Intended for healthcare professionals

Rapid response to:

Head To Head

Are there too many female medical graduates? No

BMJ 2008; 336 doi: (Published 03 April 2008) Cite this as: BMJ 2008;336:749

Rapid Response:

The personal is professional

Imagine your brilliant daughter is training to be a doctor. She has a string of perfect scores in her school exams, she loves her degree and has found her vocation in one of the hospital specialities. Then she chooses to downsize her career ambitions because she knows that at some point in the future (and at this point in her life she can't say when) she would like to have a family. However her perception of hospital medicine is that it's inflexible and unforgiving towards family life.

Conversations with undergraduate female students often circled around this theme and I began to wonder if there was a trend. So as part of my undergraduate training I did a research project and reached the sad conclusion that women are choosing between "personal commitments and professional power"(1) even before they qualify as doctors.

The entire medical student population (years 1-5) at the Institute of Health, University of East Anglia, was given a questionnaire based on the British Medical Association's Cohort Study of 1995 Medical Graduates. From a 47% response rate (262/619) hospital-based specialities were the most popular overall (60%) with the remainder split roughly 50:50 between general practice or being undecided. There was no significant difference based on gender or stage of training.

However in the hospital specialities significant gender differences emerged in male preference for Surgery and Radiology and female preference for Obstetrics and Gynaecology. Undecided students and students who changed their minds about their career aspirations during their training were more likely to be female. They were also more likely to consider part -time working at some point in their career in both early (years 1-3) and later (years 4-5) stages of their training.

A small focus group met to unpick the questionnaire answers. What emerged was that personal circumstances such as having a family had a greater influence over the career aspirations of undergraduate females. Male undergraduates tended not to anticipate the career impact of such circumstances. This may explain why more females than males considered part-time working and were more undecided about their career aspirations compared to males.

These findings suggest that to make best use of women doctors in the National Health Service (NHS), all specialities need to develop posts which allow less than full-time working. This should become easier for workforce planners as the recent swell in undergraduate recruitment starts to hit the wards.

Brian McKinstry is right. For years women have been unfairly discriminated against in medicine. However, their rising numbers do not suggest that the glass ceiling has lifted. Barriers to the success a woman might seek are still built into workforce planning and career structures. In fact they are so endemic, that undergraduate females are already anticipating their implications.

Finola Lynch FY1 doctor, East of England deanery

1 Showalter E. Improving the position of women in medicine. BMJ 1999;318:71-2

Competing interests: I am a member of the MWF

Competing interests: No competing interests

10 April 2008
Finola C Lynch
James Paget University Hospitals NHS Foundation Trust, Lowestoft Road, Great Yarmouth, NR31 6LA