Unoffical Guide to Medicine Essay Competition – Secondary School Runner-up: Poppy Pierce

Well done to Poppy on being a runner-up in the secondary school category of our ‘Unofficial Guide to Medicine Essay Competition’ for her essay on “Female doctors in the workplace: What are the specific challenges they face? How can these be overcome?”

---

My name is Poppy Angelica and I am 16 years old. I am studying Chemistry, Biology, Physics and Psychology at Haggerston Sixth form. I want to study medicine so that I can care for those who are at their most vulnerable. I love the satisfaction of helping people and I know medical school will give me the skills to do so. I believe there is so much more research still to be done. In medicine you see the rewards of your labour unfold before your eyes and the field of expertise continually expands.

---

Female doctors in the workplace: What are the specific challenges they face? How can these be overcome?

According to the most up to date information provided by the General Medical Council (GMC), there is a huge disparity in the number of female and male specialist registrars; with only one third of total positions held by women (1). This indicates women are facing significant problems within the workplace. It is beyond the scope of this essay to elucidate and discuss all of the conceivable problems; however the author will consider all issues arising as a consequence of motherhood. In addition the role of institutional sexism and problems with access at all levels will be discussed, and solutions proposed for both.
Whilst one could argue that the status quo i.e. a male dominant profession is fine as is, it is a system that was built upon prejudices of gender, class and race and needs to be deconstructed so the NHS can truly serve its population with a representative work force. Dr Maureen Baker, a medical doctor and previous Chair of the Royal College of General Practitioners says, “Ultimately, it is our patients who benefit from a diverse workforce. This is one area where we are streets ahead of the corporate world – yet figures will undoubtedly be seized on as another excuse to criticize women GPs who work part-time.” (2) The implication of this quote is that inequality among doctors results in inequality for patients. Although social expectations and laws have changed and thus strengthened a women’s position in the workforce, gender bias remains pervasive in medicine. Professor Jonathon Grant, director of the Policy Institute at King’s College London addresses the long-standing gender imbalance in clinical academia as well as laboratory-based medical sciences. According to his research in 2014, he states that this inequality increases substantially with seniority, with women representing only 15% of professors in UK medical schools (3).
Exposing women to female role models can potentially negate the negative stereotypes that girls internalise regarding their competence in the workplace. A study by Sarah D. Herrmann (2016) aims to understand the extent to which a female role model can have an impact on the academic performance of a female student. The study revealed that chemistry students were 77 per cent less likely to receive the grades D, E or F, or withdraw (from school), compared to the students who had no connection with a female role model (4). The findings exemplify how a female role model can exert positivity and illustrate the possibility of overcoming gender barriers. This was clearly illustrated by the increased success of the students introduced to a role model.
An example of a female in a senior position who demanded access for women in medicine is Sophia Jex-Blake (1840-1912). She continuously, with fortitude, resisted the repression of women’s access to the health-care system. She insisted on expanding the possibilities of being a female doctor and proved that women were more than capable of meeting the demands of discipline in a doctor’s work place. Access to knowledge about current female role models and posthumous recognition of late female role models in STEM is the most effective way to incentivise young girls. In places where there are female leaders in action, it gives hope to girls that it is possible to achieve success in such esteemed occupations. Dufflo, an MIT Economist, and her colleagues, surveyed families with children age 11 to 15 in 495 villages in the West Bengal region of India. In areas with a long-serving female leader in government, the gender gap in teen education goals disappeared, due to the girls setting higher goals for themselves. The study also found that these girls were 25% more likely to expect to achieve the same level of education as their male peers (5).
Surveys from employers report that child-care services decrease employee absences by 20-30% (6). This puts the problems arising from the lack of child-care into perspective, by demonstrating that it is in a hospital’s best interest to provide the tools necessary for doctors who are mothers. To provide childcare facilities in hospitals costs the NHS money; however the greater concern lies with the payments for unfilled medical positions due to the increasing number of women in medicine not having appropriate facilities to complete their job. Denis Campbell, Health Policy Editor writing for the Guardian, explains that stand-in doctors are earning as much as £155 an hour for covering shifts (7). This exhibits the current deterioration in NHS provider finance due to locums demanding extortionate rates of pay. In addition, the resistance of the workplace to accommodating childbirth responsibilities contributes to the difference in employment status in medicine. When a female doctor prioritises her domesticity and is absent, a more appropriate, stable and fairer solution for this would be to provide childcare facilities. This allows a mother to balance both her work and home life, without one interrupting the other. In a study conducted at Stanford University School of Medicine, women ranked a flexible work environment with regard to child or elder care, including access to available emergency child care on- site or near the medical centre, as the highest priority and most important need to improve the career success and well-being of female faculty (8).
In 1966 the Oxford deanery’s regional medical officer, Rosemary Rue, introduced a scheme called “the part-time training scheme for married women doctors.” (9) Before this, a career in hospital medicine was inconceivable for most married women with dependent children. Despite this progress, the portrayal of a part-time doctor being unreliable and not devoted – which remains pervasive – must be deconstructed. Beryl De Souza, joint honorary secretary of the Medical Women’s Federation, hopes better access and understanding of part time work will ‘help to overcome the perception that those in part time work or who are training part time only have a part time commitment to medicine’. (10) This implies that commitment is not a measurement of hours one works for, but the attitude one acquires. By offering access to information about part-time opportunities, people will learn to accept part-time doctors as the norm.
The underrepresentation of women in senior roles in medicine is reasoned by the fact that there is still a “work dominated culture within the profession that favours men, which involves working unsocial hours,” says Beryl De Souza. (11) Evidently, this barrier can prevent a woman from taking on such a role, however for those who have resisted the oppressive nature of medicine, their achievements can illuminate. By recognizing the accomplishments of a female doctor, it can create a pathway for many other aspiring females. Tracey, Jagsi, Starr and Tarbell (2004) studied the experiences in a pilot medical faculty mentoring program at the Massachusetts General Hospital (12). Mentees noted that the program increased visibility and successfully provided them with a role model. This demonstrates that a structured mentoring program can result in benefits for women pursuing careers in medicine. The lack of senior female mentors means females may not seek career guidance and thus not be able to make an informed choice on their current or future profession.
Considering the issues addressed above, as an advocate of equal rights, the rights for the nature of ones sex predetermines how these rights have a need to be flexible. By initiating change and supporting girls at a young age, there is hope for overcoming the challenges a female doctor faces in the workplace. In addition, the environment of the workplace, with inadequate facilities and pervasive institutional sexism, creates barriers for current and aspiring female doctors; however a solution to this is to address the needs that are more specific to the female gender.

---

Sources

1. http://www.gmc-uk.org/doctors/register/search_stats.asp
2. http://www.telegraph.co.uk/news/nhs/10724511/The-doctor-Shell-see-you-now.html
3. Penny M, Jeffries R, Grant J, Davies SC. Women and academic medicine: a review of the evidence on female representation. J R Soc Med [Internet]. 2014;107(7):259–63. Available from: http://jrs.sagepub.com/content/107/7/259.full
4. Herrmann SD, Adelman RM, Bodford JE, Graudejus O, Okun MA, Kwan VSY. The Effects of a Female Role Model on Academic Performance and Persistence of Women in STEM Courses. Basic Appl Soc Psych [Internet]. 2016 Sep 2;38(5):258– 68. Available from: http://www.tandfonline.com/doi/abs/10.1080/01973533.2016.1209757
5. http://www.huffingtonpost.com/2012/01/18/mit-study-india-female-leaders- politicians-aspirations_n_1213998.html
6. http://childcarecouncil.com/wp-content/uploads/2014/07/Why-Should-Employers- Care-ECLC.pdf
7. https://www.theguardian.com/society/2016/dec/18/nhs-doctors-locums-pay- finance-hospitals
8. McGuire LK, Bergen MR, Polan ML. Career advancement for women faculty in a U.S. school of medicine: perceived needs. Acad Med. 2004;79(4):319–325. [PubMed] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3771163/
9. Dame Rosemary Rue. BMJ [Internet]. 2005;330(7484):199. Available from: http://www.bmj.com/content/330/7484/199
10. Karthy Oxtoby: Women in medicine. BMJ Careers: 2009 http://careers.bmj.com/careers/advice/Women_in_medicine
11. Karthy Oxtoby: Are women breaking down barriers to leadership roles in medicine? BMJ Careers: 2013 http://careers.bmj.com/careers/advice/view-article.html?id=20014723
12. Sheila C. Grossman PDABC. Mentoring in Nursing: A Dynamic and Collaborative Process [Internet]. Springer Publishing Company; 2007. Available from: https://books.google.co.uk/books?id=yu8bsM5InBQC