Chairs still elude female medics

Lack of progress to top posts stirs talk of positive discrimination for women. Melanie Newman investigates

Female academics are still underrepresented in the top medical posts, according to the British Medical Association's Good Employment Practice Guide .

At Oxford University's Medical School, for example, the ratio of male to female clinical academics is 85 to 15. The guide revealed that out of 40 clinical academic professors in the department, there are no women.

"I have applied twice for a chair and been turned down, yet have seen male clinical academics with shorter CVs get personal chairs," said one female clinical academic at Oxford, who wished to remain anonymous. "It is a problem. Women coming up the ranks have no role models in academic medicine."

An Oxford University spokeswoman said the numbers involved were "complex": titular professors were not submitted to the BMA and the school does have two female clinical professors (in dermatology and cardiology), who were not included in the BMA figures.

But she said: "The university is acutely conscious that in certain areas and at certain levels women are very much in the minority."

Oxford has set up a personal development programme, Springboard, designed to boost female representation in senior university roles. Research for the programme found there was no discrimination against women in the selection process, but that females were much less likely to apply for senior jobs.

One female medical academic at Oxford said she believed the problem was not direct discrimination but that the predominance of "men who have spent so little time with their children they have no concept of what is involved" resulted in a culture of academic life that was "incompatible with normality".

"Men in Oxford do not see themselves as responsible for home life," she said. Promotion for women would entail "too many demands, not enough time and no support". "Women are not prepared to wing it as men do. Confidence on returning to work is a major issue," she added.

Oxford is not alone in its gender imbalance among medical academics who carry out clinical work for the NHS as well as research for universities, and are employed under joint contracts.

The BMA guide revealed that Nottingham University's Medical School has is a male-female clinical academic staff ratio of 75 to 25, with just two female clinical professors out of a total of 56.

"I suspect there is a subtle, unconscious discrimination here," one of Nottingham's female academics said. "I do not know anybody who feels discriminated against, but some do feel that life is perhaps made easier for their male colleagues. There are role models for trainees and students (in the department) but more female chairs would be better."

A Nottingham spokesman said: "Over the past three years, equal proportions of applications from women and men have been appointed to clinical academic roles." As at Oxford, however, he said "fewer women choose to apply". He added that benchmarking undertaken as part of the university's Gender Equality Scheme suggested the school was "in line with the national picture in terms of female employment in this professorial field".

According to the Medical Schools Council, 11 per cent of professorial staff in the UK's medical schools are women, compared with 16.5 per cent across academia as a whole. In 2006, six schools had no female clinical professors in post. This imbalance is not unique to medicine, but the fact that 61 per cent of newly qualified doctors are female, while numbers of both sexes entering academic medicine are in decline, has made it a matter of serious concern to the MSC.

Last week's MSC report, Women in Clinical Academia , noted that while numbers of women in senior positions were slowly increasing, at the current rate of change it would take many years to correct the cumulative deficit, which was "unacceptable".

In her foreword to the report, Baroness Ilora Finlay of Llandaff, a professor of palliative medicine and president of the Royal Society of Medicine, warned that unless women could be attracted to academic careers, the teachers of the next generation of medical students would simply not exist.

"A lack of women at the highest levels in higher education institutions engenders a fundamental underuse of talent and a lack of motivation among women working at less senior academic grades," the report said. "This has a negative impact on the productivity of the workforce."

Students are also affected. One was cited in the report saying: "I am always really impressed when I see a professor with a woman's name. I'm sorry, but it is so unusual."

The MSC believes the time may have come for quotas or targets to be introduced. The European Union has had targets for women's representation in science since 2001. "Though it has been argued that this approach will worsen the situation by fostering resentment against women, it is also plausible that it will improve matters by breaking down patterns of behaviour that perpetuate discrimination," the report said.

Bhupinder Sandhu, former president of the Medical Women's Federation and a professor of paediatric gastroenterology at the University of the West of England, wants the MSC to set its own target for medical schools. "It's not as though there is a shortage of capable females," she said.

Positive discrimination is a tricky issue, as Equal Opportunities Commissioner Sue Ashtiany told delegates at the MSC's conference last week.

While public sector bodies such as universities now have a legal duty to promote gender equality, she reminded delegates that it is illegal to make appointments on the basis of gender. "On the Continent, it is permitted to appoint on the basis of gender provided the candidates are equal in all other aspects and there is an identified inequality," she said.

The Discrimination Law Review Green Paper is looking at ways to expand employers' ability to take positive action.

The MSC wants medical schools to make academic careers more attractive to women by providing the means for them to work flexibly. Speaking to the conference, Dame Carol Black, president of the Academy of Medical Royal Colleges, referred to a 2006 survey of medical registrars that found a third of women had definite aspirations to work part-time, as did 18 per cent of men.

The MSC also wants medical schools to set up mentoring schemes, like the one at Queen's University, Belfast.

melanie.newman@thes.co.uk

• 'The main difficulty I have is there are very few female colleagues in my particular branch of academia, and it would be nice to have a bit of mentoring by a female. Women work in a very different way from men, and are less (overtly) aggressive and ambitious, so I have often been accused of "lacking focus".'
  
  Sarah Blagden, clinical senior lecturer, Imperial College London
  
• 'I moved institutions when I was in the middle ranks because I was warned by more senior women that it would take for ever to get a chair. Women there tended to get into an administrative rut, leaving them little time for research.'
  
  Anonymous female professor
  
• 'I have always heard rumours that I am sleeping with every boss I have ever worked for, which is a compliment in some regards but implies that I do not have the nous to get to where I have without employing such dastardly strategies.'
  
  Anonymous, South-east Russell Group university
  
• 'I don't feel that as a woman I've experienced discrimination, it's the need to go part-time that has been a problem - and in my speciality that doesn't just affect women. While my department has been very supportive, the demands of the RAE aren't tailored to part-timers.'
  
  Claudia Estcourt, senior lecturer in sexual health and HIV, Queen Mary's School of Medicine and Dentistry