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Medical women: internet resource

July 2006

Setting the scene
Many women, including female doctors, are striving to achieve equality in the workplace across the UK.

There are currently two laws focusing on the equal opportunities of women in their places of work. The Equal Pay Act (1970) provided for a statutory term to be applied in all employment contracts that entitles employees to equal pay for equal work. The 1975 Sex Discrimination Act made it unlawful to discriminate on the grounds of sex and marriage in the area of employment.

Neither of these Acts, however, has addressed all of the inequity in the workplace. For example, a gender pay gap still exists in many organisations (see references 3 and 4). In addition to remuneration, flexibility of work is important. Requests from employees for flexible working and training have affected the work culture and employers must respond to the needs of the workforce. As the number of women entering medicine has increased, it has become imperative to address career barriers and flexible working strategies to ensure a positive future for women choosing medicine as a career. Offering flexibility does not in itself improve working conditions for women, however; principles of gender equality must inform how jobs are structured and organised (see reference 5).

Over half of all students graduating from medical school in the UK are female.

In England, women represent 37 per cent of all hospital medical staff but only 25 per cent of consultants (see reference 6). Around 39 per cent of associate specialists and staff grade doctors are female, but of associate specialists and staff grade doctors who qualified in the UK, 65 per cent are female. Women are persistently under-represented in the higher levels of academic medicine and medical administration (see references 7, 8 and 9). This is despite the fact that women have been entering the medical profession in increasing numbers for at least 20 years.

These issues are highlighted by an internal review of BMA committee membership, which found that there is an under-representation of women doctors on BMA committees compared to the percentage of women actually working in medicine. The number of women in the medical workforce varies from 25 per cent (consultants) to 53 per cent (house officers). The comparable figure for BMA committees was 28 per cent. This is based on a response rate of 60 per cent; when non-responses were taken into account, the average female representation on committees was 17 per cent. (Equal opportunities monitoring of committees 2004-05, BMA).

The current lower proportions of women in more senior grades (including hospital consultants) may be a reflection of historical admission rates: that the number of women consultants reflects the number of young women entering medical schools in the 1970s and 1980s – prior to the early 1990s when the number of female medical students began to equal, and eventually outpace, that of men.

In a 2004 discussion paper from the Women in Surgical Training (WIST) group of the Royal College of Surgeons it is noted that, despite an increase in the proportion of female graduates and in the number of female SHOs these increases are not yet translating into more consultant surgeons, of which only 7 per cent are female (see reference 10).

Similarly, a report by the Royal College of Physicians, Women in hospital medicine: career choices and opportunities (2001) - download as a pdf here, found that there are fewer women than might be expected in the acute medical specialties, in academia and in positions of seniority (see reference 11). The report’s recommendations included the following:

• the need for more part-time consultant posts
• expansion of flexible and part-time training opportunities
• improvement in career guidance, mentoring and educational opportunities for those who do not work standard hours or who need a period of retraining/revalidation
• adequate childcare places with out-of-hours provision should be available
• equal opportunities for women in academic medicine and positions of seniority.

There is also a need to recognise that the culture within many medical specialties reflects a historic and essentially a male dominated hierarchy which needs to be addressed. In order to identify career barriers faced by female doctors and to track progress towards gender equality in the medical profession it is vital that equal opportunities monitoring is carried out consistently by all employers, professional bodies and other relevant organisations, such as the GMC, PMETB and the ACCEA. The results of such monitoring should always be published.

The BMA EOC recommends that monitoring by gender should be combined with ethnic monitoring so that potential discrimination against black and ethnic minority women can also be identified. The BMA report Examining equality: a survey of royal college examinations (2006) - read more here (see reference 12) found that the majority of royal colleges performed monitoring of examination candidates by gender. Data provided showed that overall female candidates slightly out-performed men in examinations for the Royal College of General Practitioners, the Royal College of Paediatrics and Child Health and the Royal College of Physicians. Disappointingly, none of the other colleges provided any further information for this part of the survey, other than to say that they did monitor examination candidates. Analysis of the data provided by some royal colleges on the gender of their examiners showed a bias in favour of men and that the number of women on examiners’ panels is disproportionate in relation to the consultant medical workforce.

An 2005 article in the BMJ by Isobel Allen, Women doctors and their careers: what now? - read more here , summarises the current situation for women doctors, and how this has changed in the last few years (see reference 13).