Dr Brian McKinstry of Edinburgh University is a brave man. Writing in the latest issue of the British Medical Journal, he described the increasing number of women doctors as “bad for medicine” and forecast a staffing crisis down the line.
He was not allowed to get away with it, of course. His arguments were met with a chorus of female objection, led by Prof Jane Dacre of University College, London. She argued in the same issue of the BMJ that, if more women than men were qualifying as doctors, it was because they were outperforming men. She also pointed out that women were under-represented in certain specialities and at senior levels of the profession. Thus, it was to be inferred, women were still very far from attaining anything like equality.
Now I accept all Prof Dacre’s arguments. It is right that girls’ superior grades at school are reflected in the greater number admitted to study medicine. And it is bad that women are still so poorly represented at the top of the profession. Having said that, though, I have more than a sneaking sympathy for Dr McKinstry when he argues that the growing gender imbalance in medicine may have a malign effect in the longer term.
Indeed, I would venture to go rather further than he has. It is not only medicine that is being altered by the growing number of female entrants, but other professions, too. And while many of the changes may be positive, in terms of the superior jobs now open to women, the way that it is happening is producing a level of professional segregation that could threaten the very equality of pay, status and prospects that the feminist pioneers hoped to achieve.
It is beyond dispute that professional segregation is increasing. In teaching, the gender imbalance is more and more marked, not just in primary schools, but state secondaries as well. This has to do not only with all the checks now made on those who want to work with children, but with the subject and career choices that young men and women make.
In higher education, whole departments now tend to be almost all male or almost all female – among teaching staff and students alike. The dearth of female scientists is now as acute as it was even when far fewer women went to university. Arts and social studies are feminised.
In the law, where – as in medicine – more women than men are now qualifying as solicitors and, as of last year, as barristers, women opt disproportionately for family and legal-aid work, and are strikingly absent from the partnerships and committees that constitute the profession’s higher reaches.
It would be wrong to conclude, however, that this gender divide stems from women being reluctantly shunted into certain specialities – although surgery is an area where the length of training, as well as the male “club”, may militate against women. Far more, it reflects the choices that women themselves are making.
As the better performers at school and, increasingly, university, they have the pick of professions that are openly competitive. Yet they seem fatally attracted to those areas that bring relatively lower status and pay. More women are also gravitating to the public sector, while their participation in the private sector has been static.
And when you look more closely, these choices are quite rational. Even in this day and age, more women than you might expect are choosing jobs that will accommodate the future they anticipate as mothers, or carers. Professional women, like their less skilled sisters, are gravitating towards work that provides family-friendly hours (schools), unquestioned compliance with gender equality provisions (the public sector), or self-employment that is risk-free and offers pay more than adequate to work half-time (GPs and barristers).
A couple where the woman works in the public sector, with its job security, maternity leave and part-time possibilities, and the man takes the risks – and potential rewards – in the private sector could be described as today’s “dream team”. The increasing job segregation, however, exacerbates three unfortunate realities.
First, women working “flexibly” to accommodate their own families will be reluctant to extend that flexibility to hours that other full-time employees require – consider the decline in out of school activities and the stalemate over GP surgery hours.
Second, boys will rarely be taught by a male teacher, men will find it harder to consult a male GP, and public services will reflect less and less the society of which they are part. And third, this informal male-female settlement postpones indefinitely the revolution that is really needed: in the traditional division of responsibility for childcare.