Gender, Careers and Inequalities in Medicine and Medical Education: International Perspectives: Volume 2

In this introductory chapter, I discuss the rationale for this edited collection and the contribution it can make to advancing knowledge of gender inequalities and promoting social justice in the medical profession and medical education. I provide a short overview of and critique of popular debates in the medical community in the United Kingdom and I also discuss briefly research about women’s careers in the United Kingdom and globally. The introductory chapter provides a description of each chapter and its contribution to scholarship about gender, careers and inequalities in Medicine/Medical Education.

This chapter explores the inequalities and restrictions faced by women as they entered the medical profession in the United Kingdom. A case study in the first hospital in the United Kingdom to be founded and run by women, the Edinburgh Hospital for Women and Children, it demonstrates the importance of history for understanding women doctor’s early career choices and opportunities. The chapter begins with an outline of nineteenth-century notions of feminine propriety. It considers how middle-class women sought to subvert these restrictions and gain an active role in public life, and explores how this impacted upon arguments in favour of medical women. It reveals the significance of the changing nature of medical knowledge in this period, and considers how this contributed to the emergence of two distinct specialisms, both of which became the preserve of women doctors: maternal welfare schemes in the 1900s, and the treatment of VD in the inter-war period. The chapter concludes with its contribution to this edited collection.

This chapter investigates the role of gender, mentoring and social capital and contributes to literature about the career development of women in senior management roles in the National Health Service of the UK. It draws on a doctoral study of senior-level managers in a Scottish NHS Board. The data collected are: (i) documentary; (ii) quantitative; and (iii) qualitative. The quantitative data are collected through questionnaires, while the source of qualitative data is in-depth semi-structured interviews. The doctoral study is embedded within an interpretivist and feminist paradigm. Although access to mentoring and social capital was seen as likely to enhance the career progression of females to senior managerial roles, gendered work and family expectations, gendered organisational culture, and normative performances of gendered senior management were identified as obstacles in taking advantages of mentoring and social capital. To the best of our knowledge, this is the only piece of work that explicitly investigates the role of mentoring and social capital in managing gender diversity at the senior managerial positions of the NHS.

Women remain under-represented in leadership positions in both clinical medicine and medical education, despite a rapid increase in the proportion of women in the medical profession. This chapter explores potential reasons for this under-representation and how it can be ameliorated, drawing on a range of international literatures, theories and practices. We consider both the ‘demand’ for and ‘supply’ of women as leaders, by examining: how evolving theories of leadership help to explain women’s’ leadership roles and opportunities, how employment patterns theory and gender schemas help to explain women’s career choices, how women aspiring to leadership can be affected by the ‘glass ceiling’ and the ‘glass cliff’ and the importance of professional development and mentoring initiatives. We conclude that high-level national strategies will need to be reinforced by real shifts in culture and structures before women and men are equally valued for their leadership and followership contributions in medicine and medical education.

The predicted doctors’ shortage in Austria and the increasing feminisation of the medical profession are aspects of a passionate debate on gender inequality in medical careers and particularly on sufficient medical care in Austria. Therefore, this review summarises main findings on gender inequality in medical careers in Austria using an intersectional lens.

The intersections derived from literature elucidate that gender inequality is not predominantly dependent on having a family including children, but that various combinations of these intersections influence women’s careers.

There is a need to further investigate intersections influencing medical careers in women and to relate these to affirmative action measures. Affirmative action measures need quotas and consideration of various areas besides work–family balance. There is a need to evaluate and adapt interventions to promote women in medicine according to the intersections derived from the literature.

The purpose of this study was to explore the cultural and structural conditions that influence male and female physicians’ career choices and career expectations. Although women constitute 59 percent of the physicians and 55 percent of the specialists in Finland in 2014, the rate of women in oto-rhino-laryngology (38 percent) was one of the lowest among the specialties. The data consist of semi-structured interviews with young physicians (N = 19), who have entered a career in oto-rhino-laryngology (ORL) in Finland.

The results point to three features which characterize the career pattern in the specialty. First, the specialty is not one that draws students to medicine per se but rather one that is chosen during medical training. The decision to specialize in ORL was by many respondents framed as a “coincidence,” while others were attracted by the diverse character of the specialty. Second, the skills needed for being a “good” practitioner were defined as handiness, courage, and social skills, but these were not defined in a gendered way. Third, the career prospects for women within the specialty were defined by a neutralizing or a gendering framework. The neutralizing framework was represented by the pipeline argument which suggests that there is a temporary time lag in women’s representation in higher positions and that women are advancing steadily in the academic and administrative pipeline. The gendering framework pointed to the male ethos of the surgical tasks in the specialty as a barrier for women’s advancement in those areas. This chapter concludes that the pipeline view belittles existing gender inequalities in men’s and women’s medical careers and views gender differences as temporary maladjustments rather than inherent features of gendered organizations.

Feminization of medicine in France has come about in several stages, in connection with student and medical specialists recruitment. Its dynamics show that it can’t be considered as a virtually definitive gender reversal, but should rather be viewed as a dynamic recomposition closely related to societal changes and economic situations. I explain the way women succeeded in entering medicine via the concours, and how their situation has often given rise to wrongful interpretations concerning their ‘choices’. Finally, I reflect on the complex connections between feminization and the democratization of medical recruitment, on the one hand, and with the transformations within the liberal model in medicine, on the other. I conclude that the feminization of medicine questions a wide array of social relations in the domains of family, health, economics and politics, as a complex social fact.

This chapter focuses on the orientation towards the medical profession shown by 18-year-old Sardinian students who were asked to write in an essay how they imagined their future. Interest in the medical profession opens up interesting views on what this path may represent for young people given the current general climate of work uncertainty. This chapter focuses on students’ career narratives and, in particular, on their perceived difficulties in accessing medical studies and on the reasons this profession appears so attractive to them. Medicine is, in fact, constructed as a solid, gendered professional path, with a clear vocation career-wise, and it is kept safe from the increasing uncertainty of the labour market. Further, a career in medicine is easy to imagine because there are several medical TV series. Third, the concept of medicine is embedded with positive values and care-centred attitudes, and it therefore ‘sounds good’. The specific ways in which these orientations are gendered are discussed.