Women in academic medicine still have to battle against macho culture

BMJ 2008; 336 doi: (Published 01 May 2008) Cite this as: BMJ 2008;336:979
  1. Zosia Kmietowicz

Women trying to carve out a career in academic medicine in the United Kingdom continue to face a dominant male “club culture,” misplaced competition, exclusion, and lack of support, says a report out this week.

Despite the fact that women have made up more than 40% of medical graduates in the past 20 years and now account for 60% of medical students, women doctors are still strikingly under-represented in the university sector, especially in senior posts, says the report from the women in academic medicine project, a research venture funded by a variety of sources, including the government and the BMA.

The report makes a raft of recommendations for government, institutions, professionals, and journals aimed at rectifying the imbalance, which currently leaves one in five medical schools without a female professor. Of the 33 heads of UK medical schools only two are women, says the report, and 11% of professorships are held by women.

“Given the demographic changes in medical schools and the availability of a major competitive employer such as the NHS, unless the reasons for this [to attract and retain women doctors] are addressed it is unlikely that this situation will be reversed,” it says.

The report includes a survey of the factors that doctors think impede their careers and compares for the first time the progress of doctors working in higher education with those in clinical posts. It found that although men and women experienced barriers to progression in their career, such barriers were more likely to be faced by women and were most acute among women in academic posts.

Of 1162 respondents to the online survey more than half of the women (52%) and 40% of the men said that workplace factors or personal circumstances had an especially detrimental effect on their career. As important factors they cited lack of support and encouragement, a culture of long working hours, meetings outside the normal working day, and the attitudes of colleagues and senior management.

Themes from focus groups showed, the report said, that many women thought that “there is a folklore that if you are a woman you won’t get ahead in academic medicine.” It adds: “There is an inherent cultural issue that needs to be addressed within academia—one of macho, aggressive, cut throat attitude.”

Many women believe that decisions about new appointments in higher education are made “in the pub” rather than by an appointment panel, as is the case for NHS posts.

Competition in academic medicine is unnecessarily overemphasised, says the report, and this is accompanied by an over-reliance on the research assessment exercise—which ranks the quality of institutions’ research and thus determines how much research funding they get—to define success. Many women feel marginalised because they tend to be involved in teaching rather than research so miss out on the reward system provided by the exercise.

“Women’s careers are more varied than men’s, and if that is not valued then women won’t apply for jobs,” said Anita Holdcroft, the report’s lead author and emeritus reader in anaesthetics at Imperial College London. “It is important that we meet European standards on the number of women chairing and sitting on academic boards so that women are qualified to get higher professional posts. And we need to do this in a timely manner, not to have to wait another 20 years.”


View Abstract

Log in

Log in through your institution


* For online subscription