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Downstream effect of numbers of female medical students


Guest Kirsteen

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Guest Kirsteen

Hi there,

 

I thought of this while reading the other, related thread on the relatively high proportion of female to male medical school matriculants (those who successfully gained entry to and registered in a program). Do any of you think this relatively large number of women may impact the selection of individuals for residency or beyond? It certainly might enable reform in terms of part-time residencies, something that is commonly taken advantage of in the UK when female doctors wish to work part-time to take care of their families.

 

Cheers,

Kirsteen

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There has been talk, especially in Britain, about the numbers of female med students. ....

 

They have been less than positive....see this BMJ article:

 

bmj.bmjjournals.com/cgi/r...7340/754/b

 

The conclusion:

 

Females tend to work less and don't work as long...they like to work part-time and take lots of time off... conclusion: educating too many female physicians is a waste of taxpayer money and is going to contribute to the shortage of physicians....as each 'seat' in medical school will translate into less 'work' of a practicing physician and a higher 'per working year cost' of education. Some would like to see a 'negaitive selection' bias against female applicants to give advantages to males....even when the male applicant is clearly inferior.

 

I also think that it is HIGHLY unlikely that they are going to go to part-time residency spots in Canada....it is against Royal College regulations, would be close to impossible in some specialties, would require twice as many residents in a program to make it work and would effectively double training time... Fam med would be 4 years....surgery would be 10 years, internal medicine and some pediatrics specialty training would take 12 years....neurosurg would take 14 years.... And with half of a resident's salary to go with it...residents working half time would be living far below the poverty line....with the current debt load there is NO WAY that we can afford to work part time as residents...even if we wanted to!

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Guest Kirsteen

Hi there,

 

Thanks for the link, aneliz.

 

It's all a bit interesting, because although the folks in the UK appear to be up in arms over this issue and its variants, I don't hear too many rumblings hereabouts, even though we appear to be facing the same conundrum. Should we possibly be electing a House of Lords to maintain a little consistency in Canadian healthcare policy-making? ;)

Back to residencies, the problem might be perceived as being amplified in the UK because they currently do offer part-time residencies. My pal (who is finishing up her training in Obs/Gyn in southern England) transferred from a full-time Obs/Gyn residency to a part-time. You're correct, it effectively did double the length of time remaining for her to complete the residency. She's happy though: she works a little longer to complete the training that will lead to a consultancy and she spends a lot of time with her kids.

 

Looking forward, if an increasing number of women graduate from Canadian medical schools, that will be a potentially large proportion of smart women in the OMA. Those guys have never been shy when it has come to ridding oil tanker issues of inertia. In short, I don't think it's inconceivable for this sort of suggested policy change to arise in the not-so-distant future.

 

Cheers,

Kirsteen

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At the risk of sounding politically incorrect I am going to have to agree with aneliz. There's nothing wrong with women going into medicine, but I think it is also short-sighted for schools like McMaster and UBC (although I hear it's better now) to indirectly (or directly) select females over males. It is hard to believe that any med school's criteria can be deemed fair when the entering class has an 80/20 ratio consistently from year to year. This reminds me of affirmative action in the US, although affirmative action is not bad because it recruits for underrepresented subgroups into medicine. Women, nowadays, are hardly underrepresented in medical school. In high ranking positions, maybe, but that will all change in ten or twenty years.

 

Also, women tend to pick more primary care oriented specialties (which is a good thing) but you wonder whether some specialities in surgery, for instance, will have a shortage in a few years when no one is going into it.

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There have also been several Canadian studies that looked at visible ethnic minorities in Canada and their representation in medical schools and asian and south asian students account for a larger percentage of the medical school classes than they do of the population....again, it would be interesting to see what the schools are doing (intentionally or not) to make this happen or if it is reflective of the applicant pool.

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Guest UWOMED2005

Don't forget factor in the fact applicants have to hit the minimums. If all the "stupid white men" (to borrow a phrase from Michael Moore) applying are pulling 1.0 GPAs and 3/3/3/L MCATs, then I'd hope there'd be a bias towards towards the other applicants.

 

On the representation of ethnic minorities in medicine, I think it's the application pool. It seems to me that the ratios are similar in traditional premed programs here at UWO. In some ethnic backgrounds and sometimes for parents who came to Canada with no economic resources and dedicated their whole lives to their children's future, making sure their kids get into medicine or something similar is more important than listening to their kids's desire to perform post-modern interpretive dance.

 

It's actually a pattern that has been present to a greater or lesser degree throughout Canada's history. At least, certainly in my family. Jim Bob O'Hara comes to Canada for Ireland looking to improve him and his children's future lot. He finds he can only find menial work here, so he works his bloody butt off building the Rideau Canal or working a the 7-11 (depending what century we're talking about,) devoting every penny to his kid's education. His kids then sometimes feel pressured to go into a career they did not want to because their parents pushed them, and they do really well in terms of $$. This rubs off on their kids (the 3rd generation) who decide they absolutely have to do something they enjoy (such as post-modern interpretive dance) even if they don't make the $$ their parents do.

 

As to Aneliz's point, yeah it's one that I've heard a few times voiced by doctors around town. I heard one family doctor point out the fact that there are enough family doctors in London to cover all the patients, if it weren't for the fact so many of them were and/or "half-retiring" early (ie cutting their practice drastically a few years before their real retirement, something common to male and female physicians) working part-time (common to male and female physicians but perceived to be more common in women with young children), and/or taking maternity leave (more common with women - men can take paternity leave now but rarely do.)

 

The scary thing is that while such opinions might sound sexist, there's a grain of truth to the argument. A lot of women do choose "lifestyle" professions so they can be closer to their kids, and I know a number of female classmates who are planning to work part-time while their kids are young. This particularly a problem with family medicine where physicians with full rosters are needed to solve the problem (ie London needs 25 family physicians, but if the physicians they bring in work only part time that means we need at least 50 instead!) but family physicians as a whole are allowed to set their own hours. This is not just a problem for the system, but for the patient too. If you've got a problem that has to be seen by your family doc on Tuesday but that doc only works Monday, Wednesday, Friday and can't fit you until next week. . . that's a problem.

 

But the question is - is this a problem with letting women into the system, or a problem with the system itself?

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Guest cracked30

I agree with meds2005, It is even more striking when looking at surgical programs. Few women. If the trend of disproportionate numbers of women in medical school continues, negative lifestyle specialties, surgery, will suffer.

 

There's no easy answer, Dalton and George here in Ontario seem to think they can hire more NP's and invest in public health and the crunch will disappear.

 

I'm just crossing my fingers and wondering when the baby boomers, the ones who hold the political inertia in Ontario and Canada, will say enough is enough! Then some hard decisions about delisting services and privatization will occur.

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Guest Kirsteen

Hi there,

 

I was reading a Canadian political policy publication today, which focused on issues relating to financial leadership of this country. However, I came upon the following bit that rung as salient to this issue:

 

Slowly changing macro-forces rarely force political attention until it is too late and a crisis hits us with a gale force: Thus rising prices slowly start to accelerate bit by bit and suddenly you are in an inflationary spiral or deficits begin to accumulate and eventually you are in a debt trap borrowing money to pay interest on yesterday's loans.

 

I ask you to try substituting "rising prices" with "rate of doctor retirement, medical professional brain drain and increase in female undergraduate medical program graduates". Given these factors, it would be frightening to see, if no other pre-emptive action is taken (which I sincerely hope is not the case), where Canadian health care will be ten years from today.

 

Cheers,

Kirsteen

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