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Sixty per cent of doctors graduating in 2006 were women, but medical academia remains the preserve of men, reveals research published this week.
Only two out of 33 heads of medical schools are women and only 11% of professors are women, points out the research project, Women in Academic Medicine.
Few female doctors are attracted into or retained by academia, it says, and with a major competitor like the NHS, this is unlikely to change unless action is taken.
The research backs up calls by England's chief medical officer, Liam Donaldson, in his 2006 annual report for removal of opportunity blocks for women pursuing any medical career (doi: 10.1136/bmj.39280.523657.4E).
In it he says inflexible working hours, poor childcare provision, and an absence of tax incentives are all obstacles to women generally, but these are “exacerbated by the work patterns in modern medicine.” He added: “The hurdles in academic medicine appear particularly unfriendly to women.”
Women in Academic Medicine surveyed 1162 doctors online in 2006. Of these 38% were working in higher education, 53% in the NHS, and 7% in other sectors or on a career break. Seventy three per cent were female. All respondents were self selecting.
The project, partially funded by the BMA's Health Policy and Economic Research Unit, found that both women and men were facing many of the same barriers but not to the same extent—women reported greater obstacles to career progression than men.
Flexible working ranked as the top factor for the 53% of women and 42% of men who saw working conditions as influencial in their career choice across both NHS and higher education staff. Yet a quarter of respondents did not know whether their contracts allowed them to work flexibly.
Women in medical schools felt they had less active encouragement from senior colleagues to apply for posts that would take them up the career ladder: 38% of women in higher education said they had been encouraged to apply higher by their bosses, compared with 43% of men. In the NHS, 37% of women reported being encouraged and 33% of men.
Female respondents had less knowledge of the processes for promotion in both sectors (61% of women in higher education said they knew how to get promoted compared with 77% of men; in the NHS 65% of women and 69% of men knew).
Four times as many women as men saw the lack of role models as a factor influencing career progression (16% of female respondents from medical schools and 4% of male respondents; 13% of NHS women and 3% of men).
Only 6% of women working in medical schools had edited a medical journal, whereas more than double the number of men had (14%). In the NHS three times as many men as women had achieved this (2% women and 6% men).
The project recommends knowledge on promotions should be made explicit and transparent to all staff, with active identification of posts for women. Appointments commitees should include a greater diversity of people from minority groups to help to reduce bias.
Mentoring of women should be more widely available, and female role models and networking should be encouraged—for example, by encouraging more women to attend conferences. Greater provision for taking families to these events would help, allowing women with childcare commitments to network after hours. A long hours culture should be actively discouraged, the report recommends.
Job share posts should be established for both research and senior positions, and quality child and adult care facilities should be made available on or near university sites.
At its launch conference, delegates criticised the project for its lack of explicitness in identifying factors that prevent women from progressing—family commitments needed to be mentioned, not hidden away, they said.
Subgroup analysis for the final report would bring these factors out, said Anita Holdcroft, project leader and a consultant anaesthestist at Chelsea and Westiminster Hospital.
Others said that what was needed was a cultural change. Ruth Gilbert, a director at the Institute for Child Health, University College London, said men were reluctant to take up the option of flexible working even if it was there, which stopped it from becoming more widespread.
Good practice examples and further recommendations from the conference will be added to the full report, which is to be published this autumn.
Women in Academic Medicine: Developing equality in governance and management for career progressionwww.bma.org.uk/ap.nsf/Content/WAM2007