to the family in the opposite

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E. Gjerberg / Social Science & Medicine 57 (2003) 13271341

direction, for example by choosing a speciality and a

work situation that was easier to combine with family
responsibilities. Although both men and women described this kind of adapting strategy, women more
often mentioned this accommodating relationship between work and family, as found in a recent study of
British doctors (Dumelow et al., 2000).
Similarities and differences in the familywork interface
of women specialistsindividual choices or occupational
constraints?
There was a marked difference between family and
career behaviour in different women doctors in this
study. Although women doctors in hospital-based
specialities were not more often childless or single than
women doctors in primary health care, they more often
deferred the rst birth, and on average had fewer
children. They had more seldom worked part-time, both
in the present employment and throughout their career.
Specialist training takes about 56 years to become
fully qualied, and complete specialist competence, and
is not normally achieved until the doctors are in their
early thirties. Delay of the rst birth thus increases the
possibilities of completing specialist training without
interruptions. Interruptions in speciality training are
more seldom found in hospital-based specialities than in
general practice and community medicine. This is
probably due to special requirements inherent in the
specialities, occupational traditions, and the character of
different medical elds. Qualifying in general practice or
community medicine may require less condensed training than several hospital-based specialities. For example,
continuity at the beginning of the career in order to
achieve professional competence and security may be
judged as more necessary in surgery or internal medicine
than in general practice, as well as being an indication of
commitment to the eld. Moreover, taking care of small
children in combination with a hospital career may be
very hard. Most hospital-based specialities are characterised by long working hours, weekend and evening
duties, and there are small opportunities for part-time
work.
Like other exible time schedules, part-time work is
generally considered as one way of dealing with the
incompatible demands of jobs and family obligations
(Desai & Waite, 1991). In addition to the right to
parental leave and State-sponsored childcare arrangements, the provision of part-time work and exible work
programmes have been very important in explaining the
extensive use of the dual strategy of Scandinavian
women (Esping Andersen, 1990; Ellingster & R^nsen,
1996; Leira, 1998). The nding that Norwegian women
doctors more often tend to work part-time than their
male colleagues corresponds with other studies of
womens career paths in medicine (Allen, 1994; Tait &

Platt, 1995). However, women doctors use of part-time

work is of limited extent compared with other Norwegian women with education at college or university level
(Jensen, 2000).
The variations in part-time work of women doctors
and the fact that the time spent on specialist training in
most hospital-based specialities is not inuenced by the
number of children have to be viewed within the
opportunity structure of the different specialities. In
Norway it has been possible for several years to
specialise by working part-time in general practice,
community medicine, and occupational medicine, while
until recently this has not been available or considered
as unacceptable in most hospital specialities. The greater
availability of part-time tenure in general practice
compared with hospital-based specialities has to be
explained within the historical context of primary health
care throughout the last decades. The expansion of
primary health services from the end of 1970s gave
better job opportunities and made it easier for women
doctors to negotiate part-time work and regular hours in
primary care, especially in the big cities (Gjerberg, 2001).
Although the formal obstacles to specialise by working part-time have now been removed, the attitudes of
colleagues and senior members of the hospital staff will
have a vital effect on the number of doctors who go
ahead with training as hospital specialists in part-time
jobs. The esteem doctors hold in the eyes of their
colleagues has often been linked to their dedication to
work. This dedication used to be regarded as being
synonymous with the number of hours worked: the
more hours you worked, the more doctor you were
(Lorber, 1993; Keizer, 1997).
The variations in the family work interface of women
doctors could be viewed as largely an outcome of
individual choices rather than the effect of constraints
imposed by the organisational structure of different
specialities. Doctors in primary care have been able to
take the combination of work and family life more into
account in developing their career, but it is difcult to
argue that they have chosen primary care because they
are more family-oriented than doctors in hospital-based
specialties. However, as the differences between hospital-based specialties and primary care are markedly
different in many ways, I would suggest that, at least in
part, the differences are due to necessary adjustment
strategies to the organisational structure as well as to
individual choices.
Dual careers within medicine
A limited number of studies have examined the dualdoctor couple, particularly emphasising its impact on
women doctors career and domestic relationships
(Lorber, 1982; Izraeli, 1988; Johnson, Johnson, & Liese,
1992; Tesch, Osborne, Simpson, Murray, & Spiro, 1992;

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E. Gjerberg / Social Science & Medicine 57 (2003) 13271341

Sobecks et al., 1999, Hinze, 2000, sterlie, 2001). There

is, however, no consistent evidence that dual-doctor
relationships have a different impact on women doctors
career and household tasks than other dual-career
relationships.
The present study demonstrated that female doctors
married to doctors more often specialised and spent less
time on training than other female doctors. Other
studies, both in Norway (sterlie, 2001) and USA
(Lorber, 1982) have shown that dual-doctor couples
experience more enjoyment from shared interests,
general supportiveness, and more understanding of the
demands of medical work than doctors whose partners
are not doctors. Knowledge and understanding by the
spouse of the necessity of being on call, working
irregular hours, and attending courses as part of the
specialist training may be essential in order to achieve a
good balance between training and family obligations.
In addition, being married to another doctor represents
a mentor-effect, because the spouse is generally older
and knows the system, is supportive and acts through his
own network. Thus, marriage to another doctor may
create an additional link in the web of professional
networks for women doctors.
Indications of a more egalitarian division of the
family labour between doctor couples compared with
other doctors were found in an earlier survey on
Norwegian doctors (Hofoss & Gjerberg, 1994). Greater
equality was achieved primarily because the male
doctors increased their investments in family time; they
reported more hours spent on domestic work than
doctors married to women with other occupations. It is
likely that a more egalitarian division of the domestic
and caring work facilitates the workfamily balance,
especially for women. Other studies of doctor couples
have demonstrated that the support that husbands give
to their wives may also have a positive payoff for men,
in that the husbands who support their wives in both
their domestic and professional careers less often suffer
from the burnout syndrome than those who do not
(Izraeli, 1988).
The data of the dual-doctor couple has focused on
doctors who are still married to another doctor. Less is
known of those who were divorced from partners who
were doctors. The very opposite of a nurturing relationship is competition and lack of support, which do not
promote either career or family life. A more complete
presentation of both positive and negative aspects of
being married to a colleague is, however, outside the
scope of this study.

Conclusion
Women doctors who qualied at the beginning of the
1980s did not have to renounce family life to have a

1339

medical career. However, in spite of career opportunities

being formally equal, women doctors careers are still
more affected by family responsibilities than those of
male doctors.
The effect of gender on career pattern and family
varies according to the speciality. In hospital-based
specialities women and men have similar career patterns,
and, with few exceptions, women work full-time
throughout their career, and time spent on completing
specialist training is not affected by having children. The
fact that women doctors in hospital-based specialities
more often postpone having children, on average have
fewer children, and more seldom work part-time than
other women doctors, raises the question of whether
they are doing this by choice or as a result of structural
and/or organisational circumstances? The results suggest
that women doctors pursuing a career in hospital-based
specialities need to conform to the employers expectations that are typically rooted in the male pattern of
uninterrupted, full-time commitment to job. Hospitalbased specialities are often characterised by long and
unpredictable hours, being on call, and a scarcity of
part-time work. The expectation of long working hours
and the lack of part-time work are choices made by
those organising these services and need to be challenged. There is a need of a fundamental change in the
hospital culture, enabling doctors to be more involved in
their family life without it being detrimental to their
career. A more equal division of domestic and caring
responsibilities, and better opportunities in hospitalbased specialities to adjust work to family responsibilities when having small children, would probably reduce
the gender differences in how family responsibilities
affect the medical careers of men and women, and allow
more women to complete specialisation in hospitalbased specialities.

References
Allen, I. (1988). Doctors and their career. London: Policy
Studies Institute.
Allen, I. (1994). Doctors and their careers. A new generation.
London: Policy Studies Institute.
Arbeseb, C., Myraker, E., Steinsholt, I. M., Thesen, J., &
rbeck, L. (1999). Hva br(aker vi for? (What are we
fussing about?). Tidsskrift for den norske lgeforening, 94,
12151220.
Becker, G. S. (1985). Human capital, effort, and the sexual
division of labor. Journal of Labor Economics, 3, 533558.
Beiser, C., & Roberts, J. (1993). Medical marriages. British
Medical Journal, 309, 1673.
Bergquist, S., Duchac, B. W., Schalin, V. A., Zastrow, J. F.,
Barr, V. L., & Borowiecki, T. (1985). Perceptions of
freshman medical students of gender differences in
medical speciality choice. Journal of Medical Education,
60, 379383.

ARTICLE IN PRESS
1340

E. Gjerberg / Social Science & Medicine 57 (2003) 13271341

Central Bureau of Statistics of Norway (CBS) (1998). Labour

market statistics.
Central Bureau of Statistics of Norway (CBS) (2001). Labour
market statistics.
Chafetz, J. S., & Hagan, J. (1996). The gender division of labor
and family change in industrial societies: A theoretical
accounting. Journal of Comparative Family Studies, 17,
185219.
Crompton, R. (1999). The decline of the male breadwinner:
Explanations and interpretations. In R. Crompton (Eds.),
Restructuring gender relations and employment. Oxford:
University Press.
Crompton, R., & Harris, F. (1998). Gender relations and
employment: The impact of occupation. Work, Employment
and Society, 112, 297315.
Crompton, R., Le Feuvre, N., Birkelund, G. E. (1999). The
restructuring of gender relations within the medical profession. In R. Crompton (Eds.), Restructuring gender relations
and employment. Oxford: University Press.
Desai, S., & Waite, L. J. (1991). Womens employment during
pregnancy and after the rst birth: Occupational characteristics and work commitment. American Sociological Review,
56, 551566.
Drachman, V. (1986). The limits of progress: The professional
lives of women doctors 18811926. Bulletin of the History of
Medicine, 60, 5872.
Drobnic, S., Blossfeldt, H. P., & Rohwer, G. (1999). Dynamics
of womens employment patterns over the family life course:
A comparison of the United states and Germany. Journal of
Marriage and the Family, 61, 133146.
Dumelow, C., Littlejohns, P., & Grifths, S. (2000). Relation
between a career and family life for English hospital
consultants: Qualitative, semistructured interview study.
British Medical Journal, 320, 14371440.
Ellingster, A. L. (1995). Ulikhet i det postindustrielle
samfunn: Klasse, kj^nn og generasjon. Sosiologisk Tidsskrift,
4, 263284.
Ellingster, A. L. (1999). Dual breadwinners between state and
market. In R. Crompton (Eds.), Restructuring gender
relations and employment. Oxford: University Press.
Ellingster, A. L., Noack, T., & R^nsen, M. (1997). Sosial
ulikhet blant kvinner: Polarisering, utjevning eller status
quo? Tidsskrift for samfunnsforskning, 38, 3369.
Ellingster, A. L., & R^nsen, M. (1996). The dual strategy:
Motherhood and the work contract in Scandinavia.
European Journal of Population, 12, 239260.
Esping Andersen, G. (1990). The three worlds of welfare
capitalism. Cambridge: Policy Press.
Gjerberg, E. (2001). Medical womentowards integration? An
analysis of the speciality choices made by two cohorts of
Norwegian doctors. Social Science & Medicine, 52, 331343.
Gjerberg, E. (2002). Gender similarities in doctors preferencesand gender differences in nal specialisation. Social
Science & Medicine, 54, 591605.
Gjerberg, E. G., & Aasland, O. G. (1999). Bruker leger for lang
tid p(a a( spesialisere seg? (Do doctors take too long
specialising?) Working notes no. 1. Oslo: The Norwegian
Medical Associations Research Institute.
Gjerberg, E., & Hofoss, D. (1995). Harkj^nn betydning for om
legen blir spesialist? En analyse av spesialiseringsgrad blant
kvinnelige og mannlige leger. (Does gender affect the

doctors decision to become a specialist? An analysis of

the degree of specialization in female and male doctors.
Tidsskrift for Den Norske Lgeforening, 115, 12531257.
Hakim, C. (1991). Grateful slaves and self-made women: Fact
and fantasy in womens work orientation. European
Sociology Review, 7, 101121.
Hakim, C. (1998). Developing a sociology for the twenty-rst
century: Preference theory. British Journal of Sociology, 49,
137143.
Hansen, M. N. (1995). Sex segregation and the welfare state.
Rapport 1995:2. Oslo: Institute for Social Research.
Hinze, S. W. (2000). Inside medical marriage. The effect of
gender on income. Work and Occupations, 27, 464499.
Hofoss, D., Gjerberg, E. (1994). Legers arbeidstid (Doctors
working hours). Tidsskrift for den norske lgeforening, 114,
30593063.
Izraeli, D. N. (1988). Burning out in medicine: A comparison of
husbands and wives in dual-career couples. Work and
family: Theory, research and applications. Journal of Social
Behavior and Personality, 3, 329346.
Jensen, R. S. (2000). Kvinner og jobb etter sm(abarnsfasen.
Rapport nr. 10. Oslo: Institute for Social Research.
Johnson, C. A., Johnson, B. E., & Liese, B. C. (1991). Dualdoctor marriages: The British experience. Journal of
American Medical Womens Association, 46, 155159.
Johnson, C. A., Johnson, B. E., & Liese, B. C. (1992). Dualdoctor marriages: Career development. Family Medicine, 24,
205208.
Keizer, M. (1997). Gender and career in medicine. Netherlands
Journal of Social Science, 33, 94112.
Kvrner, K. J., Aasland, O. G., & Botten, G. S. (1999). Female
medical leadership: Cross sectional study. British Medical
Journal, 318, 9194.
Lappeg(ard, T. (1999). Akademikere f(ar ogs(a barn bare senere
Academics also have children only later. Samfunnsspeilet, 5,
714.
Leira, A. (1998). The modernisation of motherhood. In E.
Drew, R. Emerek, & E. Mahon (Eds.), Women, work and
the family in Europe. London: Routledge.
Lindahl, A. K., & Killi, M. (1984). Familien eller yrket? En
unders^kelse av kvinnelige legers livs- og arbeidssituasjon.
Rapport nr. 6. Oslo: Gruppe for helsetjenesteforskning.
Lorber, J. (1982). How physician spouses inuence each others
careers. Journal of American Medical Womens Association,
37, 2126.
Lorber, J. (1984). Women physicians: careers, status and power.
New York: Tavistock.
Lorber, J. (1993). Why women physicians will never be true
equals in the American medical profession. In E. Riska, &
K. Wegar (Eds.), Gender, work and medicine. Women and the
medical division of labour. London: Sage Studies in
International Sociology.
Martin, S. C., Arnold, R. M., & Parker, R. M. (1988). Gender
and medical socialisation. Journal of Health and Social
Behavior, 29, 191205.
Norwegian Medical Association (NMA) (1993). Specialist
training for physicians in Norway.
OECD (2001). Employment outlook.
Parliamentary Report no. 85 (19701971) (Stortingsmelding nr
85 (19701971)). Om helsetjenesten utenfor sykehus (Health
services outside hospital).

ARTICLE IN PRESS
E. Gjerberg / Social Science & Medicine 57 (2003) 13271341
Parliamentary Report no. 45 (19727193) (Stortingsmelding
nr 45 (19721973)). Tillegg til Stortingsmelding nr
85 Om helsetjenesten utenfor sykehus (Supplement to
Report to the Storting no. 85. Health Services outside
hospital).
Riska, E., & Wegar, K. (1993). Women physician: A new force
in medicine? In E. Riska, & K. Wegar (Eds.), Gender, work
and medicine. Women and the medical division of labour.
London: Sage.
Skrede, K., & S^rensen A. M. (1983). P(a sporet av en ny
kvinnerolle. In K. Skrede, & K. Tornes (Eds.), Studier i
kvinners livsl^p. Oslo: Universitetsforlaget.
Sobecks, N. W., Justice, A. C., Hinze, S., Chirayath, H. T.,
Lasek, R. J, Chren, M. M., Aucott, J., Juknialis, B.,
Fortinsky, R., Youngner, S., & Landefeld, C. S. (1999).
When doctors marry doctors: A survey exploring the
professional and family lives of young physicians. Annals
of Internal Medicine, 130, 312319.
Steinsholt, I. M., Rygh, E., & Thesen, J. (1990). Kvinner i
legeyrket. Utviklingstendenser i spesialisering og karrier-

1341

em^nster. (Females in the medical profession. Tendencies in

specialising and career patterns.) Tidsskrift for den Norske
L!cgeforen, 110, 32553259.
Tait, A., & Platt, M. J. (1995). Women consultants, their
background and training: Some myths explored. Medical
Education, 29, 372376.
Tesch, B. J., Osborne, J., Simpson, D. E., Murray, S. F., &
Spiro, J. (1992). Women physicians in dual-physician
relationships compared with those in other dual-career
relationships. Academic Medicine, 67, 542544.
Uhlenberg, P., & Cooney, T. M. (1990). Male and female
physicians: Family and career comparisons. Social Science
and Medicine, 3, 373378.
Wei, L. J., Lin, D. Y., & Weissfeld, L. (1989). Regression
analysis of multivariate incomplete failure time data by
modeling marginal distributions. Journal of American
Statistical Association, 84, 10651073.
sterli, W. (2001). Sosial st^tte i samlivet. Legers opplevelse av
partnerst^tte i yrkeskarrieren. Hovedfagsoppgave i sosiologi. Universitetet i Trondheim.