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The consequences the of rise in female doctors
I've been having an interesting debate with my step dad today and decided to put it to TSR to get your opinions.
I accept I'm likely to be flamed for this, as it is controversial, as are all gender debates. However, I think it's an interesting enough topic to put up with it for. This has nothing to do with the competence of the doctor, simply the implications for the NHS and ultimately patient care. I will be using generalisations because it's impossible to discuss without using them.
Note, primarily my statistics are coming from the BBC (I avoid the dailymail at all costs) and the repercussions are derived from talking to doctors and from first hand experience at hospitals in SE Wales and from my parents experiences in these hospitals (Both Pharma reps)
Men can also work part time, however, it is *generally* women who do the majority of part time work. When women and men both follow full time positions they are shown to progress at their careers at similar rates. The only difficulties arise when families (generally) come in to play and part time work becomes a consideration.
Anyway, after 2017 the majority of doctors will be female. You can already see this is going to happen considering that female medical students outnumber male students at almost 3:2. Currently, women make up almost 40% of all doctors, 42% of GPs and 28% of all consultants.
However, in the future if more doctors are female the NHS will need to employ more doctors. Women are far more likely to work part time and take maternity leave, often on SPR rotations. This causes difficulty with maternity cover (Logistically, it's difficult to cover an SPR rotation half way through without being forced to use expensive locums) as well as needing to spend more money on more doctors as logically you require more part timers to fill full time hours. The Royal College of Physicians has warned an increase in female doctors may come at the detriment of patient care.
For example, there are two consultants working in SE Wales hospitals that I am going to draw upon. I am not using this as a general rule of thumb, but simply highlighting cases. One has been doing her SPR rotation for 10 years, and another will be taking 8. If this is allowed within the NHS it is 1. Taking up SPR training slots within hospitals and 2. Costing the NHS money to cover the long term part time.
It can also create resentment between colleagues. Some will feel that they are being overstretched and their good will pushed due to increasing organisational complexity because of those that want to work full time.
There's also the issue of retirement. Particually in general practise. A lot of older, full time male GPS are soon to retire (The elder generation of doctors is primarily male) leaving behind a work force of part timers. Figures show that women GPs contribute about 60% of the activity of their male counterparts in training, teaching, research and committee work in Scotland. This is a concern indeed. This trend is represented across "family friendly" specilities such as obs&gyn as well.
There is also the issue of part time work within certain specialities. Managing certain cases is both highly unpredictable and technical. With children and childcare commitments it can be difficult to stay after hours to oversee special cases without putting strain on others. This is especially noticeable in surgery and goes in some way to explain why there are fewer women going into surgery.
There is also the concern with those returning to work. I'll use another, generic example to show my point. A female doctor, in her second year of SPR rotation can take one year’s maternity leave. She can then return to work a year later and be out on the wards, within her first week with no recap training with all the responsibilities’ of a second year SPR.
It's been proven that the longer you don't think about things the more of it you forget. Some studies show that if you do not think about things for two weeks your knowledge can become cloudy, never mind a year. Should doctors returning from long absences, such as maternity leave be forced to have recap training? Should they have temporary reduced responsibilities? Would this be costly to the NHS? In some professions this is mandatory. You have to have training before returning to work after maternity leave.
However, it is not all bad news. Female doctors offer more choice to patients, especially important with ethnic minorities and religions who may impose a certain gendered doctor examine them for certain reasons. It is also good to see that the barriers preventing women from entering the medical profession are being broken down. You cannot discriminate against applications for anything based on gender, be it medical school, foundation placements or rotations. Who knows how anyone will react in the following years/during that placement.
What are your thought on this? Should patients/the NHS be worried? Will the large influx of part time doctors damage patient care? Should women be advised to specialise in disciplines with more predictable work patterns and more opportunities to take part time work such as general practise?
Opinions? I'm hoping my points can be discussed without this falling into pit of flaming angry feminists, however, I understand if my points come across as sexist and I will try to clarify them if they do. Men can go part time as well, however women are far more likely and a rise in part time work can easily be predicted given the massive influx of female doctors.
NOTE: I apologise for my ill thought out/mixed up post/poorly structured post, it's almost 12.30am however I thought I'd best post now and get most of my thoughts down before I forget.
EDIT: Christ, that's a lot of text. I've tried to space it as best I can. I doubt I'll get many responses now, bar tl;dr, didn't realise I'd wrote so much. Ah well.
I accept I'm likely to be flamed for this, as it is controversial, as are all gender debates. However, I think it's an interesting enough topic to put up with it for. This has nothing to do with the competence of the doctor, simply the implications for the NHS and ultimately patient care. I will be using generalisations because it's impossible to discuss without using them.
Note, primarily my statistics are coming from the BBC (I avoid the dailymail at all costs) and the repercussions are derived from talking to doctors and from first hand experience at hospitals in SE Wales and from my parents experiences in these hospitals (Both Pharma reps)
Men can also work part time, however, it is *generally* women who do the majority of part time work. When women and men both follow full time positions they are shown to progress at their careers at similar rates. The only difficulties arise when families (generally) come in to play and part time work becomes a consideration.
Anyway, after 2017 the majority of doctors will be female. You can already see this is going to happen considering that female medical students outnumber male students at almost 3:2. Currently, women make up almost 40% of all doctors, 42% of GPs and 28% of all consultants.
However, in the future if more doctors are female the NHS will need to employ more doctors. Women are far more likely to work part time and take maternity leave, often on SPR rotations. This causes difficulty with maternity cover (Logistically, it's difficult to cover an SPR rotation half way through without being forced to use expensive locums) as well as needing to spend more money on more doctors as logically you require more part timers to fill full time hours. The Royal College of Physicians has warned an increase in female doctors may come at the detriment of patient care.
For example, there are two consultants working in SE Wales hospitals that I am going to draw upon. I am not using this as a general rule of thumb, but simply highlighting cases. One has been doing her SPR rotation for 10 years, and another will be taking 8. If this is allowed within the NHS it is 1. Taking up SPR training slots within hospitals and 2. Costing the NHS money to cover the long term part time.
It can also create resentment between colleagues. Some will feel that they are being overstretched and their good will pushed due to increasing organisational complexity because of those that want to work full time.
There's also the issue of retirement. Particually in general practise. A lot of older, full time male GPS are soon to retire (The elder generation of doctors is primarily male) leaving behind a work force of part timers. Figures show that women GPs contribute about 60% of the activity of their male counterparts in training, teaching, research and committee work in Scotland. This is a concern indeed. This trend is represented across "family friendly" specilities such as obs&gyn as well.
There is also the issue of part time work within certain specialities. Managing certain cases is both highly unpredictable and technical. With children and childcare commitments it can be difficult to stay after hours to oversee special cases without putting strain on others. This is especially noticeable in surgery and goes in some way to explain why there are fewer women going into surgery.
There is also the concern with those returning to work. I'll use another, generic example to show my point. A female doctor, in her second year of SPR rotation can take one year’s maternity leave. She can then return to work a year later and be out on the wards, within her first week with no recap training with all the responsibilities’ of a second year SPR.
It's been proven that the longer you don't think about things the more of it you forget. Some studies show that if you do not think about things for two weeks your knowledge can become cloudy, never mind a year. Should doctors returning from long absences, such as maternity leave be forced to have recap training? Should they have temporary reduced responsibilities? Would this be costly to the NHS? In some professions this is mandatory. You have to have training before returning to work after maternity leave.
However, it is not all bad news. Female doctors offer more choice to patients, especially important with ethnic minorities and religions who may impose a certain gendered doctor examine them for certain reasons. It is also good to see that the barriers preventing women from entering the medical profession are being broken down. You cannot discriminate against applications for anything based on gender, be it medical school, foundation placements or rotations. Who knows how anyone will react in the following years/during that placement.
What are your thought on this? Should patients/the NHS be worried? Will the large influx of part time doctors damage patient care? Should women be advised to specialise in disciplines with more predictable work patterns and more opportunities to take part time work such as general practise?
Opinions? I'm hoping my points can be discussed without this falling into pit of flaming angry feminists, however, I understand if my points come across as sexist and I will try to clarify them if they do. Men can go part time as well, however women are far more likely and a rise in part time work can easily be predicted given the massive influx of female doctors.
NOTE: I apologise for my ill thought out/mixed up post/poorly structured post, it's almost 12.30am however I thought I'd best post now and get most of my thoughts down before I forget.
EDIT: Christ, that's a lot of text. I've tried to space it as best I can. I doubt I'll get many responses now, bar tl;dr, didn't realise I'd wrote so much. Ah well.
Scroll to see replies
I read it. Intresting point never really thought of it that way. Hmm, i see a similar thing at college in the media depeartment that is mostly female staff, and 3 are pregant at the same time so that will cause the same problem. I suppose they might make it so you have to check with your boss before having a kid? Stupid i know but its all i can think off.
I did read all your post despite its admirable length. My answer is quite simple: it could cause problems, but we won't know what problems and how big they'll be until they happen so there's no point worrying. Sorry for the short reply 
Are these not the same issues faced by all employers? Admittedly, all this is paid for by the taxpayer, and it is the country that feels the effects, but the same could be said for teaching, at least.
I think it's already the case, but requiring all doctors to go on refresher courses every now and again would be good. It ought to be compulsory for all doctors, even if they don't take breaks, due to new drugs coming out or being allowed by NICE, or even changes in procedures.
I think it's already the case, but requiring all doctors to go on refresher courses every now and again would be good. It ought to be compulsory for all doctors, even if they don't take breaks, due to new drugs coming out or being allowed by NICE, or even changes in procedures.
Hopple
Are these not the same issues faced by all employers? Admittedly, all this is paid for by the taxpayer, and it is the country that feels the effects, but the same could be said for teaching, at least.
I think it's already the case, but requiring all doctors to go on refresher courses every now and again would be good. It ought to be compulsory for all doctors, even if they don't take breaks, due to new drugs coming out or being allowed by NICE, or even changes in procedures.
I think it's already the case, but requiring all doctors to go on refresher courses every now and again would be good. It ought to be compulsory for all doctors, even if they don't take breaks, due to new drugs coming out or being allowed by NICE, or even changes in procedures.
They are faced by all employers yes. However, with current trents women are going to continue to outnumber men and at this rate, nobody knows when it will stop. I highly doubt you will have a vast majority female work force, but a high majority may not be such a doubtful thing.
As you said, this is all paid for by the taxpayer. The NHS is already budget pushed as it is, without the need to employ more doctors to cover part time work. When teachers are covered it costs a hell of a lot less, there are more qualified teachers and patient care has more obvious effects if diminished.
Generally, doctors while out and working will already be doing these courses, finding out about new drugs, new interactions, new guidelines from NICE as it will be relevent to day to day work. It will not all arrive in one go as it would when starting. It is unlikely to assume people on maternity leave will also be keeping up to date on all current medical events, clinical trials, papers while also caring for a new born.
Rob da Mop
I did read all your post despite its admirable length. My answer is quite simple: it could cause problems, but we won't know what problems and how big they'll be until they happen so there's no point worrying. Sorry for the short reply
There's also the issue of retirement. Particually in general practise. A lot of older, full time male GPS are soon to retire (The elder generation of doctors is primarily male) leaving behind a work force of part timers. Figures show that women GPs contribute about 60% of the activity of their male counterparts in training, teaching, research and committee work in Scotland. This is a concern indeed. This trend is represented across "family friendly" specilities such as obs&gyn as well.
EDIT: Added this point to the original post.
RollerBall
However, with current trents women are going to continue to outnumber men and at this rate, nobody knows when it will stop.
One again, polygamy will be an acceptable lifestyle choice. I'll get a wife in every speciality
Single Malt
One again, polygamy will be an acceptable lifestyle choice. I'll get a wife in every speciality
Lmao, out of context quotes FTW! It could be like trading cards. Gota marry 'em all, femaledoctors!
I read it. I don't really have anything to add, but wanted to say that I read it in spite of the length. 
RollerBall
They are faced by all employeres yes. However, with current trents women are going to continue to outnumber men and at this rate, nobody knows when it will stop. I highly doubt you will have a vast majority female work force, but a high majority may not be such a doubtful thing.
As you said, this is all paid for by the taxpayer. The NHS is already budget pushed as it is, without the need to employ more doctors to cover part time work. When teachers are covered it costs a hell of a lot less, there are more qualified teachers and patient care has more obvious effects if diminished.
Generally, doctors while out and working will already be doing these courses, finding out about new drugs, new interactions, new guidelines from NICE as it will be relevent to day to day work. It will not all arrive in one go as it would when starting. It is unlikely to assume people on maternity leave will also be keeping up to date on all current medical events, clinical trials, papers while also caring for a new born.
As you said, this is all paid for by the taxpayer. The NHS is already budget pushed as it is, without the need to employ more doctors to cover part time work. When teachers are covered it costs a hell of a lot less, there are more qualified teachers and patient care has more obvious effects if diminished.
Generally, doctors while out and working will already be doing these courses, finding out about new drugs, new interactions, new guidelines from NICE as it will be relevent to day to day work. It will not all arrive in one go as it would when starting. It is unlikely to assume people on maternity leave will also be keeping up to date on all current medical events, clinical trials, papers while also caring for a new born.
So what do you suggest? Ideally you'd like all doctors to not take time off work, for the sake of the patients and the country's finances. If we can presume that, in general, a doctor in a marriage/partnership is the higher paid, perhaps it is possible to rig parental leave in such a way that it makes sense for the higher earner, regardless of gender, takes the time off to look after children? The transfer of leave from one parent to another goes some way in that direction, but there is of course still the social expectation for the mother to be the one to take time off, though if she is the higher earner that effect is lessened. Increasing awareness of this potential problem would be a good thing, I feel, in that mothers would recognise the need to prepare before coming back to work, in order to hit the ground running, though I'm sure many do so already.
RollerBall
It's been proven that the longer you don't think about things the more of it you forget. Some studies show that if you do not think about things for two weeks your knowledge can become cloudy, never mind a year. Should doctors returning from long absences, such as maternity leave be forced to have recap training? Should they have temporary reduced responsibilities? Would this be costly to the NHS? In some professions this is mandatory. You have to have training before returning to work after maternity leave.
It's been proven that the longer you don't think about things the more of it you forget. Some studies show that if you do not think about things for two weeks your knowledge can become cloudy, never mind a year. Should doctors returning from long absences, such as maternity leave be forced to have recap training? Should they have temporary reduced responsibilities? Would this be costly to the NHS? In some professions this is mandatory. You have to have training before returning to work after maternity leave.
You have basically done a very good job of tackling the debate yourself - the only thing I wanted to add is in relation to the above :
Doctors would still have to complete their compulsory CPD hours for the year they were off on maternity leave so I dont think it would be too much of a problem - but I get your point.
From the GMC -
" As we have set out in paragraph 10 of Good Medical Practice (September 2001):
'You must keep your knowledge and skills up to date throughout your working life. In particular, you should take part regularly in educational activities which maintain and further develop your competence and performance.'
Doctors are responsible for keeping themselves up to date in all areas of their practice. Revalidation will mean doctors must show us that they are up to date and fit to practise medicine. When revalidation is introduced in 2005 onwards, all doctors will need to demonstrate regularly that they are doing this"
CAPTAIN101
You have basically done a very good job of tackling the debate yourself - the only thing I wanted to add is in relation to the above :
Doctors would still have to complete their compulsory CPD hours for the year they were off on maternity leave so I dont think it would be too much of a problem - but I get your point.
From the GMC -
" As we have set out in paragraph 10 of Good Medical Practice (September 2001):
'You must keep your knowledge and skills up to date throughout your working life. In particular, you should take part regularly in educational activities which maintain and further develop your competence and performance.'
Doctors are responsible for keeping themselves up to date in all areas of their practice. Revalidation will mean doctors must show us that they are up to date and fit to practise medicine. When revalidation is introduced in 2005 onwards, all doctors will need to demonstrate regularly that they are doing this"
Doctors would still have to complete their compulsory CPD hours for the year they were off on maternity leave so I dont think it would be too much of a problem - but I get your point.
From the GMC -
" As we have set out in paragraph 10 of Good Medical Practice (September 2001):
'You must keep your knowledge and skills up to date throughout your working life. In particular, you should take part regularly in educational activities which maintain and further develop your competence and performance.'
Doctors are responsible for keeping themselves up to date in all areas of their practice. Revalidation will mean doctors must show us that they are up to date and fit to practise medicine. When revalidation is introduced in 2005 onwards, all doctors will need to demonstrate regularly that they are doing this"
Revalidation is every 5 years though, perhaps it should be brought forward to the end of large spells of leave (10-12 months) to assess fitness to practise.
CPD hours are a new concept to me which I have little understanding of. Is it basically a portfolio type thing with developments? To track career progress etc?
RollerBall
Revalidation is every 5 years though, perhaps it should be brought forward to the end of large spells of leave (10-12 months) to assess fitness to practise.
CPD hours are a new concept to me which I have little understanding of. Is it basically a portfolio type thing with developments? To track career progress etc?
CPD hours are a new concept to me which I have little understanding of. Is it basically a portfolio type thing with developments? To track career progress etc?
CPD is a way of ensuring continuing levels of professional competence - many other HCPs e.g. Pharmacists already have to do at least 30 hours of extra courses etc every year and can be called at random to a hearing where they will be assessed to ensure they are still capable of practicing - although whether medics CPD is as rigid in its structure im really not sure - maybe a current doctor could help?
Im only going to be starting medicine in september so I have no personal experience of any of this, I am just reading about it on the GMC website!
Well if they're less productive, at least the ST1 and ST3 bottlenecks won't be so tough as more positions will be required :P .
As others have said - this is simply a result of how the workforce is changing. There's those detriments that you've listed, but taking a step back of course women benefit the economy. While they once stayed at home, they now work and contribute productivity to the economy. Yes you might see some benefits if you try to take them out of public sector jobs, but if they didn't work across the board you wouldn't be able to pay for those public sector services anyway. In the end you can just look at how the economy has grown as the workforce has increased and diversified to see that the inclusion of women is a good thing.
As others have said - this is simply a result of how the workforce is changing. There's those detriments that you've listed, but taking a step back of course women benefit the economy. While they once stayed at home, they now work and contribute productivity to the economy. Yes you might see some benefits if you try to take them out of public sector jobs, but if they didn't work across the board you wouldn't be able to pay for those public sector services anyway. In the end you can just look at how the economy has grown as the workforce has increased and diversified to see that the inclusion of women is a good thing.
My understanding is that after time off over 6 months you have to be supervised rather closely for a while on returning to work, in certain specialities at least.
As for the subject of more women... Its all good news if you fancy a career locuming. It looks to me like a good way to make more money whilst taking less crap and as so I'm all for more reproductively minded women in medicine.
A more sinister worry though is the historical trend between more male professions going more female, and then loosing their status, and with it pay.
As for the subject of more women... Its all good news if you fancy a career locuming. It looks to me like a good way to make more money whilst taking less crap and as so I'm all for more reproductively minded women in medicine.
A more sinister worry though is the historical trend between more male professions going more female, and then loosing their status, and with it pay.
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