June 12 2008 - A debate in the British Medical Journal earlier this year questioned
whether the UK is producing too many female medical graduates.
Brian McKinstry, senior research fellow at the University of Edinburgh commented:
"Increasing numbers of female graduates will create a major shortfall in primary care provision
and may also affect education, research, and development. Evidence is growing to demonstrate the negative
consequences of the feminism of primary care in the UK and elsewhere. For example, fewer women than men choose
to work out of hours, and the increase in women doctors may have partly influenced the recent abandonment of out
of hours work by general practitioners in the UK."
Brian McKinstry argues that the full impact of this trend lies in the future. For example, the
majority of general practitioners over 45 years, mostly working full time, are male whereas those under 45 are
mostly female and working part time. Unless employment patterns change, there will be a major shortfall in primary
care provision as older doctors retire.
He cites an American study of women in internal medicine that found those
who were mothers had fewer publications than male doctors with children, while Scottish data indicates that women
contribute about 60 per cent of the activity of men in general practice development. He concludes that unless there
is a profound change in societal views on responsibility for child care "a balanced approach to recruitment in the
interests of equity and the future delivery of services is vital".
Jane Dacre from University College London counters that rather than expressing concern about having
too many women in medicine the focus should be on ensuring equality of opportunity. Acknowledging that women
outnumber men in most medical schools by about 3:2, she highlights their under-representation in some areas
"especially clinical academia and in specialties requiring more acute and on call responsibilities and more
She argues that medicine seeks to attract the best applicants regardless of gender. However, to
encourage more women into senior positions institutional barriers need to be addressed such as lack of flexibility,
opportunities for career breaks and part-time working, child care and accessible training options.
Jane Dacre added:
"The feminisation of medicine should be welcomed as an opportunity to be creative with workforce
planning and to recognise that a more flexible way of working is essential to delivering good quality patient
care at all times of the day and night."
In an accompanying editorial, Jenny Firth-Cozens from The London Deanery, acknowledged the need to take the proportional rise in female doctors into account. However, she warns that any comparison of the cost of employing male or female doctors must include estimates for poor performance, litigation, re-education, and rehabilitation that are consistently higher for men.