Sex change for medicine

The heroic story of women's entry into the medical profession has often been told. But then what went wrong? Since storming the citadel a century ago, female practitioners never escaped playing a subaltern part - to this day they comprise but a tiny fraction of prestigious specialties like surgery and cardiology and are prominent only in low-grade fields like geriatrics.

And, at least in the eyes of radical feminists, they form an equivocal breed, having to play the "honorary male" role and thereby, like it or not, sacrifice gender loyalties for acceptance in a profession that has been a prop to patriarchy if not downright misogynistic. It is these problems that are addressed by Rosemary Pringle, professor of women's studies at Griffith University, in her inquiry into medical women in Britain and Australia - a comparative study deploying a historical perspective but centred upon a solid basis of interviews.

Pringle's aim is to demythologise - or at least to show that the old conspiracy theories no longer apply and that some of the gender wars are actually drawing to a close. She correctly insists, of course, that discrimination and "old boy" prejudices still thwart female careers: many of her informants spoke bitterly of sexist sneers or job interviews that juddered to a halt after a positive response to the question: "Do you intend to have children?" Neither does she make light of the dreadful strains forced upon female doctors, notably the ludicrously long working hours. Even for successful women, identity conflicts have been severe, and several found it all too much. "Medicine is one big career of loss," one interviewee told her. "You lose your youth. You lose your vitality. You lose your vibrancy... I just don't know if I want to sacrifice my entire life to the God of medicine."

Pringle's message is nonetheless upbeat: things are truly changing. Above all, more and more women are entering medical school - over half of today's recruits in Britain are female. And slowly but surely women are making their presence felt - for instance, in respect of working arrangements. Particularly in Australia, where funded women's health centres and the insurance system make for greater flexibility, women have been opting for permanent part-time posts - a shift with tremendous potential for the restructuring of careers throughout the profession. Moreover, with today's consumer ethos, women doctors are in demand, being regarded as more "caring". Meanwhile the mere presence of more women is making them feel less like permanent misfits and so modifying medicine's ethos. In the next decades, Pringle predicts, medicine will surely grow less masculine.

This admirable study is informed by a theoretical underpinning, but its real strength lies in its fresh research, its feel for the pulse of the present, its crisp prose, and Pringle's bold refusal to bow to the old cliches. Sex and Medicine is essential reading for anyone concerned with where the medical profession is going.

Roy Porter is professor in the social history of medicine, Wellcome Institute.