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'Sexism in medicine keeps women in junior positions'

Sexist attitudes and a macho work culture cause the absence of women from the most senior posts in medicine, a report said yesterday.

Sexist attitudes and a macho work culture cause the absence of women from the most senior posts in medicine, a report said yesterday.

Male hospital consultants and managers are accused of holding back the careers of female doctors by denying them flexible hours and insisting they work punishing rotas at nights and weekends that do not fit with family life, the report from the British Medical Association says. The situation is critical because medicine is becoming a female-dominated profession. More than 61 per cent of medical students are women, double the proportion of 30 years ago. On present trends, women doctors are expected to outnumber male colleagues by 2012. The proportion of women winning places at medical school has risen every year for the past eight years, and women already outnumber men among junior doctors by 53 per cent to 47 per cent.

But at the top of the profession, men still rule. Seventy-six per cent of hospital consultants are men, compared to 24 per cent who are women. Although this reflects the larger number of men who entered medical schools 30 years ago, women account for a higher proportion (37 per cent) of the lower-grade hospital doctors called associate specialists who are fully trained as are consultants but have not achieved the same professional status.

One woman doctor told the researchers: "I had to work for [a male consultant] who was completely opposed to women in medicine. He had been heard telling women medical students that they should be at home having children." Another said: "If men gave birth I think the medical profession would be structured somewhat differently."

The BMA is the voice of the medical profession, representing 120,000 doctors in the UK and abroad, and it launched the report, Career Barriers in Medicine, on the eve of its annual conference in Llandudno yesterday. The report finds doctors have been held back because of racism, homophobia, discrimination, disability and gender, and calls for zero tolerance of all discrimination.

More than seven in 10 consultants are white, yet among the lower-ranking associate specialist grade six in 10 are from ethnic minorities. George Rae, chair of the BMA's Equal Opportunities Committee, said: "The doctors who participated in this study have told us not enough is being done in the NHS to combat discrimination. It makes uncomfortable reading. It is not acceptable for anyone to think this is someone else's problem. We are all responsible for creating the environment and it is only through our collective and individual actions that we can start to move forward."

On women doctors, the report calls for a "dramatic evaluation of the structure of the medical profession" to end gender discrimination. But it adds: "Flexible training and work is an insufficient solution on its own. Other factors need to be addressed, such as work culture and stereotypes."

High-pressure specialities such as cardiology have the lowest proportion of women consultants, at 7 per cent, compared to those that require greater counselling skills, such as palliative medicine (for patients with terminal illnesses), where the proportion is 59 per cent. Among GPs leaving practices, 74 per cent of women cited "family reasons" compared to 16 per cent of men.