Gender and medical careers

Abstract

The concerns about physicians’ career advancement tend to be raised in gender terms, because women presently constitute close to and will soon form a majority of the medical students in most western societies. The question is to what extent female and male medical students and residents today make similar or different career and lifestyle choices? Two major mechanisms have been referred to as the reason for gender differences in career paths for physicians. The major theoretical framework tends to be the socialization or sex-role theory and later versions of this explanatory framework. The other mechanism referred to is structural and points to the barriers or the concrete support that women and men experience in making their career decisions. Studies of medical students in the UK and US have shown that women students expected family demands to hamper career plans, while male students were less influenced by family concerns. The importance of role models and mentors in setting the career goals of medical students and residents has recently confirmed early studies of the topic. A number of studies have documented that early negative experiences or lack of encouragement in medical school deter women from choosing surgery as a career. Recent studies suggest that lifestyle choices rather than merely career advancement influence both female and male surgeons’ career plans.

Introduction

During the past 20 years, women have become an increasing part of the medical profession in Europe and North-America. While women's general advancement in higher education is one of the underlying factors behind the increasing number of female students in medical schools, the proportion of women among medical practitioners does vary between countries. Health care systems differ as do the status and autonomy of the medical profession in those systems. In health care systems, where the medical profession has had a considerable autonomy in comparison to those where a majority of the physicians have been salaried employees in the public sector, the debate about the implications of having more women physicians has been more explicit. As an example, data on the American medical profession are continuously collected and analyzed to identify trends in medical careers to control the future training and practice of physicians.

Two issues related to career choices in medicine seem to be pertinent in most western societies regardless of the health care system. First, the aging populations imply that more physicians will be needed in the future, especially in some specialties like surgery. Second, large cohorts of baby-boomer physicians are close to retirement. At issue is not only a numerical replacement of an increasing number of physicians but also the emergence of a new generation of physicians which tends to make different lifestyle choices than previous generations. The concern about physician's career choices tends to be raised in gender terms, because women presently constitute close to half and will soon form a majority of the medical students in most western societies. The question, which medical educators tend to ask, is to what extent female and male medical students and residents today make similar or different career and lifestyle choices? This question will be the focus of this literature review. The review will mainly include studies from various western countries although American and British studies will dominate because most research has been done in those two countries. Furthermore, the review will take surgery as a case study because this specialty has been markedly male-dominated. It will emerge that women's increasing share of surgeons coincides with some structural and cultural changes taking place in surgical work itself regardless of the increasing numbers of women entering the specialty.