GROWING numbers of women entering the medical profession, and demanding flexible working hours and maternity leave, will create a major shortfall in the future provision of primary care, an expert has warned.
Dr Brian McKinstry, a senior research fellow at Edinburgh University, said an excess of female graduates was bad for medicine, just as an excess of male graduates had been in the past.
Dr McKinstry said women's earlier retirement and the fact
they were less likely to carry out research work would be detrimental to medicine.
He also claimed women medics spent longer with their patients.
Writing in the British Medical Journal, he called for the numbers entering medical schools to reflect society – roughly half men and half women. At the moment, women students outnumber men by about three to two
In 2002-3, all UK medical schools had more female students than male – in some cases, more than 65 per cent were women.
Dr McKinstry said the main concerns focused on the work-patterns of women doctors, who tended towards "family-friendly" specialities, such as primary care and psychiatry, rather than surgery. "This unequal distribution means some specialities feel the implications of part-time working and maternity leave, such as lack of continuity of care and resource use, disproportionately," he wrote.
Dr McKinstry, a GP in West Lothian, said female doctors were much more likely to work part-time than male medics.
"Despite many years of feminist discourse, society still expects women to reduce work commitments to look after children and not to return to full-time work until their children are older," he wrote.
And more female GPs than men planned to retire before the age of 60, he added.
Dr McKinstry said fewer women than men chose to work out-of-hours. He added that the increase in women doctors may have partly influenced the recent departure of GPs from out-of-hours work.
Because of part-time working and earlier retirement, he said, a greater number of women in medicine would cause a "major shortfall in primary-care provision".
He also said women were less likely to carry out research, teaching, training and committee work, which could affect the development of the profession as a whole.
Dr McKinstry claimed women were more likely to spend longer with patients.
"I think patients feel better for having a longer appointment, but I don't know to what extent that is going to have an effect on disease prevention and helping people get over illness quicker," he said.
He conceded that women had been unfairly discriminated against in medicine for many years. But unless there was a change in society in terms of responsibility for childcare, there needed to be more balance in the recruitment of women into the profession, he said.
Professor Jane Dacre, from University College London, also writing in the BMJ, said that, rather than worrying about too many women in medicine, people should be focusing on ensuring equal opportunities.
She also pointed out that women performed better in medical exams than men.
"Rather than focus on the detrimental effect of having too many female graduates, the feminisation of medicine should be welcomed as an opportunity to be creative with workforce planning and to recognise that a more flexible approach is required to deliver good-quality patient care at all times of day and night," she said.
Dr Sally Winning, a member of the British Medical Association's Scottish Council, said: "As the number of women entering medicine has increased, it has become imperative to address career barriers and flexible-working strategies to ensure a positive future for women choosing medicine as a career."
A spokesman for the Equality and Human Rights Commission said more creative planning was essential to ensure workplace practices were designed to meet the real needs of mothers, fathers and carers.
Diagnosis of medical woes meets a mixed receptionWHEN Dr Brian McKinstry told his colleagues he had agreed to write in the British Medical Journal arguing that there were too many female medical graduates in the UK, they thought he must be mad.
"They thought people would be outraged," he said.
Then when he showed the article to a number of fellow doctors before publication, he received a mixed response.
"Some of the women I showed the report to did not like it and were quite angry.
"But others could see the point I was making and said it was well argued.
"All the men loved it, obviously."
Dr McKinstry accepted that his opinion may cause some controversy. But he said that he had sympathies for women trying to carve a career in medicine.
"I do think women have a really hard time in the medical profession.
"We need a change in society which makes it easier for them to have a career and a family, but that is not a simple solution.
"But we have got to take these issues into account, because it does have a knock-on effect for the development of the profession."
