Although it is almost a whole week past International Women’s
Day (March 8th), now seems like a good time to write at length about women
and gender in Medicine - I’m not going to wait through the next 51 weeks of international
man time just to make this post more date-appropriate. Anyway, no one has ever
been accused of sexism on the internet so this should be quite safe.
I have just finished my Obstetrics and Gynaecology placement
at the Birmingham Women’s Hospital. Unexpectedly I found the subject really quite
interesting. Women have always been (and mostly remain) almost a complete
mystery to me so learning a bit about how they are put together has been
enlightening. Before medical school I was quite sure I would never
specialise in O+G: I think I subscribed to the lazy stereotype that male
doctors who do O+G must be socially unusual, or worse, creepy. I’ve come to
realise that this is pretty unfair. There is nothing special about gynaecological
problems and I don’t think male gynaecologists should be at all maligned for
taking an interest in women’s health. The gender of healthcare professionals is rarely relevant, and articles like
this don't help.
Turns out the specialty is attractive to at least
10 American doctors, and they make some persuasive points, such as the observation that O+G
is a varied specialty that is often a lot more optimistic than some of the
others – the patients are often younger with more treatable conditions and
happier outcomes like the delivery of a new hilarious tiny idiot person.
A point these Americans don’t raise is that by
definition a male gynaecologist/obstetrician can never experience any of the
problems or procedures his patients do. I’m not sure whether this is an
advantage or a disadvantage. Does it matter? Is the cardiologist expected to
know what a heart attack feels like? But I observe that some of the female
students I was on placement with might visibly cringe more during teaching on
childbirth for example - is greater insight afforded by virtue of being of female
anatomy and physiology? Or perhaps greater clarity can be usefully achieved if
your male gynaecologist can be objective? Perhaps the “surgical” nature of the
career or antisocial schedule and on-calls are more suited to ancient presumed
male characteristics. I’ll sit on the fence for this issue (and all issues - the
extra height gives me a better view). From what I’ve seen in hospital the
patients on the whole don’t themselves seem to mind much whether it is a man or
woman treating them.
However, I’ve never been more aware of my gender than when
inside the women’s hospital. Even the hospital’s name reminds me that my puny Y
chromosome excludes me from the club. For example in the genital vandalism of
childbirth men may arguably have an important role early on, but the overall experience
of pregnancy and labour is almost entirely restricted to women. Part of the
medical degree curriculum involves observing and assisting in the delivery of
babies, and in order to see more “normal” deliveries this involves shadowing
midwives as they guide expectant mothers through the process. It is interesting
(I think) to note that almost all midwives are female; in 2008 there were
132 (0.37%)
men out of 35,505 UK registered midwives. It appears that midwives suffer more from gender stereotyping than male gynaecologist. Or at least it might
be - I have completely failed to find the equivalent statistic for O+G doctors.
There are certainly loads of occupations where men outnumber women, but I can’t
think of any where the imbalance is quite so extreme, and often there are
positive steps being taken to address the imbalance.
For example what I do know is that currently only
9.5% of consultant surgeons are female. This could be partly explained as historically
medicine has been male-dominated and it will take some time for more recent
female doctors to go through the training - the year I started medical school
55% of entrants were female (and most still are). A career in surgery is
unattractive to women, and to me, for lots of reasons, but I’m digressing. And after
my five weeks obsessing over gender and medicine I don’t really know what my
point is. Some might say that the gender-specific ability to empathise with certain
conditions could be useful, or perhaps appreciated by some patients, but I
really don’t think there is any actual reason, beyond slow-changing societal structure and attitudes, why a man or a woman should be
better or worse at any job. Groundbreaking stuff.