Equality for women in medical careers is long overdue - but the NHS can deliver it

Almost 125 years after Marion Gilchrist became the first woman to graduate in medicine in Scotland, women still face barriers to career progression as doctors. Glasgow GP Dr Patricia Moultrie reflects on Scotland's first Women in Medicine conference and considers what needs to change.

Glasgow GP Dr Patricia Moultrie

BMA Scotland held its first ever Women in Medicine conference last month in Stirling. This was an opportunity to discuss the challenges women face in their careers as doctors. Women from across all disciplines of medicine attended, and heard from some inspiring speakers, including women who had excelled in their fields. It was very encouraging to hear their stories and learn from their experiences.

Women have always been central in providing medical care, whether offering remedies in the home, nursing or acting as herbalists. However, the medical profession has been male dominated for most of its history. In Europe, this came about from the 1400s, when many cities and governments decided that only those trained in universities could formally practise medicine.

As women were not allowed to attend universities they could not gain a licence. It was only in the last 100 years or so, after much struggle, that women won the right to study and practise medicine in the same way as men.

Women in general practice

In 1894, Marion Gilchrist became the first woman to graduate in medicine in Scotland; she was also the first woman to graduate from Glasgow University. She went on to become a general practitioner and ophthalmic surgeon as well as being an active suffragette. During her career, she was a prominent member of the BMA for 54 years and the first woman chair of its Glasgow division.

Significant progress has been made since Dr Gilchrist blazed a trail for women in medicine, but we still have much further to go to have true gender equality. Although the doctor workforce is almost gender equal in numbers, with data showing 47% women and 53% men in 2015, there is a much starker under-representation of women in senior roles. A total of 66% of consultants were men as were 56% of GP partners, in 2015. There are also some specialties that are still mainly men, such as surgery (89%) and emergency medicine (68%) as the BMA's Equality Lens report showed.

And what about the gender pay gap? Data from the Office for National Statistics (ONS) shows that the gender pay gap for doctors remains high, with women doctors’ median hourly pay being 30% less than men’s. To some extent this is likely to reflect many factors, including women’s recent entry to the profession, different career choices, career breaks and periods of part-time work, and the unequal impact of caring responsibilities and unpaid work.

Gender pay gap

But part of the gender pay gap remains 'unexplained' and the onus is on employers to consider how much of this comes down to ongoing bias/discrimination and how this can be addressed. Some solutions include enforcing paternity leave and subsidising childcare.

There can be no doubt that women still face barriers to career progression. Data from a BMA Cohort Study this year indicated that 28% of women respondents had taken a career break compared to 10% of men. It also showed that number of children is a strong predictor of female junior doctors’ career behaviour in terms of working overseas, taking a career break and speciality move, while number of children has no impact on male doctors’ career behaviour.

So what’s the answer? There's no easy fix, but what is clear is that everyone benefits from equal relationships between men and women. Children whose parents share responsibility for looking after them are happier, healthier and more successful. Couples who share responsibilities have stronger marriages. Diverse teams in the workplace produce better results.

This isn’t easy stuff, but if we all support women as leaders and men as caregivers, we’ll get closer to a world where our children are comfortable doing anythin­g - from cooking dinner to performing surgery. It seems ambitious, but I really do believe it’s possible. As a first step, it would be great to see some men attending the next Women in Medicine conference.

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