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Flawed research must not be used to stereotype women doctors
- Professor Bhupinder Sandhu, Dr Justin Varney, Co-chair, Equal Opportunities Committee, BMA (16 October 2008)
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Re: Flawed research must not be used to stereotype women doctors - Authors' response
- Karen Bloor, Alan Maynard, Nick Freemantle (21 October 2008)
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Professor Bhupinder Sandhu, Co-chair, Equal Opportunities Committee, BMA BMA House, Tavistock Square, London WC1H 9JP, Dr Justin Varney, Co-chair, Equal Opportunities Committee, BMA
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The paper on “Gender and variation in activity rates of hospital consultants” (J R Soc Med 2008;101:27-33) is fundamentally flawed. As co- chairs of the BMA’s equal opportunities committee we are concerned that this research could feed into an inaccurate or stereotypical perspective of women doctors. The main weakness of this study is that the two sets of gender data were not properly matched for speciality. Only about one in six of the sample was female and the smaller proportion of females was not distributed evenly amongst the specialties. For example, a large proportion of female consultants worked in paediatric medicine (823 male/412 female), whereas few were represented in trauma and orthopaedics (1276 male/33 female). Paediatrics is a specialty requiring long consultation times, and the average paediatrician, male or female, would see 10 to 12 patients per session. Trauma specialists, whether male or female, would normally get through around 20 patients or more. So, in this paper, the difference in the male and female productivity is likely to be more to do with specialties and really nothing to do with the gender. This sort of research is important, for example for workforce planning and in assessing patient care, but we need to ensure that the methodology does not contain bias. Doctors’ gain experience of different specialties during their training and professional working lives and will, therefore, understand that a different amount of time is needed for different specialty and sub- specialty problems. To ignore this fact, makes the paper’s findings not only invalid but also dangerously misleading. We would appreciate seeing data analysis by gender on work output from the paediatric speciality subgroup where the numbers are a bit more equal (male to female ratio 2:1). We expect that other readers of the BMJ would like to have sight this data analysis too. Competing interests: None declared |
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Karen Bloor, Senior Research Fellow Unviersity of York, YO10 5DD, Alan Maynard, Nick Freemantle
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We recommend that Sandhu and Varney, and anyone else interested in the issue, read our paper describing the meticulous statistical analysis that was used to account for imbalances and confounding factors (http://dx.doi.org/10.1258/jrsm.2007.070424 ). This analysis led to the firm and methodologically robust conclusions which Sandhu and Varney appear to seek to discredit. Of course they are correct to say that women are not evenly distributed throughout the ten specialties included. The carefully designed model isolated the effect of gender from other relevant factors, including specialty, but also age and hospital Trust. In response to Sandhu and Varney’s final point, we have indeed looked separately at Paediatric Medicine; the specialty with the highest proportion of women consultants. The pattern of activity rates by gender for this specialty is no different to the others; women in all age groups undertake, on average, notably fewer FCEs than men, with and without adjustment for casemix. Our research was designed, conducted and written up with due diligence to avoid the stereotyping that concerns Sandhu and Varney; their criticisms are unhelpful and ill-informed. Competing interests: None declared |
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