Why are so many obs/gynae doctors male??

[dontlaugh]

Bearing in mind medical students are now roughly 50/50 in college and the numbers of qualifying GPs are majority female. i often wondered about this and am now brave enough to post here.
Discuss!

[InMyPrime]

There is actually also a shortage of midwives, Elephants, particularly of midwives who can attend births in hospital, rather than say community midwives. It's just reflected as a general shortage of staff since it is an almost 100% female profession rather than an imbalance between genders.

When I worked in the medical field and colleagues were saying that our local maternity hospital was totally oversubscribed. I said 'well, why don't they just hire more midwives since they're cheaper than doctors / ob-gyns?'. Response was that there's a shortage of experienced midwives as it's a tough area to attract trainees into because of the anti-family / anti-social hours and high stress.

[BikeRunSki]

Sally Thanks for your posts, they are very interesting. It was hard enough becoming established as a female civil engineer (undergraduate intake is about 20% female) with site work/v early starts and site placements all over the country. Along with all the "Unusual job for a girl..." comments and patriachy. Certainly influenced why I didn't have any DC until I was 37.

[ElephantsAndMiasmas]

Thanks for the insight Sally. :) Any thoughts on the midwife thing?

Can we get started on the campaign to officially rename that speciality now please?

[TheRealMBJ]

Ah, but Aye many male registrars have wife's who become SAHM to take up the slack if they choose to have children while training.

[VivaLeBeaver]

Well nursing and midwifery are predominately female roles. Yes it's crap hours and you know that when you sign up for it. But if I had a choice of specialising in an area that didn't involve working weekends, etc then I'd probably do that. Well I would if I'd still earn the same, but if I was a clinic midwife I'd lose about a third of my pay.

But if I was a dr and deciding on a specialism and in a position to choose between something more 9-5 and obstetric chaos I might decide that ent looked fascinating.


I asked a male reg once why he chose obs and gynae. He said he never thought he'd like it but as part of his junior dr rotation he was allocated a placement and he loved it. He said he'd never have asked for a placement in obs. He said there was a fantastic variety of work that you don't get anywhe else. Surgery without actually been a surgeon, all the oncology stuff, infertility challenges and then all the obs stuff as well. He said it's very rewarding.

[TheRealMBJ]

Elephants I think that the MW thing stems from the origin if midwifery, and as it is a caring, supportive role that is seen as a woman's job, it is one very few men are attracted to

[sallysparrow157]

elephants - nope, midwives, the same as nurses, work shifts - they are at work from x in the morning to y in the evening then they hand over to the night team and go home. Consultant surgeons, when they are on call, may go home at 5 or 6 pm and not be disturbed all night, may be up all night with a difficult operation and then be expected to do a clinic from 9am, or may get home at 10pm, get into bed then get called out again at midnight and have to go back in as the registrar needs help in theatre.
Also midwives and nurses get to choose when the majority of their shifts are (some will do mainly nights so they can put the kids to bed, go to work, be home to take the kids to school then sleep til afternoon school run time) so it's actually very family - friendly

dontlaugh - no, sexual thrills have not been mentioned in this thread and I apologise if you thought I was implying that that's what you were getting at. I have seen it questioned on threads here in the past though and it really makes me angry - because I am female no-one even thinks of accusing me of being a paedophile because I look at small childrens genitalia pretty frequently as part of my job but some people imply that, just because they are male, gynaecologists who are every bit as professional and dedicated to their job as I am must be a little bit pervy.

[sallysparrow157]

there is certainly a lot of 'ooh, i don't think i would like a male midwife' on mumsnet too!

[Iteotwawki]

Male consultants have families, but many of them will have relied heavily on wives / extended family / childcare providers during training - female consultants don't always make career choices that mean they see less of their children.

A urologist will treat both male and female patients so "willyologist" is incorrect. As has been pointed out, women also have a urinary system.

Where I currently work, there are 3 o&g consultants, 2 male; 3 urologists, 2 male; 5 general surgeons, 3 male.

More and more female registrars are coming through the system, it's only a matter of time before the numbers start evening out.

[MillyR]

When I was a teen, there was a lot of nurses' accommodation at the hospital, although I'm not sure that is the case now. Would a possible solution be for there to be family accommodation for doctors, midwives etc more on site. They could then put childcare on site too, possibly 24 hours, to allow primary carers to work anti-social hours.

[AyeRobot]

I was being facetious, of course

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.

[mathanxiety]

It's a combination of the years required for education coinciding with the main childbearing opportunity for women, which means women have to think very hard about specialising in any medical field, and the hours of OBs especially -- until you get to your 50s or so and may be able to have a private practice with others, you will be on call and have to be available at all hours due to the nature of the practice. Same goes for A & E specialists, neurosurgeons who do A & E, etc.

And let's face it, most women don't have wives. A friend who is training for A & E work is due any day with her second child but couldn't have managed to have even one without her mother leaving home to go and live with her and her H when the first was born -- they then moved to a teaching hosp closer to the GPs' home so that her parents could be there around the clock to take care of their little DS and the baby due later this year. She looks haggard and terribly tired now, in her third trimester, with the horrible hours. It is a major physical slog for anyone, let alone a pregnant woman.

By contrast, another friend who is a maternity nurse has been able to combine night shift work and having three children with not much bother, especially since they all got to school age. Her DH was on duty at home all night when they were babies and they hired a nanny for 7 or 8 daytime hours.

[NellieForbush]

Elephants

Difference between midwifery and Ob&Gyn (my thoughts, not a statistic).

Many men and women go into medicine and decide much later what they would like to specialise in and potentially surprise themselves when they find they are interested in Obs.

Going into midwifery is totally different. The aim is to care for women and babies during "normal" pregnancies and deliveries (and I would say empower women to have the pregnancy and birth that is best for them)

The role is so different.

[VivaLeBeaver]

A lot of midwives only train to be midwives in their 30s, 40s or even older. So their children may be a bit older when they start work meaning that unsocial hours isn't as big an issue.

[iskra]

To add to Nellie, the earliest you could start specialist ob training is 7 years after entering medical school (assuming 5 year degree). A midwife enters a 3 year degree to train totally focused on midwifery.

[vadasultenfuss]

A medical student told me that obs are wannabe surgeons (mostly male) who arent good enough to get into mainstream surgery (vv competitive). Therefore it is a lot of mens fallback choice in the way it isnt for women.

Also some people seem to think that all obgyns are consultants. Not true and in fact the vast majority of c sections are done by registrars.

[lachesis]

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.

[Iteotwawki]

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.

[mathanxiety]

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.

[mathanxiety]

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.

[TheRealMBJ]

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.

[jenniec79]

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.

[Iteotwawki]

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.

[wonkylegs]

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)