It makes me sad because this doesn't really surprise me at all. It angers me, but it doesn't surprise me.

Thanks for the post. I'm going to read the rebuttal now.

I don't understand--is there any evidence that female physicians are worse doctors? Or is his complaint really that he won't be able to tell off-color jokes any more if he has a significant number of female colleagues?

I find these arguments interesting. For years mothers have told their daughters that they have to be twice as good as men to succeed in their world. And hey - it looks like women in the US and UK are doing that, so of course suddenly, society has to move the goalposts to make it even easier for men.

Was Brian McKinstry clutching his pearls and gnashing his teeth when men outranked women? I think not. What a tool.

Isn't there a shortage of primary care docs in the UK, as well as one in the States?

To my knowledge, primary care isn't the treatment of diseases but the practice of teaching patients how to maintain or improve their health, like preventive maintenance. So with this goal in mind, it's only obvious that a primary care physician would spend more time talking to their patient than, say, excising tumors.

I'd love to assume that Dr. McKinstry knows what primary care entails, since he's a doctor and all, but the fact that he's criticizing these doctors for doing their job well can only lead me to the conclusion that he's mad that they're not men.

Tch. If guys want to do be more competitive on the med school interviews, then they'll just have to up their game. Babies.

Yadayada, another man afraid of women being in charge. What will happen to the future of the field! If ladies start having jobs with big important responsibilities, does that mean I have to listen to them? Will books and TV shows and movies start to have them as main characters? Nooooo!

But as for Vanessa's last paragraph, maybe I read too much into her comment but I don't think the "hussies" swipe was necessary -- the insinuation wasn't that there's any hanky panky going on in the interviews, but that students are being admitted based on skills that girls excel at at that age (ie: conversational). Again, boo hoo.

And while I'm at it, I have to ask -- why is it that, regardless of the field, whenever women excel they aren't praised for raising the bar or invigorating an industry but are blamed for invoking its immanent doom?? I think that's even more fucked up than the who-makes-a-better-doctor debate.

Interesting that he's bemoaning that women go into primary care, when that is where we have a big shortage here in the U.S.

Also note: while he says that doctors should have the ability to "live with risk," it really is the patient, not the doctor, who will have to like with whatever risks the doctor takes (in the test not done, the question not asked).

There was a similar article in Macleans magazine about how women are contributing to the doctor shortage in Canada: Adding Fuel to the Doctor Crisis. I couldn't believe how the tone seemed to be blaming female GPs, not only for taking time off to have children, but for working shorter hours to care for their families, and even for "ghettoizing" medicine by choosing to go into General Practice (or Pediatrics, Dermatology or Geriatrics) instead of "important" fields like Surgery and failing to provide role-models in those fields to following generations of female doctors. They even got knocked because they weren't getting enough Administrative positions because it's difficult to be promoted when you've taken time off for maternity leave or are working part time. Needless to say the article makes me want to tear my hair out.

Darnit, broken link, try here: Adding Fuel to the Doctor Crisis

Darnit! For some reason it's adding "feministing.com/archives/" to the front of my url. *sigh* Take that part out and it will work fine.

For me, McKinstry's argument had one high point: "The main thing we need is a revolution in the attitude of society towards childcare and who has the responsibility for childcare."

Too bad it got lost in all the rest of that crap.

There are SOOO many logical flaws in this argument, I don't even know where to start...he admits that it wasn't until recently that women rivaled the number of men in med schools, but then uses the fact that most doctors over the age of 45 are men to show women take too much time off or don't work as long. Maybe, it could be that there were so few women med school graduates several decades ago that OF COURSE there will be an imbalance in the number of older doctors. He also talks about how younger male doctors say they want to work less and spend more time with family, but assumes it won't happen because it hasn't in the past, without letting time show what will happen. He talks about the importance of competent doctors going into "hard core medical fields" yet he went into primary care. Why is he downplaying the critical importance of his own field of medicine?

It really sounds like someone is trying to "rationalize" his own sour grapes!!

While the stupidity in this article is blatantly obvious, what is not obvious is where Dr. Field said that 18 year old girls were hussies. Maybe he was merely stating the obvious - girls at that age tend to be more articulate than boys, and so of course will interview better than them. Perhaps you're reading too much in to that statement?

He was talking about how " society " insists on women bringing up children so they have to take time off... And it didn't occur to the interviewer to comment on the fact that it would be perfectly reasonable for men to bring up children...
Just straightforward sexism I thought.

I am SO-O-O tired of these gender stereotypes! Bedside manner means bad doctor? Wow! And, yes, most 18-year-old women have better communication skills than 18-year-old guys, and no, that doesn't mean that girls are smarter. It might mean that we are socializing kids differently, which isn't good, and there might be a little of that left-right brain difference going on, too.

If women are not treating as many patients as men (which seems to be the gist of the only legitimate argument in here - between maternity leave, fewer hours, and more time per patient, female physicians are not treating as many patients as their male counterparts), there is a very, very, very simple solution: train more doctors.

There have been some questions in the legal field about training women to be lawyers when they will not end up practising law. The complaint seems to go: why not give that spot at Harvard Law to someone who will actually take the education and use it in the legal profession? Legitimate. With limited resources and limited educational resources, esp. in Britain where, IIRC, the state subsidises educational expenses for physicians, we ought to be sure that those resources are going to people who are going to use them for their intended purpose.

Medical school admission is not a birthright - for men or women. Part of it is a contract to be a doctor and to provide patients with high-quality care. Should we radically increase our educational expenses simply because more than half of the incoming doctors do not want to use their education in full-time employment?

"If women are not treating as many patients as men (which seems to be the gist of the only legitimate argument in here - between maternity leave, fewer hours, and more time per patient, female physicians are not treating as many patients as their male counterparts), there is a very, very, very simple solution: train more doctors."

That was actually mentioned in the BBC article:

"...

"Dr Steve Field, chair of the Royal College of GPs, said he welcomed more women in the profession.

"But he added that there were concerns over the fact that girls tended to do better in the interview process for medical school at age 18.

"'I'm concerned about how we select into medical school as it seems to be more difficult for boys post A-level.

"'I'm all for graduate entry, people who have already done a degree, as they come from more diverse backgrounds, they are more mature, and you also get more men.'"

Remember, in some nations such as the UK right now, medical school is an undergraduate program. Would-be doctors there enroll in med school right after finishing secondary school. Dr Field seems to be for also allowing some students to enroll in med school after they earn bachelors degrees (as most med students do in the US).

And once again, we see another verse of the same old song:

If men are overrepresented in some way, that's "natural". If women achieve even parity, it's a "crisis", a "war against boys", or whatever. Not that I'm advocating it, but isn't it interesting that precisely no one ever even suggests the "nature" explanation in the latter case?

There are so many absurd assumptions in your last paragraph, oenephile:

Medical school admission is not a birthright - for men or women.

No one said it was. That's why they have to go through an interview to see if they are a decent candidate. You seem to be arguing that women don't pass that interview on their own merits but are handed it without any effort. That's even worse than this guy who's complaining that there are too many female doctors.

I would add that it isn't men's birthright to have far less of the burden of caring for children fall on them, but they sure do act like it, which is likely a large part of the reason that female doctors cannot work as much as male doctors can. Male doctors can have children and a career because their wives usually look after the children, but apparently female doctors aren't allowed to have children because they don't have wives to look after them.

Part of it is a contract to be a doctor and to provide patients with high-quality care.

Which is what these women do. It is not an "either/or" equation.

Should we radically increase our educational expenses simply because more than half of the incoming doctors do not want to use their education in full-time employment?

First, I don't know how that would INCREASE educational expenses if it already is as you claim it is.

Second, as someone else mentioned above, it isn't just the female doctors who want to work a little less in order to spend time with their children; male doctors do too.

Third, who says female doctors don't "want" to use their education to be employed full-time? Have you looked at any studies on the division of household labor in the UK based on sex lately? It is still abhorrently tilted onto the woman in the relationship. Again, if men shared the burden of caring for children (both if they wanted to and were able to), female doctors might be able to work full-time and still have children if they wanted to.

Don't blame women for the decisions they have to make in situations that they have little control over. Especially on a feminist site.

I'm in an MD/MPH program. The article by McKinstry is a summary of every irritated digression ever uttered by one of my male professors. I can't even express my exasperation at this point. I'm going to go back to my reading on parasitic infections--I think I'll feel more appreciated and useful that way.

"If men are overrepresented in some way, that's "natural". If women achieve even parity, it's a "crisis", a "war against boys", or whatever."

If boys are failing academically, is that not a problem? I agree with you that gender parity within careers isn't important, but the training of our youth is very different. If an entire generation of young men is struggling in school, doesn't that show a problem with our system of education? I know that if girls were in anyway disadvantage, opinions would be significantly different.

WaxGhost:

You are seriously delusional. Or paranoid. Haven't decided which.

You seem to be arguing that women don't pass that interview on their own merits but are handed it without any effort.
ROFLMAO. No, I did not argue that, think that, or otherwise imply that. Welcome to reality.

but apparently female doctors aren't allowed to have children because they don't have wives to look after them.
Who said that female doctors weren't allowed to have children? Not me!

As for your third section - babe, reread what I wrote, take a Prozac, and calm down. I never suggested anything like what you think I did.

Apparently, "feminism" means "mind-reading"; more specifically, it means "reading the minds of people who say things that do not fall in line with the orthodoxy." It is just as restrictive, stupid, and absurd as sexism - which it, just wrapped up in a different bow.

Look, if female doctors don't get the same amount of work done that male doctors do, there is a problem. The problem lies with many things (biology, society) and has many possible solutions (hiring more doctors, training more doctors, getting men to do more household work), which comes with its own set of problems (practical ability to re-tool society, cost). If you don't like that, I suggest you see a shrink, because reality might be a little too tough for you.

Or rather saying that I'm crazy, you could actually attempt to argue the points. But that would require maturity and logic.

To begin with full disclosure... I am a male med student.

95% of what this guy is writing is on its face complete misogynist asshattery. Oh, so primary care might be more feminine... as if that wouldn't be an improvement. Boo hoo. I don't need to say much more that hasn't already been said above.

There is only one comment that gives me pause: that now, more and more doctors are going part-time.

As anyone can tell you, primary care doctors are becoming increasingly scarce in this country. The ones that exist are increasingly backlogged, which is why it can take months before you can get an appointment.

Doctors deciding to work parttime is a huge problem. A medical degree awarded to someone who wants to work 20 hours a week is detrimental to society when that same degree could have gone to someone willing to work 80 hours a week.

There is a woman in my class who says she wants to quit medicine completely -- as in, not even work parttime, but 100% quit -- once she has children. This despite the fact that her loser husband makes at most 1/3 a doctor's salary. Is it not a serious problem that people like her take med school slots that could have gone to people who would actually practicie medicine instead of being housewives?

Medicine is serious business. Women who go into the field need to be reminded that it is ok for them to actually *gasp* value their careers instead of being forced into the traditional mommy-first,career-second molds. Otherwise, not only are they shortchanged... but so are all of their patients.

Wait a minute.

First, someone needs to demonstrate to me that having overworked primary care physicians working 80 hours a week provides superior patient care to say 2 physicians working 40 hours a week; or 3 physicians working part time.

Secondly, with today's technology, there are ample opportunities to actually expand patient care e.g. consultations via telephone or email from a home office, even after hours. This would improve patient care and allow physicians greater flexibility for home life.

Thirdly, off-hours health care is clearly a huge unmet need. I'm sure that there are many physicians who would be willing to work off-hours for the opportunity to be home during the week to take their kids to school, etc.

The current system is self-serving and inefficient. Many aspects of the "crisis" are industry produced.

"Doctors deciding to work parttime is a huge problem. A medical degree awarded to someone who wants to work 20 hours a week is detrimental to society when that same degree could have gone to someone willing to work 80 hours a week."

That's a good point.

"First, someone needs to demonstrate to me that having overworked primary care physicians working 80 hours a week provides superior patient care to say 2 physicians working 40 hours a week; or 3 physicians working part time."

That's another good point.

"There is a woman in my class who says she wants to quit medicine completely -- as in, not even work parttime, but 100% quit -- once she has children."

That reminds me of the "brain drain" situation some medical schools abroad face. In their case it's more about graduates wanting to not work in the country by emigrating and being full-time doctors elsewhere, but either way that's still fewer doctors available locally.

Spike the cat, I'd add to your April 5, 2008 06:25 AM post

Fourthly, it's not only a matter of new doctors choosing to work part-time. It boils down to yet another a labor shortage. Yet again an employer needs to ponder "what can we do to attract more qualified workers [in this case, doctors] away from their other options [in this case, those include staying at home and working in another country]?"

I'm an American living in the UK, and Dr. Steve Field's comment ("I'm concerned about how we select into medical school as it seems to be more difficult for boys post A-level [than girls]") reminded me of something that my partner's daughter just learned in her A-level Sociology class -- which includes a whole unit on feminism, and is blessed with a terrific teacher. She learned that
the secondary school exams used for university placement back in her grandmother's day were graded differently for girls than for boys. Girls were considered to "mature" earlier than boys, and therefore their grades were bumped down a notch to discount this "advantage" over the boys. Which of course insured that boys, not girls, won most of the coveted slots in top schools...including, I presume, the medical slots.

"Third, who says female doctors don't "want" to use their education to be employed full-time? Have you looked at any studies on the division of household labor in the UK based on sex lately?"

Firstly, these women aren't normal people. They certainly have access to enough money that they could oursource housework and childcare while working fulltime as doctors - they're not forced into it because their husbands are unwilling to tidy up.

Secondly, it is actually pretty obvious that these women don't "want" to work full time if you look at the big picture. They don't just work part time because their forced to by childcare responsibilities - which is what most feminist analysis seems to ignore. They work part time even after their children are independent, continue to work full time when their children have grown. And then they retire earlier than men too. It is a lifestyle choice, rather than forced on them.

On the one hand I can see the attractions. If you can live confortably on a part-time doctors salary, why work full time if you don't have to and could be enjoying your life? On the other hand it is really expensive to train doctors, and why should we only get 1/2 a doctor for the training costs?

One time I saw somebody throw out in an argument that some doctors were worried about the feminization of medicine because they thought it would drive down the prestige and salary of doctors, which this person said had happened with nurses and teachers. Does anyone have information on any of those things? It would be interesting to fact check that. I of course wouldn't say we should keep women out of medicine for that reason; I would say that's gotta be due to sexism, and the sexism is what needs to change.

On the other hand it is really expensive to train doctors, and why should we only get 1/2 a doctor for the training costs?

Uh, because the doctor in question is generally the one paying off his/her medical school loan debts?

There is one (extremely rural) town near where I grew up that has a hard time attracting doctors, so they offer a full scholarship for anyone willing to sign a contract saying they'll live for 10 years in that town as its doctor. That is not the norm, however. Most doctors don't go that route. Although I'm sure there are grants and such, they quite honestly don't owe you anything for the cost of their training.

"'On the other hand it is really expensive to train doctors, and why should we only get 1/2 a doctor for the training costs?'

"Uh, because the doctor in question is generally the one paying off his/her medical school loan debts?"

Does that apply in the Uk too?

Uh, because the doctor in question is generally the one paying off his/her medical school loan debts?

That isn't the way it works in the UK. The taxpayer pays £250,000 to put someone through medical training. And then the taxpayer pays even more to train them as they progress through the ranks in the NHS to consultant or GP.

I do think with more women doctors the way forward will be to change the funding scheme, and move towards the debt based model.

Really? I live in the UK. I am originally from the US, though, so there are of course still things I'm not completely familiar with. I figured there were taxpayer expenses once they graduate and are completing their residency, but while they're still in university? Even for students who aren't from low income families?

Just checking at a few medical school websites, it seems that annual tuition fees run around £3,500. Bursaries are available for students from lower income houses. Where does the £250,000 from taxpayers figure in?

"Just checking at a few medical school websites, it seems that annual tuition fees run around £3,500. Bursaries are available for students from lower income houses. Where does the £250,000 from taxpayers figure in?"

I got the impression that the £250,000 per student from taxpayers figures in the medical schools having a gap between the £3,500 per student in tuition revenue and the expenses of staying open...

Mina's right. £3.5k/yr is a good chunk of the costs towards a degree in something like English or History. But it's absolutely nothing for medicine. If you just think about the tech that they train doctors on, or clinical lecturers salaries, the costs are huge.

250's the accepted figure. Just google "£250,000 medic training" for references. And that's without taking into account supporting student living costs through subsidised loans, grants and bursaries.

I could definitely see where the schools would need some additional money from taxpayers to stay open, but £250,000 for each student just seems so much. It's nearly half a million dollars. In the US I think the average debt for medical students is around $150,000, and they go to school for a longer amount of time. Things usually cost more over here, but that's just ridiculous.

Yes but in the US universities subsidize the cost of medical education. The $200,000 students are charged is only about half the cost of educating them; it's the reason why Med schools usually have such huge endowments and never increase class size; they need enough money to pay for all their students.

Speaking as someone's whose Mother, Grandmother, father and sisters are all doctors, I can say with some authority that some of his criticisms are valid. My Grandmother practiced as an ob-gyn until her mid-seventies and is as good as any male doctor. My mother however did let her career take a back seat and even she would admit to being not close to the physician my Dad is. Perhaps the answer is to mimic the American system and make students do a degree first, that way only the people really intent on practicing medicine will bo ther going to med school.

There's a lot of double standards going on here.

I've got no problem with meritocracy based admissions to medical school. If women are more successful than men in the process, then good for them.

Bu