Why are so many obs/gynae doctors male??

"I mean most of them have been ill in the head"

Really?

The hospital I'm booked into is a small country hospital who scans at every appointment, I'm a public patient, but I'm sure care varies in bigger hospitals. You do see the consultant at every appointment too. I'm sure that will be cut in the Decemeber budget too

We get 2 scans offered as routine on the NHS. At 12 weeks and 20 weeks and unless you really want consultant care or are high-risk antenatal care is the preserve of the midwives.

Thanks TheRealMBJ I'm in Ireland, how did you know? Do the women in the UK not see the baby on screen? I had no idea about childbirth/pregnancy until I found out I was pregnant (2 months ago) since then I've been really interested in how they are viewed by the medical profession, thats why this thread caught my attention.

Very interesting article sakura. It did make me think though how medicine in general is often used to control women, but I suppose Ob/Gyn and Psychiatry are particularly guilty.

Pam most individual Ob/Gyn are lovely, dedicated doctors and wouldn't dream of abusing their position. It is really lovely to see your baby on screen too (you're not in the UK then are you?). It is the whole field of Obstetrics and gynae including the medicalisation of childbirth that is at fault.

Oh Sakura that made me feel sick. I'm off to my first ante-natal/gynae appointment in 2 hrs.... :( I'm so excited about seeing the baby on screen though, its not all medical

WTF are men doing in the gynecological profession? I would really like to know the answer to this question.
If you read opinions of many gynecologists historically their opinions are sick, I mean most of them have been ill in the head, and the way they regard women is stomach-churning

I believe it's always important to take history into account, when discussing the present

You wouldn't ommit the historical backdrop of slavery when you were discussing how black people got to America.

I've written an article on this subject.

When I was googling images to write the article I was so disturbed by what I saw, namely the instruments of torture used on women by men posing as "doctors", that I felt physically ill.

When you see it all in historical context, gynecology cannot be seen as anything other than pure woman-hatred. Pure misogyny.

Springbok I think that MTAS and the MMC debacle of 2007 and beyond really did more to hamper women getting ahead in hospital medicine than had been improved in the previous 10 years. I'm sure you also know plenty of couples who work 200 miles apart, with the DC's at nursery somewhere inbetween. Not just surgical specialties, but they were less feminine to begin with, so it's more visible again there.

I am in the same boat as jennie both in specialty and my lack of training number. Whilst my bosses are supportive in principal about me having a small child, they are not happy at all with the inevitable clock watching that I have to do when I am due to pick my ds up from the CM. Couple that with a four hour daily commute and job insecurity and it is a fairly unattractive choice. It's not one I could have made without my dh being fantastic and supportive.

I have yet to work in a department with a female consultant orthopaedic surgeon. We are slowly increasing numbers but it is a slow process given the nature (and length) of training.

To return to a side issue which for reasons unbeknownst to me is bugging me, plastic surgeons have a lot of commitments out of hours. Plastics consultants (NHS) get called in at all hours for their complex patients and surgery can often be prolonged unexpectantly. It is one of the reasons why I got put off it as a specialty very early. This of course does not hold true for private plastic surgeons but for your NHS consultants, it really underplays what they do.

I was wondering if MMC will have a role in shaping what specialties junior doctors choose? I haven't heard anything about it for a while, but remember a lot of coomentary when it was rolling out a couple of years ago about how dreadful it was - in terms of unpredictability and uncertainty (as well as being an additional unwelcome source of stress).

It wasn't designed to disadvantage women, but it might have that effect owing to its adverse impact on settling in one location. It might make GP training look more attractive, if you don't want to keep moving.

Does anyone have an up to date read out on this?

the difference in hours, particularly out-of-hours and on-call work between hospital doctors and GPs make a huge difference in determining how family friendly that work will be. I know of several doctors (male as well as female) who chose to move into GP from hospital based specialties because they felt that they would not be able to be the kind of parents thay wanted to be and sustain that level of working life.

Equally I know a female ex-GP with three kids who has moved back to Paeds - brave choice but again it's about the support you get from home. Most women are the supporters of a career not the supported, sadly.

iteo If you're in a numbered post it may be. I'm still in the realm of LAT jobs and piecing together my career (which still happens a lot in surgical specialties (I'm ortho not O&G) so very tricky. Any gaps in service are a big deal and fixed term contracts leave little room to argue if your term runs out while you would be away. Add in trusts "trying it on" and it's certainly not easy yet.

This interesting study on medical students at the University of South Carolina posits gender-related values associated with interpretation of how work and life are related.

As far as OB/GYN (or Pediatric practice) counting as primary care -- this study was done in the US where the majority of prenatal care is delivered by OB/GYNs and children attend a pediatrician as opposed to GP, as opposed to the UK, where it's midwife care and GP care afterwards.

It is interesting to note that the men and women were statistically similar in terms of marital status or parental status, yet women tended to want to work shorter hours after qualifying than the men, and prioritised spending what leisure time they had with family and friends, whereas men tended to heavily prioritise sport, whether married or not, and whether parents or not. [from the study -- 'The value the female students place on time with family and friends is consistent with statements female physicians usually make, indicating they make significant career decisions, including specialty choice, based on family considerations ']

Men also tended to opt for the more interventionist areas of medicine, i.e. surgical specialties, where high adrenaline environments prevail, where relationship with a patient is more likely to consist of a review of data, x-rays, previous history, and perhaps where you get the chance to play superhero every day, saving a life by removing a tumour or appendix or whatever, whereas women were opting for medical roles that where more likely to feature one on one nurturing/teaching/encouragement/coaching through a process. It is interesting that more men than women are attracted to the more problem solving OB/GYN profession in the UK, where the OB is the 7th Cavalry of the profession.

As far as deeper values go I'm not sure -- men maybe like to have the prototypical male role of instant problem solving, with a scalpel? Whereas maybe women prefer to get immersed in process and communication? (Anecdotal perhaps, but a lot of women complain that when they complain about something going on in their lives their H's put on their Mr Fixit hat and annoy the women solving their ishoos instead of just listening and tut tutting and making a cuppa for them, which is what the women really want.)

'I said anyone could join the club if they were prepared to put in the hours - male or female. Not that women can do it if they work as hard as men, but anyone can do it if they work hard enough.'

Iteotowski -- It is not a matter of working hard enough, though. (It patently isn't, if there are more lazy male registrars than female yet males are over-represented in the profession..) Putting in the hours is where it becomes very difficult for the women. Not working hard. Nobody is saying women are not prepared to work hard, but you are failing to understand that it is the hours that make a huge difference for women. There is a difference between working hard and being free to put in the hours, and you completely confound these two things.

You would simply not know unless a male reg told you if he had children or family responsibilities, because most men getting ahead (by putting in the hours) in any very demanding profession (thinking law or finance here too) are able to do so because the details of family life are in someone else's hands. Very few women otoh have a secretary or wife figure at home handling things. Putting in the hours is where it becomes very difficult for the women. Not working hard.

Beside the arguments put forward here about long and inconvenient working hours, which are all relevant, does anyone know of any deeper philosophical reasons why there seems to be such a high proportion of men in this field?

But it isn't a different discussion. It goes towards explaining why there are fewer women in training in surgical specialities and why men training to be surgeons are less involved in family life.

I have decided to take time out to have a family, completely, partly because of the fact that because I trained abroad, it is harder for me to enter into the system at the same level I was at at home and, for me, having small children and the training schedule is not compatible. But also because the nature of the work I have done in this country has been as jenny describes 3-6 monthly 'contracts' with trusts who then work very hard not to pay.

It is a more complex issue involving societal structures and biology not just the demographic of students completing medical school.

I think it doesn't just apply to O&G but to a lot of hospital based consultants it's easier to do it if you have support at home ('wife' ) or no family to care for. DH is a cardiologist (medical not surgical) there are very few woman at the top in that specialty either. Rubbish job and training commitments tend to coincide with prime childbearing years which makes it difficult in very competitive specialties to get enough 'extra' training to make your cv attractive enough for the top jobs. Majority of our female dr friends are GP's partially helped by the more family friendly nature if the job and the far greater ease to job share.
I think in many professional jobs these days there is a more even split but as you get higher up in the career ladder you are less likely to find women as the amount of time you need to devote is difficult no matter how much effort you make (I never have enough hours in the day and as we are both professionals one of us has to give .... At the moment it's me but more due to problems with my health)

TheRealMBJ - that's not what I said. I said anyone could join the club if they were prepared to put in the hours - male or female. Not that women can do it if they work as hard as men, but anyone can do it if they work hard enough.

That women don't often have the same support at home as a man with sahw is a completely different topic of discussion.

For what it's worth, I have met very few lazy female trainees - and very many lazy males!

jennyc79 they must have made it easier to take mat leave, I had no problem with either of my boys (having been in each placement less than a year). I had more concerns with the fact that I was expected to work full time including 18h night shifts up until I left (38 weeks 1st time round!) which included carrying a crash bleep! I hope they've changed that now too. Maternity pay on the NHS for doctors is actually very very good - one of the better schemes as far as I know.

A few thoughts;

It takes 5-7 years to go through undergraduate medical training, plus the same again postgrad to become a consultant - even though medical school intakes are more feminine these days it will take time to filter through. Consultants getting their jobs at say 40 will generally stay in one job for 25 years, so senior consultants have more probability of being male.

Taking maternity leave as a junior hospital doctor is not easy. Yes it is as legal as anywhere else, but most juniors spend an amount of time on 6 month contracts strung together into a rotation - every trust then tries to wheedle out of paying up! Afterwards, either you have to apply for flexible training (which you may well not be able to have due to cuts in funding) or carry on full time when you get back.

Full time is NOT just 39 hours a week either, most hospital docs in training posts work 48 hours a week plus and it's often a case of staying late at the last minute if eg a list in theatre overruns. My (male) boss was meant to do the nursery run yesterday evening, but had to get his wife to do it when we still had umpteen patients to see in clinic at 4pm. He has 2 DCs, but he wouldn't be able to do it without his DW (who I believe is either SAHM or very PT) There is much more scope to be a PT worker straight after undergraduate training in nursing or midwifery.

Surgical specialties are more prone to these issues than GP or medical ones because of the nature of the work and of the seniors. If your boss never had to take mat leave, or get to school events, nursery pick up etc then how can they understand that you're not being unreliable at work when you have to leave early/bang on time, yet your male colleagues don't? Added to reduced hours (from the 100+ hour weeks of 30 years ago) they get the better training!

Rotating around an area can mean a lot of moving/commuting (I do 2 hours+ daily in the car) If your DP is also a doc he may be commuting the other way! You lose your support network quite quickly moving so often for work.

All this can mean you're spending most of your 30s in the hospital/car as a surgical trainee. Men get away with this as "being the breadwinner" but being a SAHD is rarer than it should ne so women in these jobs do not have the same level of family infrastructure behind them. Doctors already tend to have their families later (I'm 32 and hoping TTc next year once I'm rid of my undergrad loans!)

I can completely see the appeal of being a GP as a trainee, and at the end of that it's more acceptable to be a PT GP than a PT hosital consultant. Even before you consider the OOH commitment (do someone's crash section at 2 am or stay at home in bed ready to get the DCs up for school tomorrow?) These days OOH GPs tend to just do that, not get up and do a clinic the next day. - and they tend to be men.

Anyone who likes can "join the club" if they are prepared to put in the years of study and training to do so and ...you need live in child care of some description (be it paid nanny, sahp, extended family)

So the reason male registrars are prepared to 'put in the years' is because they have the support they need at home. Find the whole argument that as long as 'women are willing to work as hard as men' (which is essentially what you are saying above) a very shallow, and insulting one, as that isn't really the problem. It isn't that women doctors are lazy and unwilling to work hard, it is that they simply often do not have the same support.

I do not think that any OB/GYN I ever met was anything short of dedicated and happy in his or her job. Mind you my experience of OBs came in the US, where doctors attend every birth unless you have chosen a midwife practice. One of my doctors in particular spent time in west Africa each year training nurse practitioners, doctors and midwives there to repair obstetrical fistulas, to improve prenatal care, to deliver babies as safely as possible even away from clinics, and to improve cs procedures.

While it may well be hard on either parent, it becomes well nigh impossible if both parents wish to become medical specialists without massive outside support (as is the case with my friend mentioned earlier her H is specialising in psychiatry), but additionally, since the really, really busy years of a medical training come right bang in the middle of the years when a lot of women are starting their families in fact at the 'now or never' stage -- the physical brunt of the brutally long hours can fall harder on women if they do go through pregnancy at that time in their careers, and emotionally if they decide to take their chances on conceiving still later, in their late 30s or early 40s.

My former FIL was a neurosurgeon who fathered 7 children while going through medical school, doing his national service as a medic and then embarking on his specialist training (in the US) -- he had exMIL holding the fort full time at home, arranging his meals and laundry, doing all the schlepping of the children, making arrangements for holidays; his entire life was taken care of down to the last possible detail. Most women do not have someone at home doing all that for them. It was hard on her (and I am by no means that woman's number one fan) but he simply didn't have to worry about one single aspect of his life away from the hospital.

'Anyone who likes can "join the club" if they are prepared to put in the years of study and training to do so' means in reality that a woman needs to think very hard before embarking on a medical specialisation just because of biology, never mind work-life balance. A friend I went to school with, who is now an orthopedist, expressed regret once that she hadn't gone ahead and had a baby some time during her teenage years while still at school and living at home with her family because in her early 30s she just did not have time to allocate to a relationship once she got stuck into specialisation and the work involved in establishing a career afterwards, much less think of having a child with any potential partner. She could hear that biological clock ticking and it preyed on her mind a lot.

So, it's just common or garden patriarchy in action. Only those who have someone else to do the thinking about the rest of their lives may be let into the club, Or else face burn out and/or opprobrium.

That's bollocks. Anyone who likes can "join the club" if they are prepared to put in the years of study and training to do so. I could have gone into any of the surgical specialities had they interested me (which by and large they didn't).

The hours required to study, train, pass exams and work (because most of all, surgeons need in theatre experience which unfortunately doesn't come in convenient hours) mean that you need live in child care of some description (be it paid nanny, sahp, extended family). You also need to be prepared to be away from your children much more often than in other jobs which are more amenable to part time or shift working. This is hard on either parent!

vadasultenfuss the med student who spoke to you was also talking bollocks. O&G surgeons are not "wannabe" general surgeons - that is just insulting.

Hmm, I knew quite a few male OB/GYNs who are gay when I worked in a women's clinic. They just liked the field is why they chose it. It gave them the opportunity to do surgery plus a whole bunch of other stuff.