To the Editor: The demands of practising medicine can have significant effects on general health, work satisfaction, professional and non-professional life.1 We conducted a survey among senior medical staff in a metropolitan teaching hospital. The survey explored the pressures of work, social and family demands on consultants, and whether there was a difference between sexes.

Participants completed a self-reported questionnaire on quality of life, levels of stress and feelings of work satisfaction, using previously validated questions and scoring from the General Health Questionnaire (GHQ-28, a 28-question subset of the GHQ)2 and Specialist Doctors Stress Inventory (SDSI).3 (Questionnaire available from authors on request.) Respondents answered anonymously and gave informed consent.

Fifty-seven per cent of consultants (54/94) returned surveys, of whom a third (18/54) were women. The response rates were comparable to those of other physician surveys.4

On average, consultants had been employed at the hospital for 10.8 (SD, 8.0) years, had been qualified for 22.2 (SD, 9.6) years, and were working 47.7 (SD, 14.0) hours per week. Eighty-one per cent (44/54) were married, 74% (40/54) had children and 54% (29/54) lived in a double-income household. Half (27/54) reported an unreasonable ratio between work hours and leisure time, and 50% (27/54) reported feeling stressed. Despite this, 65% (35/54) believed they had or would achieve their ideal medical career.

Female consultants worked fewer professional hours, but more hours in unpaid domestic work, than male consultants. Furthermore, female doctors were more likely to have had their career modified by family or social factors; more likely to use paid support to cope with their domestic workload; and, if they had children, more likely than men to have modified their careers to look after dependants (see Box).

Consultants who reported feeling stressed were more likely than other consultants to report an unreasonable ratio between work hours and leisure time (74.1% [20/27] v 48.1% [13/27]; P = 0.05). Forty-one per cent (22/54) scored above 4 on the GHQ-28, indicating that a high level of stress and psychiatric “caseness” (ie, clinically significant levels of psychiatric disturbance) is experienced by senior doctors. This result is similar to that of a UK study in which 46% (30/65) of senior doctors reported experiencing high levels of stress.5 From our data there appears to be a significant relationship between stress, psychiatric “caseness” and hours worked (P < 0.001).

Our study and others have identified potential reasons why women work fewer hours in medical work and have a shorter working life. These include having and caring for children, stress, dual-career marriages, personality and social expectations.6 Our survey highlights the fact that female consultants in Australia face undue pressure in balancing their medical and domestic roles compared with male consultants. There is a continuing need for flexibility in workplace and training environments for women in medicine to ensure equal career choice, balance between work and domestic commitments, and professional satisfaction.