Posts Tagged ‘Equality’

Female docs have made giant leaps for womankind

By Maham Khan - 3rd December 2011 10:05 pm

In the UK, women doctors are set to outnumber their male counterparts by 2017.

Some have dubbed the rise “bad for medicine” but an editorial in BMJ Student challenges this assumption.

Jane Dacre, Medical School Director at University College London, believes feminisation is a fact, but disagrees that medicine is becoming over-feminised and suggests that the rise of women doctors is bridging the gender divide. “I don’t think we have yet reached an era of feminisation. What we are doing is reaching equality,” she says.

Many studies show women dominate in specialties such as general practice, paediatrics, and palliative care, but some branches of medicine, such as cardiology and general surgery, remain closed or unattractive to women.

Neither are women reaching the highest positions and research shows that a gender pay gap still exists in medicine.

“Medicine is not a profession of gender equality,” says Anita Holdcroft, Emeritus Professor of anaesthesia at Imperial College. “Research shows women often feel uncomfortable in negotiations over pay. But yet they are doing the work. And the percentage of women who apply for clinical excellence awards is less than men.”

She suggests we need to think about how to overcome some of these gender barriers and enable women to “become visible”.

So, why are men becoming an endangered species in medicine?

Will Coppola, a senior lecturer at University College London, believes the problem starts at secondary school. “There is a serious problem with underachievement of boys at school,” he says, and goes on to suggest that medicine is becoming a less attractive career option for men for reasons such as loss of status, regulation and control, and decreased autonomy.

But is a female future bad practice?

Despite the fears propagated by the media, more women in the medical profession could lead to safer practice. A review of complaints received by the National Clinical Assessment Service (NCAS) shows women are less likely to be subject to disciplinary hearings.

Findings published in a report from the Equality and Human Rights Commission highlight the progress of women in medicine. With the report saying it will take women 55 years to reach equal status with men in the senior judiciary and 73 years for women directors in FTSE 100 companies, it seems in terms of numbers, female doctors have made giant leaps for womankind.

Tags:
Posted in Dr Blogs | No Comments »

Academic performance varies by ethnicity

By Mike Broad - 9th March 2011 10:14 am

UK trained doctors and medical students from minority ethnic groups tend to underperform academically compared with their white counterparts, research reveals.

The study concludes that this attainment gap has persisted for many years and must be tackled to ensure a fair and just method of training and assessing current and future doctors.

A third of all UK medical students and junior doctors are from minority ethnic groups. Although universities and the NHS are legally required to monitor the admission and progress of students and staff by ethnic group, evidence remains patchy.

So, researchers at University College London analysed the results of 22 reports comparing the academic performance of 23,742 medical students and UK trained doctors from different ethnic groups.

They found that candidates of non-white ethnicity underperformed compared with white candidates.

The effect was statistically significant and widespread across different medical schools, different types of exam (including those marked by machines), and in both undergraduate and postgraduate assessments.

Ethnic differences in attainment seem to be a consistent feature of medical education, say the authors. They have persisted for at least the past three decades and cannot be dismissed as atypical or local problems.

While exam performance is by no means the only marker of good performance as a doctor or medical student, they add, the fact remains that without passing finals, medical students cannot become doctors, and without passing postgraduate exams, it is much harder for doctors to progress in a medical career.

The authors call for more detailed information to track the problem as well as further research into its causes.

“Without these actions, it will be a struggle to ensure a fair and just method of training and assessing our future and current doctors,” they conclude.

“Such complex problems are unlikely to have simple solutions - what happens in medical schools is a reflection of wider society,” says Professor Aneez Esmail from the University of Manchester in accompanying editorial in the BMJ.

He believes the solutions will be found “through critically appraising assessment methods, curriculums, the way that we engage with students in an increasingly multicultural society, and the role models that we provide.”

Read the full study.

Tags: ,
Posted in Hospital Dr News | No Comments »

Female doctors facing maternity leave pressure

By Mike Broad - 24th November 2010 9:57 am

Female doctors are being pressurised into cutting their maternity leaves short and prevented from working part-time when they return, the president of the Medical Women’s Federation has warned.

Dr Clarissa Fabre says, in a letter to The Guardian, that staff shortages are to blame following cut backs.

The GP says: “Women doctors now make up 58% of medical school intake. Some 43% of these doctors are under the age of 35; many will have children and will want to work part-time for a short period for reasons of childcare.

“With the present cuts in hospital funding, and the high cost of locums, colleagues are left to provide locum cover, often at very short notice and for little extra financial reward. Women consequently feel guilty when they take maternity leave, and feel they should return to work as early as possible. There is talk also of not allowing doctor parents to work part-time when their children are very young because of the shortage of doctors to cover the rotas.”

Her letter was prompted by the recent Royal College of Surgeons research which showed that the cost of hiring locums in the NHS is now topping £750m a year - following the introduction of a 48-hour week for juniors.

Fabre called for “urgent” action. “Astonishingly, there is talk of cuts in the number of junior doctors. The reason for this is that there are not enough consultant jobs available for those already coming through the system,” she said.

“So the chaos with hospital on-call cover will get worse, with gaps in rotas, insufficient suitably trained locums available, and existing doctors being asked to do more and more. We heard only recently of a young doctor left, unsupported, to cover too many patients, and being asked to do tasks beyond her level of competency. Not only is this bad for doctors, it is unacceptable for patients.”

Tags: , ,
Posted in Hospital Dr News | 1 Comment »

Consultant “didn’t break data protection rules”

By Francesca Robinson - 28th August 2010 8:20 am

A senior diabetes consultant who was sacked for gross misconduct after faxing patient records from her hospital to a community clinic has been exonerated by the GMC.

The South Warwickshire General Hospitals Trust (SWGHT) accused Dr Shirine Boardman of breaching patient confidentiality when she sent the names and contact details of more than 80 diabetes patients to her secretary at the Apnee Sehat NHS clinic in Leamington Spa.

Boardman’s aim was to invite the patients to a structured education programme to help them manage their diabetes. She was acting in according with NICE guidance. At the time all trusts had a statutory requirement to provide this patient education.

The award winning Apnee Sehat clinic (meaning “our health” in Punjabi) was a pilot service set up by Warwickshire Primary Care Trust to provide clinical care and help to disadvantaged members of the Asian community. Boardman led the establishment of the project in 2007 as part of her employment contract with Warwick Hospital.

But the SWGHT complained that Boardman made an unauthorised transfer of confidential data from the trust in breach of GMC guidance, the Data Protection Act and the trust’s data protection policy.

The case was sent to the Information Commissioner for an alleged criminal breach of the Data Protection Act in July 2008. Shortly afterwards Boardman was sacked. The decision was later upheld by an employment tribunal.

But the Information Commissioner dropped the case and the GMC has now scrapped a fitness to practise hearing saying that Boardman acted “solely to benefit patients”.

Dr Keith Brent, deputy chairman of the BMA’s consultants committee, said: “There seems never to have been any question that Dr Boardman was anything other than a good clinician providing good care to her patients.”

Dr Sue Roberts, former government diabetes tsar, comented: “The dismissal of Dr Boardman was fundamentally unreasonable in that it disregarded good medical practice in the treatment of diabetes.”

Boardman, who has four clinical excellence awards and has won four national awards for her work, said she had been shocked by the speed with which she had been sacked.

It has taken her two years to do the research to understand the NHS data protection laws, to obtain information from the trust through Freedom of Information requests and to get the right legal experts and witnesses to help her fight her case.

“I don’t think in medical school or specialist training anybody ever told me the kind of trouble we could get into as doctors. The minute something goes wrong it’s enormously important to get the right advice from the right people because a lot could have been done to save me before I was dismissed,” she said.

Peter Bottomley, the Conservative MP for Worthing West, has raised Boardman’s case in Parliament and is calling for the individuals at SWGHT who made the complaint to account for their actions. If this does not happen he says he will be pressing health secretary Andrew Lansley to conduct a review.

He would also like the case to be investigated by the Equalities Commission. He said: “It is now clear Dr Boardman was right and they were wrong and their allegations and smears were unjustified. In my experience no male or no white consultant has ever been treated like this.”

A trust spokesman said: “The trust’s actions were in the best interests of patients as the breach of patients’ confidential information is a serious matter and one which patients themselves also take very seriously.”

Tags: , ,
Posted in Hospital Dr News | 4 Comments »

Medical students burdened by 23 grand of debt

By Mike Broad - 12th April 2010 9:08 am

Many families have to find over £3,000 a year to fund their children through medical school, a report reveals.

The BMA research says that two thirds of medical students are now relying on parental support while they study, with the average amount being given in a year standing at £3,123. This equates to over £15,000 during the course of a five-year medical degree.

The report, which surveyed nearly 2,000 students, also finds that juniors who graduated in 2009 left medical school with an average debt of £22,851 - a fifth higher than in 2008.

The number of students entering medicine from low income groups remains poor, with just one in 20 medical students coming from the lowest two income groups.

Louise McMenemy, the BMA’s student finance lead, said: “The UK is facing a growing crisis in medical student finance that many policy makers appear unwilling to address.

“It is vital that these huge financial burdens are tackled, especially by the current higher education funding review, and not exacerbated by any further rise in tuition fees. This move would be a disaster, as we are already facing a situation where the NHS risks being denied the services of talented individuals with the ability, but not the bank balance, to get them through medical school.”

Read the full report.

Tags: , ,
Posted in Hospital Dr News | No Comments »

New aptitude test for medical school shows bias

By Mike Broad - 22nd February 2010 10:44 am

A new aptitude test, aimed at increasing diversity and fairness in selecting school leaver applicants for medical school, still has inherent gender and socioeconomic bias, a study finds.

The UK Clinical Aptitude Test (UKCAT) was first used in 2006 as part of the admissions process by a consortium of 23 medical and dental schools. UKCAT’s aim was to make selection to medical school fairer and more transparent. With A Level grade inflation, discriminating between large numbers of highly able applicants on their academic achievement alone has become increasingly difficult, and participation in the profession needs to be widened.

The test is an appraisal of skills such as verbal reasoning and decision analysis, and is designed to ensure that candidates have the most appropriate mental abilities, attitudes and professional behaviours to be successful in their professional careers.

To determine whether this test provides a more equitable assessment of aptitude, Professor David James and colleagues, at University of Nottingham Medical School, analysed data from the first group of applicants who sat the UKCAT in 2006 and who achieved at least three passes at A Level in their school leaving examinations.
They found a modest correlation between A Level and UKCAT scores, which confirms that the test can be used as a reasonable proxy for A Levels in the selection process.

However, the test had an inherent favourable bias to male applicants and those from a higher socioeconomic class or from independent or grammar schools.

“These findings lead us to be cautious about use of the UKCAT and the value of any one specific sub-test within an admissions policy,” conclude the authors. They also call for further research to clarify the practical value of the UKCAT in a wider range of applicants and, importantly, its predictive role in performance at medial or dental school.
In an accompanying editorial, in the BMJ, Professor David Powis, from the University of Newcastle in Australia, says that measuring cognitive ability is a step in the right direction, but it doesn’t tackle “widening participation” - the admission of people from lower socioeconomic groups or those whose education has been compromised by attending poorer schools.
And neither does UKCAT yet provide selectors with information on the non-cognitive characteristics and personal qualities that are fundamentally essential (and those that are undesirable) in the generic good doctor, he adds. This challenge remains for the future.

Read the full paper.

Read more on improving access to the profession.

Tags: ,
Posted in Hospital Dr News | 3 Comments »

New plan to improve access to the profession

By Mike Broad - 18th January 2010 4:08 pm

Labour claims a new plan to promote social mobility will, for the first time, open up the medical profession to people from less privileged backgrounds.

In a comprehensive response to Unleashing Aspiration, the final report from the Panel on Fair Access to the Professions, the government has agreed to implement the vast majority of its 88 recommendations.

The government has promised additional support to 130,000 of the “brightest” young people from poorer backgrounds to help them secure a place at college or university.

One of the key proposals is to re-launch a forum which promotes access to the professions. The forum, chaired by minister of higher education David Lammy, will implement recommendations and ask professional organisations to report on progress.

Many of the recommendations involve improving and extending careers advice, professional placements and work experience for school children and students.

Nick Deakin, co-chair of the BMA’s medical student committee, said: “There is a great deal in this announcement which is positive, but ministers have sadly ignored the elephant in the room - tuition fees and student debt.

“A guarantee to look at how to help students from low income families at secondary school level is extremely encouraging. Research has shown that poor career advice and an absence of encouragement in the classroom are key barriers to professions like medicine. Many children in less well off areas discount medicine as a career because they regard it as a goal they can not reach. We will await the detail of these proposals with interest.”

The influential report of former health minister Alan Milburn said that careers such as medicine and law were dominated by people from affluent backgrounds.

A new Social Mobility Commission will provide expert evidence on trends and policy in social mobility and produce an annual report on progress. Professor Sir John Hills, director of the Centre for Analysis of Social Exclusion at the London School of Economics will be the chair.

In a 55-page document on social mobility, the government only mentions tuition fees once. It says it will review ‘the impact of variable tuition fees to consider a radical reshaping of the student support system’.

Deakin commented: “All the good sentiments in this announcement could be washed away if politicians decide to lift the cap on tuition fees. Just one in seven of those at medical school are from the lowest income groups, partly because of the huge debt they incur and the pressure it places on their families. Estimated debt stands at £37,000, while parents have to find £3,000 per year to support their children.

“If we are truly to get talented children enthused about medicine, we must stop pretending that financial barriers don’t exist.”

The Conservatives questioned why Labour has not done more to improve social mobility after 12 years in power.

Read a blog on the issue.

Tags: , ,
Posted in Hospital Dr News | 1 Comment »

Encouragement will widen professional access

By Liz Denny, medical student in Liverpool and the BMA's lead on accessibility - 18th December 2009 1:34 pm

There will be many of you who will approach yet another report about equality and widening access to medicine in the same way that I approach the Peter Andre and Katie Price circus.

I don’t understand it, I don’t care about it and frankly I wouldn’t be that fussed if a gigantic foot dropped down on top of it.

I sympathise with this reaction as in recent months we have been deluged with reports, pronouncements and initiatives on this topic, not least from Alan Milburn’s summer report on widening access to the professions. Unfortunately much of this has been wrapped in the overbearing language of political correctness which makes you want to pull your hair out.

But, buried beneath this mountain of political spin lies a couple of serious points. It is true, as the BMA’s new report into the make up of medical school demonstrates, that as a profession we have an appalling track record of recruiting students from low income backgrounds.

Just one in seven medical students comes from this group, despite the government pouring £392 million into widening participation schemes in recent years. The glut of spending has resulted in an increase from the lowest groups of just 1.7% since 2003. Not exactly time for the party hats and the cava.

I imagine though that many of you again would have been left unmoved by this last paragraph, possibly because you suspect that what is coming next is a call for positive discrimination. Certainly our report suggests this view is filtering through to students, with a rising rate of applicants refusing to answer questions about their social status, possibly due to a fear they could end up being penalised if they are judged to be too wealthy.

Well, this isn’t what the BMA or I believe in. Positive discrimination is as unfair as it sounds - there is nothing positive about discriminating against anyone.

What instead needs to happen is for us to remove the barriers holding back low income students. Many of these lie at school level, well before application forms are even filled in.

Pupils from low income areas receive worse grades than their counterparts in more affluent districts and, perhaps linked to this fact, many automatically think a career in medicine isn’t for them. Another issue may lie in the career advice students get, as there is evidence of an inconsistency in the quality of these services.

Certainly, in my own experience, I didn’t feel I got much encouragement to go for medicine despite my grades. There of course other barriers, not least the increasing cost of a medical degree which all politicians appear to have genetic pre-disposition to ignore - despite medical students now facing a £37,000 debt bill after graduation.

To tackle these problems we don’t need phony positive discrimination schemes. We need to look at the school system and how it interacts with medical schools, especially in terms of career advice services. We need no more increases in tuition fees and someone in Whitehall to wake up to the debt problem that threatens to bury the ambitions of thousands of students with the brains but not the wallet to get into medical school. And we also need a proactive set of mentoring schemes - an area the BMA is looking to work on - aimed at raising the sights of children so that they believe a career in medicine is within their reach.

Tackling the under representation of low income students is therefore not a flag to be raised in the cause of political correctness. It is about something more real, more practical and more important - making sure we get the best talent into our hospitals and that everyone gets the chance to fulfil their potential.

Tags: , , ,
Posted in BMA | 2 Comments »

“Only the wealthy can enter the profession”

By Mike Broad - 16th December 2009 2:25 pm

Medicine continues to be a closed shop to students from low income families, a BMA report finds.

The study, called Equality and diversity in UK medical schools, reveals that only one in seven successful applicants are from the lowest economic groups, despite them making up nearly half of the UK population.

In the past five years, there has been an increase of just 1.7% in students coming from low income backgrounds, despite £392 million being poured into widening access schemes across the higher education system since 2001.

Professor Bhupinder Sandhu, chair of the BMA’s equal opportunity committee, said: “Medical schools are still not recruiting enough students from low income backgrounds. There is evidence of a drastic gap in acceptance rates. Fifty eight per cent of applicants from the top socio-economic group obtained a place at medical school, but only 39% of applicants from the lowest group were successful - a gap of 19%.

“A combination of complex problems lies at the heart of this failure. There are clear underlying issues within education at school level, not just in the poor academic performance amongst low income students, but also in low aspirations, with many seemingly feeling a career in medicine is simply unattainable.”

The report finds, however, that medicine does attract a higher proportion of ethnic minority students when compared to the general university population, although there are large differences in acceptance rates between different ethnic groups. And women made up 56% of all accepted applicants to UK medical schools.

The study analysed the latest figures from 2008 on successful applications to UK medical schools from the Universities and Colleges Admissions Service.

Dr Vivienne Nathanson, head of science and ethics at the BMA, is concerned that lower income applicants could be further deterred by mounting levels of student debt, which are set to hit £37,000 for medical students.

She said: “The chancellor’s recent announcement of a scheme aimed at helping low income students gain exposure of medicine may help to address the fact that many do not feel a medical career is a possible career option.

“But this will not in itself solve this problem. The government must look at the cost of the medical degree and how we address the failings in our school system.”

Read the full report.

Read a blog on the issue.

Tags: , ,
Posted in Hospital Dr News | No Comments »

“Male doctors deserve to earn more”

By Francesca Robinson - 8th December 2009 6:50 pm

Male doctors should earn more than their female colleagues because they are more productive, claims a prominent health economist.

Professor Alan Maynard of York University said on average male consultants manage 10 to 15% more patients than their female counterparts.

The figures come from an analysis of consultants’ activity rates published last year.

He jokes that women see less patients because they spend more time listening to them - unlike their male counterparts: “Thus female consultants may process fewer patients but perhaps their diagnostic skills are superior and this may produce better outcomes for patients.”

Maynard’s comments are dismissed as “completely unhelpful” by Dr Helen Goodyear, a consultant paediatrician at Heartlands Hospital in Birmingham and president of the Medical Women’s Federation.

They follow a BMA report which reveals that men, on average, earn £15,000 a year more than women in medicine.

“There is no evidence for Professor Maynard’s comments. They come from one flawed study which had a number of misconceptions in it,” said Goodyear.

Women often earn less than men because they are not as forceful in their contract negotiations, she explained. “If a woman gets paid for seven sessions she will often actually do nine or ten. If a woman is on a full-time contract of 10 programmed activities her male counterpart will often be on 13 because they are not so shy in coming forward.”

If her pay was linked to productivity, Goodyear said her salary would immediately double.

The solution is for women to take more of the top leadership posts in the profession. “Women need more encouragement and mentorship to take on these roles. We need to do away with the old boys’ network where leaders who are stepping down nominate the next leader, as still happens in quite a number of posts within medicine,” said Goodyear.

But she said there is still a long way to go: “Although more women are coming in at the bottom in medicine, it is going to take at least 20 years for them to reach the top and to change the culture.”

A BMA spokesperson said there was no justification for a pay gap in the NHS of 2009. “Women doctors undertake the same training and perform the same tasks as their male counterparts - and should also receive the same level of pay.”

Tags: , ,
Posted in Hospital Dr News | No Comments »