09 mar 2009--Some years ago, well before I got engaged, I had a conversation with a young gastroenterologist about marriage. I was readying myself for medical school and concerned I would not meet anyone outside of medicine. I was certain I did not want to marry a doctor. ''No, marry a doctor,'' the fellow advised. ''When you get paged away during your anniversary dinner, only another doctor will understand.''
Recently, as a newly minted doctor, I got engaged to a medical student. Although we have common interests that extend far beyond medicine, most of my friends focus on the fact that we will both be doctors. Like the gastroenterologist, some think being in the same demanding field will help our marriage. Others think I was bound to marry a doctor, given my schedule, but wonder how we will find time to spend together. A few wink and joke about our future income.
Like me, many young doctors today are marrying other doctors. That was not the case fairly recently, when the vast majority of doctors were men and dual-doctor marriages were rare. Male doctors tended to have stay-at-home wives who took care of children and supported their husbands and their careers. About 50 percent of female doctors, on the other hand, have always married other doctors. Today, when women account for almost 50 percent of medical students and about 20 percent of all doctors, the number of these marriages is rising rapidly. Soon, perhaps half of all young doctors will be married to other doctors.
A recent study in The Annals of Internal Medicine set out to discover what these marriages were like. A group of researchers surveyed 1,208 doctors, comparing the 26 percent in dual-doctor marriages with the rest in ''mixed marriages.'' The researchers looked at three areas: number of hours worked and annual income, number of children and child-rearing arrangements, and perceptions of family and work.
Over all, they found that dual-doctor marriages were relatively happy and stable. Compared with other physicians, doctors in dual-doctor marriages reported greater satisfaction in discussing and sharing work interests with their spouses, more involvement in child rearing by both partners and a higher family income.
Dr. Robert Campagna, a 37-year-old cardiologist at New York Presbyterian Hospital who recently married an internist, said he believed that there were many advantages to marrying another doctor. ''Sarah and I speak the same language, we belong to the same clique,'' he said recently. ''I don't have to go home and say, 'I started a dopamine drip on a patient today. Oh, and by the way, dopamine is a drug we use to . . .''
The survey also found that dual-doctor marriages were traditional in many ways, particularly in the area of family. Compared with other female doctors, for example, women in dual-doctor marriages spent more time rearing children, more often arranged their work schedules to fulfill family responsibilities, worked fewer hours and earned less money.
However, neither men nor women in dual-doctor families said they felt less successful than other physicians in achieving their career or child-rearing goals.
Dr. Shari Midoneck, an infectious disease specialist at New York Presbyterian who is married to a gastroenterologist, agreed that most women in dual-doctor marriages bore the brunt of child rearing. ''The onus is on me to make sure that there's food in the house, that the kids are ready for school, that their homework is done,'' she said. ''My mother was there for us every night cooking dinner. She went on all our field trips. So I want to be there for my kids.''
Dr. Midoneck works in a practice with other women, most of whom have children, which helps her maintain flexibility in her work. ''I never miss anything with my kids,'' she said. ''If I need time off, I just take it.''
Dr. Campagna, venturing an explanation for some of the survey's results, said: ''Medicine is not a radical profession. Many women in the field tend to have traditional outlooks on their nonprofessional lives.''
But medicine has been changing and continues to change, particularly in regard to the work ethic. Doctors, both male and female, work fewer hours, and life style and family time are top considerations for medical students choosing specialties.
Still, medicine remains inflexible in many respects, especially with regard to women. For example, most residency programs do not have formal maternity leave policies, though most female residents are in their childbearing years. Medical schools still do not make proper allowance for female (or male) academics who want to hop off the tenure track to have children. A recent survey found that female academics believe having children is a hindrance to career advancement, though those with children had no regrets.
The system will change with time, as more women assume positions of power, but the increasing number of dual-doctor marriages is also bound to hasten the change. The sentiments and sympathies of the men who now run most teaching hospitals will change when more of them go home every night to their doctor wives. Instituting flexible work schedules in academic medicine and on-site child care will become more of a priority when these issues hit closer to home. The system is bound to become more flexible, reflecting the current reality of the profession instead of the outdated reality of the past, benefiting men and women alike.