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Feminisation of the Irish medical workforce-a bad thing? A good thing? I think it's just a thing. However, many disagree....

Posted Oct 14 2008 5:00am
Posted by Dr. Jane Doe.

The following is a word for word copy of an article by the, ahem, esteemed Irish journo, Kevin Myers.

“'In 1975, one in every 20 doctors who graduated from GP training schemes in the Republic was a woman. By 2003, according to a Trinity College training survey, 70pc of GP graduates were female. An old problem, gender imbalance in the medical profession, may have been rectified."
Thus runs an editorial in yesterday's 'Irish Times'; and no doubt to the liberal mind, a 70:30 ratio in favour of female graduates is actually gender balance. To be sure, the editorial admits, several paragraphs later, that the ratio between women and men was tilted -- a nice word to describe the above ratio, but the overall impression was nonetheless created that a historic injustice has been, well, 'rectified'.
Now, are you looking for an example of how the feminist agenda is wrecking Irish institutions? Take one step forward, the Irish medical profession! For years -- and long before the recent TCD survey by Professor Fergus O'Kelly -- we have known that the feminisation of the medical profession was creating a long-term disaster.
But no one dared deal with the issue in public, least of all journalists, the most ideologically 'liberal' of all professional groups, for whom, apparently, 2.3/1 = 1. Because interviews are seen as 'sexist', medical schools are obliged to demand the highest number of points in the Leaving Cert, which is taken at an age when girls are overwhelmingly superior to boys.
For the boy is not out of his intellectual chrysalis when he sits his Leaving Cert; the girl is flapping her lovely butterfly wings in the sunlight. We know this is a temporary phenomenon, related to the difference in the processes of maturation.
Other differences will unfold over the next 10 years which are overwhelmingly to the advantage of men. But any assessment of future medical students on their long-term potential or professional intent, would be vigorously opposed by those ridiculous, yet deeply sinister feminist-agenda quangos which are subsidised by the Department of Justice.
Moreover, overall, boys and girls do not belong to the same species of medical Lepidoptera; he-doctors are usually doctors for life, she-doctors are not, as a survey four years ago by two women doctors, Davida La Harpe and Fiona Graham, first revealed.
Their investigations of women GP graduates from between 1995 and 2001 showed that only 10pc intended to remain on as full time GPs. Yes, just one in 10. Which is bad -- and it could actually be far worse.
Because only two thirds of women graduates invited to participate in the survey actually did so: the other one third did not reply.
Had they already left the profession? The worst-case scenario is therefore as follows: only 6pc of GP she-graduates will be practising as full-time GPs in the long-term.
The La Harpe/Graham survey then showed that of the she-graduates who filled in the questionnaire, 13pc had already left the profession -- essentially, while in their 20s. Another one -third had ceased full-time time work. Some 40pc were already intending to abandon out-office hours, and 80pc said they would never work as a single GP in rural areas.
This is not a health system; it is a first day on the Somme. A large part of our medical schools output are casualties to retirement or part-time work within 10 years of their becoming doctors. But there is no native spare capacity to make good this shortfall: We only have enough medical places to supply our needs. But too many of these places are not being taken by serious would-be doctors, but by frivolous show-offs, who, having grabbed so many vital places in medical school, thereby revealing to the world how very clever they are, then abandon the profession totally, or in part.
The Harpe-Graham response to the crisis was itself utterly girlish: It was that the entire medical profession (and presumably the sick) must re-arrange itself around the requirements of the rising army of part-time she-doctors.
Which is rather like saying the moon should rearrange itself around the requirements of Cape Canaveral.
Well, if things continue as they are, when one of you former she-doctors falls into labour at 5 am, you'll find the midwives and obstetricians are all girls too, so the hospitals are empty.
Or maybe, you hope you can depend on the tiny handful of male doctors which our educational system, no doubt by some regrettable oversight, still produces. But those fine fellows cannot plug the huge gaps left by the mass exodus of women from a profession which they had prevented so many lads from entering in the first place.
So how are the holes in our medical system to be filled? By immigrants from 'developing' countries, of course.
No doubt their native lands consider the loss of those graduates, educated at colossal expense by impoverished socities which are crying our for more doctors, a price well worth paying, merely so that Emma and Naomi and Jessica could prove that, aged 18, they were so much smarter than their male-contemporaries.
And with this triumph achieved, they then abandon the surgery, and high-tail it for Brown Thomas -- another victory for the feminist agenda!”
Kevin Myers, Irish times.

This is the article Kevin Myers wrote for the Irish Times one month ago. While everyone who reads this paper knows what he’s like, this is not by any means the first article of its kind.
I’m posting this article in full to illustrate the kind of drivel that is written about women doctors in Ireland on a regular basis in Ireland.
Ruairi Hanley, a male GP who writes for Medicine Weekly, is also apparently no big fan of a feminised medical workforce, or indeed simply anyone choosing to work parttime:

Is it any wonder I’m a bit bitter about all of this? My last post was intended to be in defense of women being allowed equal access into a profession, and instead it appears to be being perceived as being “against men”.
Well, anyway.

Leaving the whole “feminist” issue aside:

The fact is that the Leaving Certificate is deemed to be okay for picking out candidates for every single other college course in Ireland.

All the future vets. All the future actuaries. All the future lawyers. All the future teachers. All the future nurses. All the future scientists. All the future college lecturers. It suffices as a method for allocating college places for every single one of those professions.

Just not for medicine.

Doesn’t ANYONE think that’s a little odd at all?

Ruairi Hanley, in another of his more enlightened Medicine Weekly articles stated that the reason for this “alternative entry” was so that kids of rich parents who put the pressure on would be able to secure a medical school place despite precious little Tarquin or Saoirse not bothering their arses studying enough to get one. He may be onto something too. The fact is that something is WRONG with all of this.

In order to get into medicine via the Leaving Certificate route a student needs at least two Higher level sciences. They can do three if they wish, but two is a prerequisite, and Chemistry used to be compulsory. The sciences on offer are Physics, Chemistry and Biology. Physics requires the ability to reason and understand scientific principles of how things work and apply them to solve problems, in a limited time frame in an exam situation. This is a good trait for a doctor to have.

Better than being friendly and warm when you’re in heart failure.

Chemistry requires an understanding of physics too, as the basic principles of physics govern how chemical reactions work. It requires knowledge of how to balance equations, titrate doses, understand chemical reactions in different scenarios and knowledge of toxicity.

Better than being friendly and warm when you’re in heart failure.

Biology used to be the hardest subject to get an A1 in the Leaving Cert. It requires a lot of memorisation of facts that must be accurately reproduced quickly at short notice. It requires a basic understanding of chemistry and physics also as these are the principles on which living systems work.

Better than being friendly and warm when you’re in heart failure.

Higher level English and Irish are also compulsory for wannabe medical trainees. To achieve high scores in these subjects, students have to communicate clearly and logically both written and orally, and get across a lot of information in a limited time period. They have to tailor their answers to the questions asked, and comprehend large volumes of text and be able to answer questions regarding this in a limited time frame. The same goes for the other compulsory foreign language.

Better than being friendly and warm when you’re in heart failure.

There is nothing wrong with being warm and friendly when dealing with patients, and one should endeavour to be so as much as possible. Part of the training to become a doctor deals with effective communication and sensitivity. History taking, the crucial skill of getting the right information from your patient to help you diagnose what’s going on, is a HUGE part of the medical curriculum, and one of the big things examined in final year. Observing how bad news is broken, how sensitive subjects are broached, how consideration and respect is shown to people in an environment that may be incomprehensible and frightening to them, all these things should be and indeed are integral parts of medical training.

The fact that the health system we work in does not always allow health professionals to facilitate that consideration and respect does not mean that we should start changing the way we select them.

It means we need to change the system.

If you work 100 hours a week and are frequently sleep deprived, then male or female, you’re not generally going to be a happy healthy minded person. You’re going to be irritable, short tempered, and sitting around talking to people and reassuring them is, um, not going to be very high on your list of priorities. Getting the job done so no-one dies and you don’t get sued is going to be about all you’re able for.

If because of suboptimal staffing levels you are frequently expected to be in clinic, in the emergency department, and on the wards all at the same time, you’re going to be stressed out and upset. You’re not going to be relaxed, approachable or pleasant. You’re going to give off a “don’t ask me questions dammit” vibe because you just plain don’t have time to answer them.
This does not mean people like this who worked hard, got the grades, passed the exams, and then to boot had the staying power to tolerate these working conditions should be negatively selected against by an alternative entry system that does not reward abstract reasoning ability, critical and logical thinking, good communication in different languages and all round academic ability.

It means we need to change the system.

If you are expected to be at work and work long long shifts despite illness, you are not going to be warm and friendly. You’re going to feel terrible and resent every minute you spend in the place. This isn’t going to translate into a caring communicative professional. Not rocket science.
Stupid doctors kill people. True, there are other reasons medical mishaps happen. But doctors need to have academic intelligence, and like it or not, this is the most important trait to select for in prospective doctors. All exams are skewed towards academically gifted people. This is the nature of exams. Standardised testing does have many limitations, but as regards selecting doctors it is pretty damn good in that it tests academic ability as well as the ability to work within a defined system and use it to the best advantage.

If the health system that they work in after graduation truly is producing rude, short tempered arrogant doctors who don’t communicate with patients, then we need to change that system for the good of the patients. Not the people who enter it.

People don’t like this, I have found. Many like to subscribe to the book smart emotionless boffin stereotype doctor. In all my time working in hospitals, I have met almost no-one who is actually like this. I’ve met one or two people that were quite eccentric, and a few real characters, but this stereotype that is so oft quoted as a reason to overhaul medical school entry seems not to exist in the real world.

The fact in any case is that the book smart and academically able guy/girl/hermaphrodite who spends a lot of time studying and observing is going to be the one who picks up your Miller Fisher syndrome. They’re going to be the ones who pick up that you have a saddle embolus instead of a heart attack despite your ECG changes, your troponin rise, your cardiac failure like symptoms. They’re going to spot that subtle shadow on your Xray. They’re going to remember to screen you for other conditions instead of relying on the obvious diagnosis. They’re going to be up to date with the most recent evidence based treatments because the swots read about this stuff in their spare time. They may not hold your hand when they tell you what you’ve got and they may not be as warm and empathetic as you wanted, but then again maybe they will. And they will learn with experience how to empathise with you, they will learn compassion as they observe suffering and treat it, and they will learn how to express this effectively and use it to become better doctors.

But while like all of us they are learning these things through experience of life and through their work, they will be ideally placed to save your life due to academic ability and a strong work ethic.
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