Women in Medicine Survey

1. Are you a woman physician (or soon-to-be woman physician)?

Are you a woman physician (or soon-to-be woman physician)? Yes

2. What is your chief struggle? (select all that apply)

	Not a problem	Something of a problem	A problem	A significant problem	N/A
Difficulty finding joy or satisfaction in my work	*What is your chief struggle? (select all that apply) Difficulty finding joy or satisfaction in my work Not a problem	Difficulty finding joy or satisfaction in my work Something of a problem	Difficulty finding joy or satisfaction in my work A problem	Difficulty finding joy or satisfaction in my work A significant problem	Difficulty finding joy or satisfaction in my work N/A
Disappointment in how medical practice is turning out to be	Disappointment in how medical practice is turning out to be Not a problem	Disappointment in how medical practice is turning out to be Something of a problem	Disappointment in how medical practice is turning out to be A problem	Disappointment in how medical practice is turning out to be A significant problem	Disappointment in how medical practice is turning out to be N/A
Frank burnout	Frank burnout Not a problem	Frank burnout Something of a problem	Frank burnout A problem	Frank burnout A significant problem	Frank burnout N/A
Difficulty balancing the demands of my work and motherhood	Difficulty balancing the demands of my work and motherhood Not a problem	Difficulty balancing the demands of my work and motherhood Something of a problem	Difficulty balancing the demands of my work and motherhood A problem	Difficulty balancing the demands of my work and motherhood A significant problem	Difficulty balancing the demands of my work and motherhood N/A
Difficulty balancing the demands of my work and being a wife/significant other	Difficulty balancing the demands of my work and being a wife/significant other Not a problem	Difficulty balancing the demands of my work and being a wife/significant other Something of a problem	Difficulty balancing the demands of my work and being a wife/significant other A problem	Difficulty balancing the demands of my work and being a wife/significant other A significant problem	Difficulty balancing the demands of my work and being a wife/significant other N/A
Difficulty balancing the demands of my work and my personal life	Difficulty balancing the demands of my work and my personal life Not a problem	Difficulty balancing the demands of my work and my personal life Something of a problem	Difficulty balancing the demands of my work and my personal life A problem	Difficulty balancing the demands of my work and my personal life A significant problem	Difficulty balancing the demands of my work and my personal life N/A
Finding time to care for my personal needs (social, hobbies, exercise, nutrition, spiritual etc)	Finding time to care for my personal needs (social, hobbies, exercise, nutrition, spiritual etc) Not a problem	Finding time to care for my personal needs (social, hobbies, exercise, nutrition, spiritual etc) Something of a problem	Finding time to care for my personal needs (social, hobbies, exercise, nutrition, spiritual etc) A problem	Finding time to care for my personal needs (social, hobbies, exercise, nutrition, spiritual etc) A significant problem	Finding time to care for my personal needs (social, hobbies, exercise, nutrition, spiritual etc) N/A
Difficulty developing myself professionally	Difficulty developing myself professionally Not a problem	Difficulty developing myself professionally Something of a problem	Difficulty developing myself professionally A problem	Difficulty developing myself professionally A significant problem	Difficulty developing myself professionally N/A
Wanting to leave medicine and not knowing what else to do	Wanting to leave medicine and not knowing what else to do Not a problem	Wanting to leave medicine and not knowing what else to do Something of a problem	Wanting to leave medicine and not knowing what else to do A problem	Wanting to leave medicine and not knowing what else to do A significant problem	Wanting to leave medicine and not knowing what else to do N/A
Having an idea for a different job or career and not knowing how to go about it	Having an idea for a different job or career and not knowing how to go about it Not a problem	Having an idea for a different job or career and not knowing how to go about it Something of a problem	Having an idea for a different job or career and not knowing how to go about it A problem	Having an idea for a different job or career and not knowing how to go about it A significant problem	Having an idea for a different job or career and not knowing how to go about it N/A
Wanting to start a business and not knowing which one to start	Wanting to start a business and not knowing which one to start Not a problem	Wanting to start a business and not knowing which one to start Something of a problem	Wanting to start a business and not knowing which one to start A problem	Wanting to start a business and not knowing which one to start A significant problem	Wanting to start a business and not knowing which one to start N/A
Wanting to start a business and not knowing how to go about it	Wanting to start a business and not knowing how to go about it Not a problem	Wanting to start a business and not knowing how to go about it Something of a problem	Wanting to start a business and not knowing how to go about it A problem	Wanting to start a business and not knowing how to go about it A significant problem	Wanting to start a business and not knowing how to go about it N/A
Having to be the major breadwinner for the family	Having to be the major breadwinner for the family Not a problem	Having to be the major breadwinner for the family Something of a problem	Having to be the major breadwinner for the family A problem	Having to be the major breadwinner for the family A significant problem	Having to be the major breadwinner for the family N/A
Fear of change	Fear of change Not a problem	Fear of change Something of a problem	Fear of change A problem	Fear of change A significant problem	Fear of change N/A
Fear of a financial struggle if I change careers	Fear of a financial struggle if I change careers Not a problem	Fear of a financial struggle if I change careers Something of a problem	Fear of a financial struggle if I change careers A problem	Fear of a financial struggle if I change careers A significant problem	Fear of a financial struggle if I change careers N/A

Other (optional - please explain briefly)

3. If you had access to an inspiring yet practical and affordable home study program, what would you want it to focus on providing you with?

	Not at all interested	Somewhat interested	Interested	Very interested	N/A
Concise nuggets that challenge you to experience and savor your life more deeply	*If you had access to an inspiring yet practical and affordable home study program, what would you want it to focus on providing you with? Concise nuggets that challenge you to experience and savor your life more deeply Not at all interested	Concise nuggets that challenge you to experience and savor your life more deeply Somewhat interested	Concise nuggets that challenge you to experience and savor your life more deeply Interested	Concise nuggets that challenge you to experience and savor your life more deeply Very interested	Concise nuggets that challenge you to experience and savor your life more deeply N/A
Tools for better personal and professional decision-making	Tools for better personal and professional decision-making Not at all interested	Tools for better personal and professional decision-making Somewhat interested	Tools for better personal and professional decision-making Interested	Tools for better personal and professional decision-making Very interested	Tools for better personal and professional decision-making N/A
Self-coaching tools to guide you to accomplishing your goals	Self-coaching tools to guide you to accomplishing your goals Not at all interested	Self-coaching tools to guide you to accomplishing your goals Somewhat interested	Self-coaching tools to guide you to accomplishing your goals Interested	Self-coaching tools to guide you to accomplishing your goals Very interested	Self-coaching tools to guide you to accomplishing your goals N/A
The "how-to" of new skills to help you make your desired next opportunity happen (effective networking, resume writing, increased productivity, stress management, goal attainment etc)	The "how-to" of new skills to help you make your desired next opportunity happen (effective networking, resume writing, increased productivity, stress management, goal attainment etc) Not at all interested	The "how-to" of new skills to help you make your desired next opportunity happen (effective networking, resume writing, increased productivity, stress management, goal attainment etc) Somewhat interested	The "how-to" of new skills to help you make your desired next opportunity happen (effective networking, resume writing, increased productivity, stress management, goal attainment etc) Interested	The "how-to" of new skills to help you make your desired next opportunity happen (effective networking, resume writing, increased productivity, stress management, goal attainment etc) Very interested	The "how-to" of new skills to help you make your desired next opportunity happen (effective networking, resume writing, increased productivity, stress management, goal attainment etc) N/A
Resources that help you uncover non-clinical opportunities	Resources that help you uncover non-clinical opportunities Not at all interested	Resources that help you uncover non-clinical opportunities Somewhat interested	Resources that help you uncover non-clinical opportunities Interested	Resources that help you uncover non-clinical opportunities Very interested	Resources that help you uncover non-clinical opportunities N/A

Other (optional - please make your request here)

4. What would you be willing to pay for an 8-week self study program, with email support as needed from me (your coach), that addressed the biggest challenges you have listed above?:

What would you be willing to pay for an 8-week self study program, with email support as needed from me (your coach), that addressed the biggest challenges you have listed above?: $200

$250

$500

$750

Other (please specify)

5. Would you be interested in the option of adding on limited one-on-one phone coaching time with me, Philippa Kennealy, to help ensure that the home study program is REALLY effective (3 hours total, used however you wanted it)?

Would you be interested in the option of adding on limited one-on-one phone coaching time with me, Philippa Kennealy, to help ensure that the home study program is REALLY effective (3 hours total, used however you wanted it)? Yes

Perhaps