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The Sandwich Generation in Otolaryngology

by Julie Wei, MD, MMM • April 8, 2026

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For Dr. Echanique, success often meant getting through a day where her patients were cared for, and her children felt loved, regardless of how much charting remained. I learned so much from listening to her and wished I had her clarity and resolve when struggling through all the same issues years ago. My commitment to self-compassion reminded me gently not to question if I could have done better, but instead feel proud of how far we have come, so surgeons today can model far better work–life integration for medical students and fellow trainees.

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Explore This Issue
April 2026

Systems, Leadership, and Culture

One powerful theme emerged during this panel discussion—culture matters.

I shared with the audience that I worked very hard to become a leader, so I can ensure a supportive culture for all and create positive changes based on my own experience. Recently, our new junior faculty member, who is expecting her second child this summer, came into my office and asked if she could preemptively make up calls she will miss while out on maternity leave for three months. I reassured her that she will not be assigned the same number of calls nor penalized for taking leave. I recall my own feelings of guilt and perception of not pulling my weight back in 2021, when I doubled up my calls the six weeks before I took a six-week leave for my musculoskeletal injury. Regardless of the reason for leave, including maternity leave, we should not expect the person who needs care and time away from clinical care to endure the burden of work or make up for it, and do double before or after their time off. Published data show far higher risks during pregnancy, delivery, and postpartum for female surgeons already, without the unnecessary stress and added work brought on by guilt.

Creating environments where flexibility is not stigmatized is critical. Surgeon schedules are anything but flexible. Collectively, we can create cultures within our division and departments where colleagues all step up without judgment. Where well-being is valued ahead of productivity metrics, especially considering so many of our contributions are not measurable by hospital or institutional metrics.

Dr. Simons emphasized how critical departmental understanding is when family needs temporarily eclipse professional output. Dr. Echanique spoke about how meaningful it is when senior colleagues acknowledge that this phase is real and normal.

Challenges for physicians and surgeons are not an individual’s problem—they are a cultural one.

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Filed Under: Articles, ENT Perspectives, Home Slider, Rx: Wellness Tagged With: otolaryngology, Sandwich GenerationIssue: April 2026

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  • Some Challenges Remain to Having a Universal Resident Leave Policy, But Otolaryngology Programs Are Getting Closer
  • TRIO Welcomes New Leaders in 2025
  • Mentor–Mentee Relationship: Otolaryngologists Weight in on Young Physicians’ Career Plans

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