The medical timebomb: 'too many women doctors'

The medical profession is in danger of losing its power and influence because too many women are scaling its ranks, according to the female head of Britain's most influential royalmedical college.

The medical profession is in danger of losing its power and influence because too many women are scaling its ranks, according to the female head of Britain's most influential royalmedical college.

The astonishing warning is made today by Professor Carol Black, the president of the Royal College of Physicians, only the second woman to hold the post in the college's 500 year history.

Medicine has a reputation as a chauvinistic profession led by powerful male consultants with giant egos. But it is changing rapidly. Over 60 per cent of new doctors are women and they already dominate the lower echelons of the profession. In less than a decade, women doctors will outnumber men, Professor Black said in an interview with The Independent.

While most observers have seen this as a positive trend, leading to a more caring, humane style of medicine, Professor Black is the first female leader of any profession to suggest that the increased involvement of women may be damaging. "We are feminising medicine. It has been a profession dominated by white males. What are we going to have to do to ensure it retains its influence?

"Years ago, teaching was a male dominated profession - and look what happened to teaching. I don't think they feel they are a powerful profession any more. Look at nursing, too."

Although the competence and skills of women doctors are not in question - and many patients prefer being looked after by a woman - the status of the profession is at stake, she said.

"In Russia, medicine is an almost entirely female profession. They are paid less and they are almost ignored by government. They have lost influence as a body that had competency, skills and a professional ethic. They have become just another part of the workforce. It is a case of downgrading professionalism."

Professor Black had spent two years "banging on doors" trying to persuade people to listen to her concerns, she said. Meetings with senior government figures had now taken place. "At last, people are taking this seriously. I have actually taken it to the top," she said.

The Royal College of Physicians is considered the most influential of the doctors' colleges and is responsible for standard-setting and monitoring the quality of education in the medicalspecialties.

Her comments come as the debate about work-life balance and women's roles has intensified. Professor Black, who is professor of rheumatology at the Royal Free Hospital, London, said the issue was sensitive and she could raise it only because she was a woman.

The downgrading of medicine's professional status was a serious threat and action was needed now to correct the imbalance of the sexes, she said. "I would like to see equal numbers of male and female doctors," she said.

Women doctors were equal to or better than their male colleagues in ability, but family commitments made it more difficult for them to rise to the top of the profession. "Thewomen admitted to medical school do well, they work well and they graduate well. The distinctions go to the women. But then, as the years go on, they start to make choices to balance their family and their lifestyle."

"In medicine, they choose to go into the specialties of dermatology, geriatrics and palliative care - not cardiology and gastroenterology where they are going to be required to work long hours. What worries me is who is going to be the professor of cardiology in the future? Where are we going to find the leaders of British medicine in 20 years time?"

For the profession to continue to wield influence, senior doctors had to serve on government committees and regulatory bodies as well as cope with their clinical work. For women, that was harder and they needed extra support with child care, flexible rotas and mentoring. Even then, part of medicine would still require a 24-hour commitment, she said.

"How do we ensure that women can fully participate in all the activities that were previously part of the professional life? If you can't make it possible for women to participate in everything - doing research, attending committees, influencing the Department of Health - the profession will lose its influence."

There was no female dean of a medical school, no female head of a department of surgery and no female head of a department of medicine, she said - testimony to the difficultieswomen faced in taking on the top jobs.

To rebalance the sexes in medical schools, she favoured encouraging graduate entry. At age 18, women had an advantage because they matured earlier but if medical schools took in more graduates, men would have had three years to catch up.

A working party set up by the college to consider how medical professionalism can be preserved in the 21st century will look at the role of women.

"It worries me if we don't make it possible for women to do all the things we expect a doctor to do to be at the top of the profession. But this is a difficult thing to talk about because no man can bring it to the fore," she said.

Liz Hewett, the executive director of the Royal College of Nursing, reacted to Professor Black's comments by saying that a "modern health-care workforce needs to reflect the diversity of the society it serves.?" To recruit good people there needed to be a "balance between work and home life".

Lord Robert Winston, the fertility specialist and BBC presenter, said: "It's true that now inmedical schools 60 per cent of graduates are female. [But] hopefully it's true that womenthroughout society are moving to a completely different role. I wouldn?t be too worried about this at all. I think the influence of women in our profession has been wholly good."