Transplant inequalities – a United Kingdom perspective

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Ascaso provided the definition and usage of the femininity index, collaborated as statistical consultant and in the discussion of the results, and did the critical revision of the manuscript. All the authors have approved the final version of the manuscript..

Inequalities and outcomes: end stage kidney disease in ethnic minorities

June 14, Gaceta Sanitaria. ISSN: Gender inequalities in the medical profession: are there still barriers to women physicians in the 21st century?. Descargar PDF. Pilar Arrizabalaga a , b ,. Autor para correspondencia. Under a Creative Commons license. Table 1. Table 2. Aim To analyze women's advancement compared with that of men and to determine whether advancement in hierarchical status differs from advancement in the professional recognition achieved by women from to We analyzed data on temporary and permanent positions, hierarchy, promotions, specialty, age, and sex among the participants.

Results The female-to male ratio among trainee medical specialists was higher than 1 throughout the study period. The full potential of the increasing number of women physicians will not be reached without continuing efforts to improve the hospital medicine environment. Palabras clave:. Texto completo. Introduction The presence of women in the practice of medicine goes back to the ancient times.

In Spain women did not have access to higher education until the 20th century, and full incorporation into the medicine began in the s with their incorporation into the world of work. In Spain, the advance of women physicians in their careers is unknown due to reluctance to provide such data. The structure and medical organization of the HCB has been reported previously 9.

We analyzed the disparity between women and men physicians along the formal hierarchal promotion process and the recognition of professional career promotion in the 21st century. Methods A retrospective longitudinal descriptive study was designed. Calculation of the sample size was not done since the sample size was the total number of physicians. Variables The two main variables studied were the hierarchical status and the grade of professional career. The following variables were studied: permanent, temporary and training medical positions and data related to medical executive management hierarchy and professional career PC promotion within the permanent positions.

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Regarding the category of executive management hierarchy, data on the section or unit chief, department and institute chairs; grade attained on PC promotion: specialist, senior specialist, consultant and senior consultant; specialty, sex and age from to were collected. According the femininity index in each specialty, we classified the specialties into three groups: i feminised specialties, if the relationship was more than 1; ii parity specialties, if the relationship was 1; iii and masculinised specialties, if the relationship was less than 1.

Statistical analysis The demographic characteristics of the medical workforce by year of study were expressed as absolute frequencies. A Chi-square was used for linear trend in order to study the increase in the number of women physicians for each degree of promotion during the study period. Results The study was made up of physicians, women and men. Permanent versus temporary positions. Femininity index - ratio between the number of women and men - in permanent medical positions in the specialties throughout the study period.

Including pharmacology and international health research. Including infectious diseases, autoimmune diseases and critical care medicine. Including Cardio-vascular, oral, and plastic surgery. Femininity index according to the hierarchal position throughout the years of the study. Figure 1. Femininity index according to the grade of professional career promotion throughout the years of the study.

Figure 2. There is little knowledge on the advancement of women physicians in their careers due to reluctance to provide such data. What does this study add to the literature? Strategies to address gender inequality must arise from the institution. Available at: www. Rodriguez, J. Hamel, J. Ingelfinger, E. Phimister, et al. Women in academic medicine-progress and challenges. N Engl J Med. Mayer, J. Files, M. Ko, et al. Mayo Clin Proc. JAMA, , pp. Scheurer, S. McKean, J. Miller, et al.

J Hosp Med. Mavromaras, A. Promotion to hospital consultant: regression analysis using NHS administrative data. Brit Med J. Merino, O. Does Medicine still show an unresolved discrimination against women? Experience in Two European University Hospitals. J Med Ethics. Lo Sasso, M. Richards, C. Chou, et al.

Health Affair. Cheng, A. Scott, S. Jeon, et al. What factors influence the earnings of general practitioners and medical specialists? Evidence from the medicine in Australia: balancing employment and life survey. Health Econ. Soethout, M. Heymans, O. Ten Cate. Med Teach. McManus, G. Livingston, C. The attractions of medicine: the generic motivations of medical school applicants in relation to demography, personality and achievement.

BMC Med Educ. Universidad de las Palmas de Gran Canaria, , pp. Women doctors and their careers; what now. Royal College of Physicians, , pp. Jagsi, E. Guancial, C. Worobey, et al. The gender gap in authorship of academic medical literature. A year perspective. Sidhu, P. Rajashekhar, V. Lavin, et al. The gender imbalance in academic medicine: a study of female authorship in the United Kingdom. J Roy Soc Med. Alcon, T. Med Clin. Arrizabalaga, M. Rohlfs, P. Arrizabalaga, L. Artazcoz, et al. Health, Lifestyles and Working conditions of male and female physicians in Catalonia. Mayoroba, F.

Stevens, A. Scherpbier, et al. Gender-related differences in general practice preferences: longitudinal evidence from Netherlands Health Policy, 72 , pp. Arrizabalaga, C. Eagly, B. Gender and leadership style: a meta-analysis. Psychol Bull. Currie, A. Lockett, R.

Finn, et al. Organ Stud. European Guide. Tackling Stereotypes Project. Women in Academic Medicine.

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Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Feminised Specialties. Child Psychiatry. This article evaluates the advance of women in comparison with men in medicine and determines whether the advance between the hierarchical status and the professional recognition achieved by women differs. We analyzed the disparity between women and men physicians along the formal hierarchal promotion process and the recognition of professional career promotion in the 21st century..

A retrospective longitudinal descriptive study was designed. All physicians working at the hospital in October were included, using information based on gender, age, medical specialty and professional status. Calculation of the sample size was not done since the sample size was the total number of physicians..

The two main variables studied were the hierarchical status and the grade of professional career. The following variables were studied: permanent, temporary and training medical positions and data related to medical executive management hierarchy and professional career PC promotion within the permanent positions..

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Regarding the category of executive management hierarchy, data on the section or unit chief, department and institute chairs; grade attained on PC promotion: specialist, senior specialist, consultant and senior consultant; specialty, sex and age from to were collected.. Feminization was evaluated as femininity index. This is a measure of frequent use and simple interpretation and defined as the percentage representing women with respect to the total of the variable. The ratio between the number of women and men in permanent medical positions, and in hierarchal positions and PC promotion within the permanent positions was calculated.

According the femininity index in each specialty, we classified the specialties into three groups: i feminised specialties, if the relationship was more than 1; ii parity specialties, if the relationship was 1; iii and masculinised specialties, if the relationship was less than The demographic characteristics of the medical workforce by year of study were expressed as absolute frequencies. The femininity index related to positions of hierarchy was plotted using a bar graph. The Chi-square and the Fisher exact tests were used to compare differences in the proportion of the type of employment status—permanent and temporary - and hierarchal positions held by men and women.

The ratio of the number of female versus male physicians, femininity index, and relation to the grade of PC was represented by a bar graph. A Chi-square test was used to determine trends related to hierarchal positions and grade of PC over the study period. A time series analysis was not used because the number of years studied - or periods - was small. A Chi-square was used for linear trend in order to study the increase in the number of women physicians for each degree of promotion during the study period..

The study was made up of physicians, women and men.


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Professionals beginning work from and were also included, raising the number of physicians studied to , women and men at the end of the study period in Thus, the ratio of the femininity index among the trainees was from 1. Child psychiatry and anaesthesia were feminised specialties. Dermatology and laboratory clinical chemistry, microbiology, pathological anatomy, genetics and immunology specialties appeared to show gender parity.

In nine specialties, the mean ratio of the femininity index was less than 0. Femininity index - ratio between the number of women and men - in permanent medical positions in the specialties throughout the study period.. Including pharmacology and international health research.. Including infectious diseases, autoimmune diseases and critical care medicine.. Including Cardio-vascular, oral, and plastic surgery.. The ratios between the numbers of women versus men among permanent medical positions were around 0. According to data from , this ratio slightly rose to 0.

Femininity index according to the hierarchal position throughout the years of the study.. Among the doctors with hierarchal positions section or unit chief, department and institute chairs , the proportion of women was 8. The difference in age of institute and department chairs was Promotion for women in comparison with men physicians under the PC system followed a different pathway throughout the study. Male physicians developed homogeneous progression through the 4 successive grades of PC with almost half of those applying for any grade of promotion achieving success, while significantly fewer women doctors attained the grade of consultant: The ratios between women versus men among permanent medical positions did not show equity for almost any of the grades of PC promotion.

However, in , the last year of the study, one-third of women Femininity index according to the grade of professional career promotion throughout the years of the study.. This study shows significant differences between women and men holding permanent medical positions.

Introduction

These differences progressively increase in relation to the grade of advancement over hierarchal promotion as well as over PC promotion. Therefore, when male physicians apply for promotion, female physicians have not yet obtained a permanent position, delaying the time for promotion compared to that of male physicians with similar years of professional experience.

Although the grade of PC promotion for women physicians slightly increased throughout the study, the results show that professional promotion is harder for women than for men in medicine, and add weight to earlier suggestions derived in a previous one-year study performed in two Catalan hospitals 9. The difference between women and men physicians in relation to PC promotion agrees with the growing gender gap in the starting salaries of physicians after adjustments for hours worked in internal medicine, paediatrics, family practice and emergency medicine 10, Some authors have pointed out that a gender role contributes to the trends in the popularity of specialties for women.

Academic achievement and the duration of medical studies could influence specialty preference Being female and having a parent in general practice was found to be positively associated with a preference for a career in general practice and paediatrics. Among first-year students and in those with no clerkship experience, female gender was positively associated with a preference for psychiatry.

In fact, the three specialties - primary care in family medicine, paediatrics, and psychiatry—are all related to higher importance on the perspective-taking scale of the empathy measure that is a female belief within the culture. Among students with clerkship experience and final-year students the duration of study was positively associated with a preference for a career in internal medicine. Surgical specialties continue to be chosen three times more frequently by men than by women doctors..

Personality factors had many indirect influences upon sex. A questionnaire conducted among British medical students was assessed by path analysis factors which could be grouped as four types of motivations - helping people, respect, science and indispensability- indicated the attraction of different aspects of medical practice Helping people was particularly related to agreeableness and interest in general practice, paediatrics, geriatric medicine, and with none of the specialities.

Respect was related to a surface approach to learning, and science being more open to experience and related to pathology. Indispensability was related to higher strategic learning scores, lower fantasy and stress scores and interest in surgery and acute medical specialties.

Therefore, feminization of the medical profession suggests the need for measures to stimulate the interest of female medical students in the surgical field in order to optimize human resources in the current health care systems.. The rapid increase of the number of female medical students in Spain over the past three decades is now being reflected by the growing proportions of women in all medical specialties Nonetheless, according to data from our hospital, most medical specialties still show a predominant number of men in comparison with women among the permanent specialist positions, with the difference in favour of men being even greater among higher hierarchal positions..

It has been suggested that the slower career progression of women compared with their male colleagues is a cohort effect; therefore women will increasingly assume leadership roles as they mature in the medical establishment. The analysis of our data in , the last year of this study, showed that one-third of women compared to men physicians reached the grade of senior consultant, the top level of the PC.. One may argue that the significant lack of equity shown by our data imply that women have a lower level of training than men in hospital medicine.

A lack of high profile academic due to lesser scientific output 17—19 could be the reason why fewer women reach the highest positions of leadership. Women physicians tend to be more careful than men in addressing emotional issues and assessing the socio-cultural aspects that go beyond objective pathology; they spend more time on care and the promotion of a good relationship with their patients Therefore, women may spend less time on research than men due to the conflict in the priority of their dedication to the patient for their professional satisfaction.

Thus, gender could play a role in curricular evaluation because the rules and merits helping men progress may not be as appealing or even feasible for women.. In the recent survey among Catalan general practitioners a formal hierarchal position was held by It is of note that women accounted for 8 points more than men, Differences in gender values and ambitions have been suggested as reasons why fewer women than men reach the highest levels of medical positions. The predominant responsibility for child care is still borne by women and the issue of balancing career and family seems to be of paramount importance for women physicians in Europe 22, The reason why fewer women reach the echelons of formal medical hierarchy may be due to their resignation because they do not want to assume such roles, but hardly explains the weak progress of recognition under the PC system shown by our results.

Gender roles contribute to unconscious assumptions that have little to do with the actual knowledge and abilities of an individual and negatively influence decision-making when it comes to promotion.. Undoubtedly women in medicine have forged new pathways to allow physicians to balance career and family responsibilities.

Medical centres have accommodated the needs of their workforce and adjusted policies to allow women to work part time. But time-to-tenure rules and family indicate that a balance between work and life must be applied to both sexes in order to promote equality of opportunity between men and women and that not penalise women in this career..

Our study had some limitations.

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This was conducted in one workplace and thus generalizability of the results must be cautious. We cannot exclude the possibility that a proportion of women have left the competition. Further determination of the underlying factors for the differences observed between women and men in advanced medical positions are required. Nonetheless, our study has the strength of being the first to obtain and analyse data about the advances achieved in the careers of female physicians over a period of 13 years..

In a meta-analysis Eagly 24 emphasized the ability of women encouraging leadership. Women tend to demonstrate more interest than men in the personal difficulties of team members beyond the strictly occupational, which is useful to avoid interference in the workplace.

Differences in work and opportunities, hierarchical and institutional support, lack of female mentor models and institutional gender bias may contribute to the slow career progression and limited visibility of medical women with respect to their male colleagues. Scarcity of women in senior positions inevitably means that their individual and collective opinions are less likely to be voiced in decision-making processes.

If women in medicine are not seen to be succeeding in their careers, young women will not be motivated to achieve top careers. It has been demonstrated that political and government initiatives alone are not sufficient to advance the position of women in medicine 26— Strategies to address gender inequality must arise from the institution: attitudes of the managers, visible commitment, provision of support during and on return from maternity leave, and, finally, encouraging women to apply for appointments and promotions.. Gender equality has an impact on the way hospital medicine follows the feminization of medicine because gender barriers are no longer accepted by women as easily as prior to the 21st century.

The full potential of the increasing number of women physicians will not be achieved without continuing efforts to improve the ways in which they are educated and trained in becoming specialists and the mentoring women receive. The feminization of medicine will involve a continuous renewal of the health system that should be foreseen in human resources policies..

Carmen Vives- Cases. What is known about the topic?


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There is little knowledge on the advancement of women physicians in their careers due to reluctance to provide such data.. Strategies to address gender inequality must arise from the institution.. Abellana designed the statistical analysis, collaborated in the interpretation of data with revision of the text throughout its preparation. Merino worked on the selection of the results for publication with intellectual contributions. Ascaso provided the definition and usage of the femininity index, collaborated as statistical consultant and in the discussion of the results, and did the critical revision of the manuscript.

All the authors have approved the final version of the manuscript.. June 14, Gaceta Sanitaria. ISSN: Gender inequalities in the medical profession: are there still barriers to women physicians in the 21st century?. Descargar PDF. Pilar Arrizabalaga a , b ,. Autor para correspondencia. Under a Creative Commons license. Table 1. Table 2. Aim To analyze women's advancement compared with that of men and to determine whether advancement in hierarchical status differs from advancement in the professional recognition achieved by women from to We analyzed data on temporary and permanent positions, hierarchy, promotions, specialty, age, and sex among the participants.

Results The female-to male ratio among trainee medical specialists was higher than 1 throughout the study period. The full potential of the increasing number of women physicians will not be reached without continuing efforts to improve the hospital medicine environment. Palabras clave:. Texto completo. Introduction The presence of women in the practice of medicine goes back to the ancient times. In Spain women did not have access to higher education until the 20th century, and full incorporation into the medicine began in the s with their incorporation into the world of work.

In Spain, the advance of women physicians in their careers is unknown due to reluctance to provide such data. The structure and medical organization of the HCB has been reported previously 9. We analyzed the disparity between women and men physicians along the formal hierarchal promotion process and the recognition of professional career promotion in the 21st century. Methods A retrospective longitudinal descriptive study was designed. Calculation of the sample size was not done since the sample size was the total number of physicians.

Variables The two main variables studied were the hierarchical status and the grade of professional career. The following variables were studied: permanent, temporary and training medical positions and data related to medical executive management hierarchy and professional career PC promotion within the permanent positions.

Regarding the category of executive management hierarchy, data on the section or unit chief, department and institute chairs; grade attained on PC promotion: specialist, senior specialist, consultant and senior consultant; specialty, sex and age from to were collected. According the femininity index in each specialty, we classified the specialties into three groups: i feminised specialties, if the relationship was more than 1; ii parity specialties, if the relationship was 1; iii and masculinised specialties, if the relationship was less than 1. Statistical analysis The demographic characteristics of the medical workforce by year of study were expressed as absolute frequencies.

A Chi-square was used for linear trend in order to study the increase in the number of women physicians for each degree of promotion during the study period. Results The study was made up of physicians, women and men. Permanent versus temporary positions. Femininity index - ratio between the number of women and men - in permanent medical positions in the specialties throughout the study period. Including pharmacology and international health research.

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