Although I found Dr. Carnes's recent suggestions on balancing family and career [1] to be helpful, I was disappointed to see that she excluded and misrepresented men in academic medicine. Although she clarified many of the dilemmas women face in balancing family and career, she neglected to emphasize that this balancing act is not strictly the concern of "a woman in her twenties and thirties." The "average man in academic medicine" is, in fact, concerned about how to accomplish this balancing act, too-he isn't simply out seeking "a wife who will take care of everything on the home front ... so that he can spend long hours at work and feel nurtured at home."

Contrary to Dr. Carnes's biases, I see most of my twenty-to-thirtysome professional male peers (both in and out of medicine) openly struggling to balance professional and personal lives. This struggle consistently, not erratically, involves juggling child care, keeping pediatrician appointments and attending school activities, supporting a partner's busy career, cooking meals and cleaning up, doing the laundry, paying the bills, mowing the grass, and maintaining the car, to name just a few domestic responsibilities. Emerging data support this anecdotal evidence [2-4].

Recognizing, then, that men and women alike are struggling to balance family and career, it seems that it would be more helpful to address these complex issues in a more equitable fashion. This approach may allow both men and women in academic medicine, and in other professions, to tackle these issues together and, perhaps, to find a common ground for mutual support. Such an outcome would allow both male and female academic physicians-not just "women with families"-to more fully appreciate the perks of an academic medical career.