Women in medicine - Is there a problem? A literature review of the changing gender composition, structures and occupational cultures in medicine

Medical Education

Volumn 41, Issue 1, 2007, Pages 39-49

  Kilminster, Sue ^a   Downes, Julia ^a   Gough, Brendan ^a   Murdoch Eaton, Deborah ^a   Roberts, Trudie ^a  

^a UNIVERSITY OF LEEDS   (United Kingdom)

Author keywords

*culture; Attitude of health personnel; Clinical competence *standards; Communication; Educational status; Health manpower *organisation and administration; Motivation; Physician patient relations; Physicians, women *trends

Indexed keywords

ACADEMIC ACHIEVEMENT; DOCTOR PATIENT RELATION; ECONOMIC ASPECT; EXPERIENCE; FEMALE; HEALTH CARE DELIVERY; HEALTH PERSONNEL ATTITUDE; HUMAN; INTERPERSONAL COMMUNICATION; MEDICAL EDUCATION; MEDICAL PROFESSION; METHODOLOGY; MOTIVATION; OCCUPATION; ORGANIZATION; PATIENT ATTITUDE; PHYSICIAN; PROFESSIONAL COMPETENCE; REVIEW; SEX DIFFERENCE; SEX RATIO; SKILL; SOCIAL ASPECT;

ATTITUDE OF HEALTH PERSONNEL; CLINICAL COMPETENCE; COMMUNICATION; CULTURE; EDUCATIONAL STATUS; FEMALE; FORECASTING; HEALTH MANPOWER; HUMANS; MOTIVATION; PATIENT SATISFACTION; PHYSICIAN-PATIENT RELATIONS; PHYSICIANS, WOMEN;

EID: 33845756708     PISSN: 03080110     EISSN: 13652923     Source Type: Journal    
DOI: 10.1111/j.1365-2929.2006.02645.x     Document Type: Review

References (120)

1. Brundtland GH. The woman physician in the year 2000. J Am Med Women Assoc 2000;51 (1):3-19.
2. de Koninck M, Bergeron P, Bourbonnais R. Women physicians in Quebec. Soc Sci Med 1997;44:1825-32.
3. Gjerberg E. Medical women - towards full integration? An analysis of the specialty choices made by two cohorts of Norwegian doctors. Soc Sci Med 2001;52:331-43.
4. Hojat M, Gonnella JS, Xu G. Gender comparisons of young physicians' perceptions of their medical education, professional life, and practice: a follow-up study of Jefferson Medical College graduates. Acad Med 1995;70 (4):305-12.
5. Hojat M, Gonnella JS, Erdmann JB et al. Gender comparisons of income expectations in the USA at the beginning of medical school during the past 28 years. Soc Sci Med 2000;50 (1665):1972.
6. Hojat M, Gonnella JS, Erdmann JB et al. Physicians' perceptions of the changing health care system: comparisons by gender and specialties. J Commun Health 2000;25 (6):455-71.
7. Heiligers PJM, Hingstman L. Career preferences and the work-family balance in medicine: gender differences among medical specialists. Soc Sci Med 2000;50:1235-46.
8. Redman S, Saltman D, Straton J, Young B, Paul C. Determinants of career choices among women and men medical students and interns. Med Educ 1994;28 (361):371.
9. Riska E. Towards gender balance: but will women physicians have an impact on medicine? Soc Sci Med 2001;52 (179):187.
10. Williams AP. Changing the palace guard: analysing the impact of women's entry into medicine. Gender Work Org 1999;6 (2):106-19.
11. Zimmerman MK, Hill SA. Reforming gendered health care : an assessment of change. Int J Nurs Stud 2000;30 (4):771-95.
12. Department of Health. Hospital, Public Health Medicine and Community Health Services Medical and Dental Staff in England: 1993-2003. London: HMSO 2004.
13. Department of Health. Statistics for General Medical Practitioners in England: 1993-2003. London: HMSO 2004.
14. John Hamilton. Women are from X; men are from Y. Med Educ 2003;37 (12):1068-70.
15. Lyon DS. Where have all the young men gone? Keeping men in obstetrics and gynecology. Obstet Gynecol 1997;90:634-6.
16. Lyon DS. Graduate education in women's health care: where have all the young men gone? Curr Women Health Rep 2002;2:170-4.
17. Whitcomb ME. The future of academic medicine has begun. Acad Med 2004;79 (4):281-2.
18. Williams AP, Woodward CA, Ferrier B, Cohen M. Cohort, gender and practice organization: examining the bounds of collaborative medicine among newly established female and male family physicians in Ontario. Health Serv Manage Res 1997;10:121-31.
19. Laurance J. The medical timebomb: too many women doctors. Independent, 2 August 2004.
20. Van der Reis L. Causes and effects of a changed gender ratio in medicine. Med Teacher 2004;26 (6):506-9.
21. Ramsbottom-Lucier M, Johnson MM, Elam CL. Age and gender differences in students' preadmission qualifications and medical school performances. Acad Med 1995;70 (3):236-9.
22. Cooper RA. Impact of trends in primary, secondary, and postsecondary education on applications to medical school. I. Gender considerations. Acad Med 2003;78 (9):855-63.
23. Bedi R, Gilthorpe MS. Ethnic and gender variations in university applicants to United Kingdom medical and dental schools. Br Dental J 2000;189 (4):212-5.
24. Kruijthof CJ, Van Leeuwen CD, Ventevogel P, Van Der Horst HE, Van Staveren G. Career perspectives of women and men medical students. Med Educ 1992;26:21-6.
25. Neittaanmaki L, Gross EB, Virjo I, Hyppola H, Kumpusalo E. Personal values of male and female doctors: gender aspects. Soc Sci Med 1999;48:559-68.
26. Vaglum, Wiers J, Ekeberg. Motivation for medical school: the relationship to gender and specialty preferences in a nationwide sample. Med Educ 1999;33 (4):236-42.
27. Xu G, Rattner SL, Veloski JJ, Hojat M, Fields SK, Barzansky B. A national study of the factors influencing men and women physicians' choices of primary care specialties. Acad Med 1995;70 (5):398-404.
28. Gross EB. Gender differences in physician stress. J Am Med Women Assoc 1992;47:107-25.
29. Jones BJ, Arnold L, Xu G, Epstein LC. Differences in the preparation and practice of male and female physicians from combined baccalaureate MD degree programs. J Am Med Women Assoc 2000;55:29-31.
30. Donaldson G. Dr. Mom: when the hand that rocks the cradle wields a scalpel. The Medical Post, National Survey Issue 1993; 64-70.
31. Stamps PL, Boley Cruz NT. Issues in Physician Satisfaction: New Perspectives. Ann Arbour, MI: Health Administration Press 1994.
32. Cooke L, Hutchinson M. Doctors' professional values. results from a cohort study of United Kingdom medical graduates. Med Educ 2001;35:735-42.
33. Searle J. Women and medicine - a new paradigm. Med Educ 2001;35 (8):718-9.
34. Hojat M, Nasca TJ, Cohen MJM et al. Attitudes toward physician-nurse collaboration: a cross-cultural study of male and female physicians and nurses in the United States and Mexico. Nurs Res 2001;50 (2):123-8.
35. Todisco J, Hayes S, Farnill D. Career motivations of male and female medical students. Psychol Reps 1995;77:1199-202.
36. Odborg MH, Eriksen TR, Petersson BH. The effect of gender on the physician's role. Attitudes and expectations of medical studetns examined by a questionnaire at the start of their studies. Ugeskr-Lager 1995;157:4942-6.
37. Abu-Saad I, Isralowitz RE. Gender as a determinant of work values among university students in Israel. J Soc Psychol 1997;137 (6):749-63.
38. Morinaga Y, Frieze IH, Ferligoj A. Career plans and gender-role attitudes of college students in the United States, Japan and Slovenia. Sex Roles 1993;29:317-34.
39. Bellas PA, Asch SM, Wilkes M. What students bring to medical school: attitudes to health promotion and prevention. Am J Prev Med 2000;18 (3):242-8.
40. Henderson JT, Weisman CS. Physician gender effects on preventatative screening and counselling. An analysis of male and female patients' health care experiences. Med Care 2001;39:1281-92.
41. Tervo RC, Azuma S, Palmer G, Redinius P. Medical students' attitudes toward persons with disability: a comparative study. Arch Phys Med Rehab 2002;83:1537-42.
42. Haidet P, Dains JE, Paterniti DA et al. Medical student attitudes toward the doctor-patient relationship. Med Educ 2002;36 (6):568-74.
43. Crandall SJ, Volk RJ, Loemker V. Medical students' attitudes toward providing care for the underserved. Are we training socially responsible physicians? JAMA 1993;269 (19):2519-23.
44. Kaufman DM, Laidlaw TA, Langille D, Sargeant J, MacLeod H. Differences in medical students' attitudes and self-efficacy regarding patient-doctor communication. Acad Med 2001;76 (2):188.
45. Crandall SJS, Volk RJ, Cacy D. A longitudinal investigation of medical student attitudes toward the medically indigent. Teach Learn Med 1997;9:254-60.
46. Buddeberg-Fischer B, Klaghofer R, Abel T, Buddeberg C. The influence of gender and personality traits in the career planning of Swiss medical students. Swiss Med Weekly 2003;133:535-40.
47. Dufort F, Maheux B. When female medical students are the majority: do numbers really make a difference? J Am Med Women Assoc 1995;50 (1):4-6.
48. Woloschuk W, Harasym PH, Temple W. Attitude change during medical school: a cohort study. Med Educ 2004;38 (5):522-34.
49. Batenburg V, Smal JA, Lodder A, Melker RA. Are professional attitudes related to gender and medical specialty? Med Educ 1999;33 (7):489-92.
50. Colliver JA, Marcy ML, Travis TA, Robbs RS. The interaction of student gender and standardized-patient gender on a performance-based examination of clinical competencies. Acad Med 1991;66:S31-3.
51. Alexander GL, Davis WK, Yahn AC. Following medical school graduates into practice. Acad Med 2000;75:S15-S17.
52. Case SM, Swanson DB, Ripkley DR, Bowles LT, Melnick DE. Performance of the class of 1994 in the new era of USMLE. Acad Med 1996;71:S91-S93.
53. Fabrega HJ, Ulrich R, Keshavan M. Gender differences in how medical students learn to rate psychopathology. J Nerv Mental Dis 1994;182:471-5.
54. Omigbodun OO, Omigbodun AO. Influence of gender on undergraduate performance in psychiatry at Ibadan. Nigeria Med Educ 2003;37 (12):1091-3.
55. Krueger PM. Do women medical students outperform men in obstetrics and gynecology? Acad Med 1998;73 (1):101-2.
56. Haist SA, Witzke KB, Quinlivan S, Murphy-Spencer A, Wilson JF. Clinical skills as demonstrated by a comprehensive clinical performance examination: who performs better - men or women? Adv Health Sci Educ 2003;8:189-99.
57. McDonough H, Codd C. Gender differences in the results of the final medical examination at University College Dublin. Med Educ 2000;34 (1):30-4.
58. Wang-Cheng RM, Fulkerson PK, Barnas GP, Lawrence SL. Effect of student and preceptor gender on clinical grades in an ambulatory care clerkship. Acad Med 1995;70 (4):324-6.
59. Linn BS, Zeppa R. Sex and ethnicity in surgical clerkship performance. J Med Educ 1980;55:513-20.
60. Emmons SL, Adams KE, Nichols M, Cain J. The impact of perceived gender bias on obstetrics and gynecology skills acquisition by third-year medical students. Acad Med 2004;79 (4):326-32.
61. Sharp LK, Wang R, Lipsky MS. Perception of competency to perform procedures and future practice intent: a national survey of family practice residents. Acad Med 2003;78 (9):926-32.
62. Levy BT, Merchant ML. Differences in clinical experiences based on gender of third-year medical students in a required family medicine preceptorship. Acad Med 2002;77 (12):1241-6.
63. Hicks CM, Gonzales R, Morton MT, Gibbons RV, Wigton RS, Anderson RJ. Procedural experience and comfort level in internal medicine trainees. J Gen Intern Med 2000;15:716-22.
64. Falck G, Bratteboy G. Skills or pre-registered house officers: gender differences reported in Norway. Med Educ 997;31:188-9.
65. Nore AK. From Crafty Girl to Enthusiastic Surgeon. A Qualitative Study of Women Surgeons in Norway. Administrative Centre for Health Special Project. Olso: University of Oslo 2005.
66. Foster SW, McMurray JE, Linzer M, Leavitt JW, Rosenberg M, Carnes M. Results of a gender-climate and work-environment survey at a midwestern academic health center. Acad Med 2000;75 (6):653-60.
67. Clack GB. Gender differences in medical graduates' assessment of personal attributes. Med Educ 1999;33:101-5.
68. Clance PR, O'Toole MA. The imposter phenomenon: an internal barrier to empowerment and achievement. Women Ther 1988;6:51-64.
69. Whittle SR, Murdoch Eaton DG. Attitudes towards transferable skills in medical undergraduates. Med Educ 2001;35 (2):148-53.
70. West C. When the doctor is a 'lady'. Power, status and gender in physician-patient encounters. Symbol Interact 1984;7:87-106.
71. West C. Reconceptualizing gender in physician-patient relationships. Soc Sci Med 1993;36:57-66.
72. Meeuwesen L, Schaap C, van der Staak. Verbal analysis of doctor-patient communication. Soc Sci Med 1991;32:1143-50.
73. Hall JA, Roter DL. Do patients talk differently to male and female physicians? A meta-analytic review. Patient Educ Counsel 2002;48:217-24.
74. Hall JA. Non Verbal Sex Differences: Communication Accuracy and Expressive Style. Baltimore: Johns Hopkins University Press 1984.
75. Hall JA, Irish JT, Roter DL, Ehrlich CM, Miller L. Gender in medical encounters: an analysis of physician and patient communication in a primary care setting. Health Psychol 1994;13 (5):384-92.
76. Bertakis KD, Helms LJ, Callahan EJ, Azari R, Robbins JA. The influence of gender on physician practice style. Med Care 1995;33 (4):407-16.
77. Roter DL, Hall JA. Why physicians gender matters in shaping the physician-patient relationship. J Women Health 1998;7:1093-7.
78. Roter DL, Geller G, Bernhardt B, Larson SM, Doksum T. Effects of obstetrician gender on communication and patient satisfaction. Obstet Gynecol 1999;93:635-41.
79. Roter DL, Hall JA, Aoki Y. Physician gender effects in medical communication: a meta-analytic review. JAMA 2002;288 (6):756-64.
80. Roter DL, Lipkin M, Korsgaard A. Sex differences in patients' and physicians' communication during primary care medical visits. Med Care 1991;29:1083-93.
81. Ong LML, de Haes JCJM, Hoos AM, Lammes FB. Doctor-patient communication: a review of the literature. Soc Sci Med 1995;40:903-18.
82. Chrisler JC. Gendered bodies and physical health 2001.
83. Uskul AK, Ahmad F. Physician-patient interaction: a gynecology clinic in Turkey. Soc Sci Med 2003;57:205-15.
84. Bensing JM, Van den Brink-Muinen A, De Bakker DH. Gender differences in practice style: a Dutch study of general practitioners. Med Care 1993;31 (3):219-29.
85. van Dulmen AM. Communication during gynecological out-patient encounters. J Psychosom Obstet Gynecol 1999;20:119-26.
86. van Dulmen AM, Bensing JM. Gender difference in gynaecologist communication. Women Health 2000;30:49-61.
87. Skelton JR, Hobbs FDR. Descriptive study of cooperative language in primary care consultations by male and female doctors. BMJ 1999;318 (7183):576-9.
88. Irish JT, Hall JA. Interruptive patterns in medical visits: the effects of role, status and gender. Soc Sci Med 1995;41 (6):873-81.
89. Martin SC, Arnold RM, Parker RM. Gender and medical socialization. J Health Soc Behav 1988;29:333.
90. Pringle R. Sex and Medicine: Gender, Power and Authority in the Medical Profession. Cambridge: Cambridge University Press 1998.
91. Brooks F. Women in general practice: responding to the sexual division of labour? Soc Sci Med 1998;47:181-93.
92. Aruguete MS, Roberts CA. Gender, affiliation and control in physician-patient encounters. Sex Roles 2000;42 (1/2):107-18.
93. Andersson SJ, Londberg G, Troein M. What shapes GPs work with depressed patients? A qualitative interview study. Fam Pract 2002;19 (6):623-31.
94. Smith RC, Marshall-Dorsey AA, Osborn GG et al. Evidence-based guidelines for teaching patient-centred interviewing. Patient Educ Counsel 2000;39:27-36.
95. Fallowfield L, Jenkins V, Farewell V, Saul J, Duffy A, Eves R. Efficacy of a cancer research UK communication skills training model for oncologists: a randomised controlled trial. Lancet 2002;359:650-6.
96. van der Brink-Muinen A, Bensing JM, Kerssens JJ. Gender and communication style in general practice. Differences between women's health care and regular health care. Med Care 1998;36 (1):100-6.
97. Fennema K, Meyer DL, Owen N. Sex of physician: patients preferences and stereotypes. J Fam Pract 1990;30:441-6.
98. Elstad J. Women's priorities regarding physician behaviour and their preference for a female physician. Women Health 1994;21:1-9.
99. Ahmad F, Gupta H, Rawlins J, Stewart DE. Preferences for gender of physician among Canadian European-descent and South-Asian immigrant women. Fam Pract 2002;19:146-53.
100. Kerssens JJ, Bensing JM, Andela MG. Patient preference for gender of health professionals. Soc Sci Med 1997;44:1531-40.
101. O'Flynn N, Rymer J, Wass V. Women's attitudes to the sex of medical students in a gynaecology clinic: cross sectional survey Patients as partners in medical education [Commentary]. BMJ 2002;325 (7366):683-4.
102. Rizk DEE, Al-Shebah A, El-Zubeir MA, Thomas LB, Hassan MY, Ezimokhai M. Women's perceptions of and experiences with medical student involvement in outpatient obstetric and gynaecologic care in the United Arab Emirates. Am J Obstet Gynecol 2002;187:1091-100.
103. Lurie N, Margolis K, McGovern PG, Mink P. Physican self-report of comfort and skill in providing care to patients of the opposite sex. Arch Fam Med 1998;7:134-7.
104. van Elderen T, Maes S, Rouneau C, Seegers G. Perceived gender differences in physician consulting behaviour during internal examination. Fam Pract 1998;15 (2):147-52.
105. Lurie N. Preventative care for women: does sex of the physician matter? N Engl J Med 1993;329 (478):482.
106. Franks P, Clancy CM. Physician gender bias in clinical decision making: screening for cancer in primary care. Med Care 1993;31:213-8.
107. Henderson JT, Weisman CS. Myocardial infarction in women. Cardiology 2001;86:272-85.
108. Kreuter MW, Strecher VJ, Harris R, Kobrin SC, Skinner CS. Are patients of women physicians screened more aggressively? A prospective study of physician gender and screening. J Gen Intern Med 1995;10:119-25.
109. Majeroni BA, Karuza J, Wade C, McCreadie M, Calkins E. Gender of physicians and patients and preventive care for community-based older adults. J Am Board Fam Pract 1993;6 (4):359-65.
110. Rosen MP, Davis RB, Lesky LG. Utilization of outpatient diagnostic imaging. J Gen Intern Women's Health 1997;12:407.
111. Schmittdiel J. Effect of physician and patient gender concordance on patient satisfaction and preventative care practices. J Gen Intern Med 2000;15:761-9.
112. Riska E, Wegar K. The Medical Profession in the Nordic Countries: Medical Uncertainty and Gender-Based Work. London: Routledge 1995.
113. Sleath B, Chewning B, Svarstad B, Roter D. Patient expression of complaints and adherence problems with medications during chronic disease medical visit. J Soc Admin Pharm 2000;17:71-80.
114. Toews JA, Lockyer JM, Dobson DJ et al. Analysis of stress levels among medical students, residents, and graduate students at four Canadian schools of medicine. Acad Med 1997;72 (11):997-1002.
115. Frank E, Dingle AD. Self-reported depression and suicide attempts among US women physicians. Am J Psychiatry 1999;156:1887-94.
116. Hawton K, Clements A, Sakarovitch C, Simkin S, Deeks JJ. Suicide in doctors: a study of risk according to gender, seniority and speciality in medical practitioners in England and Wales. J Epidemiol Commun Health 2001;55:293-300.
117. Wall TD, Bolden RI, Borrilla CS et al. Minor psychiatric disorder in NHS trust staff: occupational and gender differences. Br J Psychiatry 1997;171:519-23.
118. Verberne TJP. Suicide in doctors. J Epidemiol Commun Health 2002;56:237 [Letter to Editor].
119. Gjerberg E, Kjolsrod L. The doctor-nurse relationship: how easy is it to be a female doctor co-operating with a female nurse. Soc Sci Med 2001;52:189-202.
120. Wear D, Keck-McNulty C. Attitudes of female nurses and female residents toward each other: a qualitative study in one U.S. teaching hospital. Acad Everyday Work World Law Soc Enquiry 2000;25 (4):1151-83.