Influence of marital pressures and cultural constructs on females (IMPACT-F): a global study of female medical students and doctors

Abstract

BACKGROUND: Female medical students and doctors (women in medicine) face systemic gender biases, cultural expectations, and marital pressures that are linked to their career trajectories, leadership opportunities, and well-being. This study explores these barriers globally, assessing their connection to gender equity, career advancement, and retention in medicine. OBJECTIVES: To evaluate how marital and cultural pressures relate to the career progression and emotional well-being of women in medicine. METHODS: A cross-sectional online survey using convenience and snowball sampling was disseminated globally through the Hub-and-Spokes model between November 2023 and December 2023. Responses (N = 3,031) from 53 countries were analysed in SPSS after consolidating Likert scales into three categories. RESULTS: Most respondents (78.7%, N = 2386) reported that female doctors face greater societal expectations to marry, and 72.4% (N = 2195) noted that these expectations correspond with career choices. Marriage-related pressure from family or friends was reported by 61.5% (N = 1865). Over half agreed that women are expected to prioritise child-rearing (51.2%, N = 1552) or work part-time (52.7%, N = 1597). These pressures correlated with high stress (72.9%), guilt or self-blame (68.6%), and burnout (70.3%). Reported coping strategies included open communication with partners (84.6%), boundary setting (76.7%), and family or mentor support systems (72%). CONCLUSION: Societal and cultural pressures remain closely linked to the professional and personal challenges of women in medicine. Targeted policy reforms and supportive workplace structures are needed to promote gender equity and well-being in medicine.