TY - JOUR T1 - Learning or leaving? An international qualitative study of factors affecting the resilience of female family doctors JF - BJGP Open JO - BJGP Open DO - 10.3399/bjgpopen20X101017 VL - 4 IS - 1 SP - bjgpopen20X101017 AU - Alice Shiner AU - Jessica Watson AU - Noemi Doohan AU - Amanda Howe Y1 - 2020/04/01 UR - http://bjgpopen.org/content/4/1/bjgpopen20X101017.abstract N2 - ​Background Many countries have insufficient numbers of family doctors, and more females than males leave the workforce at a younger age or have difficulty sustaining careers. Understanding the differing attitudes, pressures, and perceptions between genders toward their medical occupation is important to minimise workforce attrition.​Aim To explore factors influencing the resilience of female family doctors during lifecycle transitions.​Design & setting International qualitative study with female family doctors from all world regions.​Method Twenty semi-structured online Skype interviews, followed by three focus groups to develop recommendations. Data were transcribed and analysed using applied framework analysis.​Results Interview participants described a complex interface between competing demands, expectations of their gender, and internalised expectations of themselves. Systemic barriers, such as lack of flexible working, excessive workload, and the cumulative impacts of unrealistic expectations impaired the ability to fully contribute in the workplace. At the individual level, resilience related to: the ability to make choices; previous experiences that had encouraged self-confidence; effective engagement to obtain support; and the ability to handle negative experiences. External support, such as strong personal networks, and an adaptive work setting and organisation or system maximised interviewees’ professional contributions.​Conclusion On an international scale, female family doctors experience similar pressures from competing demands during lifecycle transitions; some of which relate to expectations of the female's ’role’ in society, particularly around the additional personal pressures of caring commitments. Such situations could be predicted, planned for, and mitigated with explicit support mechanisms and availability of workplace choices. Healthcare organisations and systems around the world should recognise this need and implement recommendations to help reduce workforce losses. These findings are likely to be of interest to all health professional staff of any gender. ER -