Obstetrics and gynaecology and politics of the sexes. 23rd of October, 2018 ANTE·MERIDIEM 01:28
Professor Chris Fitzpatrick of the Coombe (one of the major Dublin maternity hospitals) just had a piece published by the Irish Times on the energetic condemnation of men involved in the CervicalCheck scandal and his discomfort with it, as a male obstetrician and gynaecologist. It’s a cry from his heart, not particularly well-sourced, and that’s fine, he’s not publishing an academic paper, he’s trying to change hearts more than minds.
I posted some of the below on the comments on the Irish Times site and prefer to re-post it here: of course, it’s not in the interest of women to have the male half of medical students rule out obstetrics and gynaecology as a career choice, especially when female doctors and medical students already disproportionately choose those specialties with a good work/life balance. Obstetrics and gynaecology is not, and can never be, absent a 90% elective Caesarean section rate, a specialty with a good work/life balance, particularly in the training years. The ideal thing for women in general would be to have all medical students and junior doctors interested in general surgery (which equally has a terrible work/life balance) conflicted about that vs. obstetrics and gynaecology, something very different from how things are now.
To be clear, I have no issue with doctors choosing speciality based on work-life balance; someone has to do the more agreeable jobs, and that generally leaves plenty of work for the rest of us, and I like my job, I get paid well for it.
Most working doctors won’t particularly disagree with me on sex and speciality choice with regard to work-life balance, but for any lay readers, let me support my comment with data. The Canadian figures on speciality by sex (I don’t see any Irish figures published, but there’s no particular reason to think there would be a massive proportional difference) are oriented by proportion of doctors working; it is more useful for my purposes to break them down by percentage of each sex working. The below is calculated from a subset of the table, ordered roughly by best work/life balance to worst work/life balance.
| Speciality | % of working female doctors in that specialty | % of working male doctors in that specialty | Relative likelihood of a female doctor working in that speciality vs. a male doctor working in that specialty | Comments |
|---|---|---|---|---|
| Medical Genetics | 0.1% | 0.008% | 2.38 | 09:00–17:00, Monday to Friday |
| Rheumatology | 0.7% | 0.4% | 1.64 | One very rare wake-me-up-in-the-middle-of-the-night emergency |
| Dermatology | 0.8% | 0.6% | 1.39 | Almost no emergencies |
| Haematology | 0.6% | 0.5% | 1.29 | Emergencies almost always handled over the phone |
| Urology | 0.2% | 0.9% | 0.23 | A really undervalued specialty when it comes to work/life balance |
| General practice | 56% | 48% | 1.17 | As I understand Canada versus .ie, these figures would underestimate how agreeable GP is here in its work/life balance. |
| Cardiothoracic surgery | 0.03% | 0.2% | 0.17 | Actually more comparable to urology in work/life balance, but the path to get there involves general surgery, which see |
| Emergency Medicine | 0.8% | 1.3% | 0.6 | |
| General Surgery | 1.4% | 2.8% | 0.51 | Loads of competition, ridiculous hours while training, minimal opportunity at the end (general medicine is eating the specialty’s lunch from one end, interventional radiology from the other) |
| Obstetrics and Gynaecology | 3.5% | 1.7% | 2.04 | This figure is very very different from General Surgery, see above. |
I have excluded anything paediatric from the table, because, well, a) the paediatrics specialities throw off the correlation massively and b) it is super-routine to come across doctors of either sex who went into the speciality because they liked children, when the speciality involves in massive part sticking needles into various parts of children who are really not on-board with the idea, and in lesser part WATCHING CHILDREN [you can’t cure] DIE, which is something you should not volunteer for if you like children. I have also excluded the laboratory medicine specialists, because I know nothing constructive about their work/life balance, beyond assuming it’s good.
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