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Focus on... The careers of women GPs

Nearly half of GPs are women, yet few reeach the top jobs. Here three female GPs describe their own experiences.

By Lilian Anekwe

Nearly half of GPs are women, yet few reeach the top jobs. Here three female GPs describe their own experiences.

Getting on for half the GPs in the country are now women, so you might think a debate over sexism and male domination of the profession was all rather old hat.

In 2007 there were 16,055 female GPs, up 36% since 1999, and representing 44% of the entire profession.

But the gains in overall numbers made by women are not matched when it comes to the very top jobs.

As far as the power and policy-making bodies and committees are concerned, a Pulse investigation shows women remain underrepresented.

The decision makers on bodies such as the GPC and the RCGP turn out, in most cases, to be men.

Women GPs are reluctant to talk on the record about the barriers they face in reaching the top. Off the record, though, it is a different story.

One senior female GP, who did not wish to be named, told Pulse: ‘I think there is a glass ceiling. But I think it's not due to sexism, it's due to something much more complex than that.

‘It might be there are different ways men and women behave. It's not necessarily we're prevented from being represented, but the way the work is done will preclude women being part of it.'

Dr Richard Fieldhouse, vice chair of the National Association of Sessional GPs, is one senior doctor who is prepared to acknowledge the ‘glass ceiling' which he says risks deskilling the female workforce by excluding them from management or leadership.

Pulse spoke to three female GPs, working in a variety of senior roles in general practice, about how they have found their careers – and what it is like trying to break through at the top of the profession.

Dr Fiona Cornish

Dr Fiona Cornish is a member of the Medical Women's Federation, which aims to advance the personal and professional development of women in general practice.

‘I got married and got a half-time partnership straight away. That's what was different – there weren't salaried GPs back then. In those days you had maternity leave reimbursed by the Family Practice Committee so there wasn't any financial burden on the practice.

‘But of course that's no longer the case. Now it's a disadvantage to have a woman who's going to have a baby. It's difficult for her because she probably won't get paid, as it's a huge expense for the practice to pay for a locum.

‘I do feel quite strongly that female GPs should be able to arrange their own childcare. I don't think they should be spoon fed. Younger doctors say "We can't do this and that unless we have childcare laid on" but I feel that if you're competent enough to be a doctor then you're competent enough to arrange childcare that suits them.

‘Now that there's a slightly two-tier arrangement female salaried doctors don't have any on call responsibilities and they don't have any management duties and that's what they get used to. So making the transition to more senior or representative roles on professional committees is difficult.

‘The things that put women off are that there's a lack of confidence. It's difficult to speak up and speak out and I think you have to be quite brave. It's a very male environment and you've got to be able to defend your views and not be regarded as a token woman.

‘Another issue for women is that if they push for too many professional arrangements then it causes resentment with the men who feel they are left to do all the on call and all the management.

‘People might think there's no longer a need for an organisation like the Medical Women's Federation but there are still a lot of issues that are unresolved and unequal for women so there is a case for it. Things like maternity care, which should be universal, vary across the country and that's retrogressive. There's still a need for campaigning – and it's at the highest levels that it's still needed.'

Dr Ruth Chapman

Dr Ruth Chapman's situation is not unlike that faced by many female GPs. After taking time off to have two children, she found the scarcity of partnerships meant she was forced to take a salaried role – and has found other means of gaining professional recognition.

‘I'm one of probably a number of women who had children in the initial stages of their career and since then, the climate has changed in general practice and there are fewer partnerships. I would imagine that this has affected women more than men.

‘After maternity leave or taking time out to have children it can be difficult for women to go back into general practice; they perhaps lack the confidence or they're not in the same sort of network.

‘I think this is where things like mentoring and appraisal can be really helpful. I think women often need a lot of extra motivation to build up their confidence and self-esteem; once they feel they are back in the groove of their careers, things like applying for roles on committees and things will follow.

‘People who are in the same position as me have to think laterally and think of other opportunities, outside of mainstream clinical practice, that are available that will give them better job satisfaction if you're been part time or out of work after having children and are struggling to reach the same status you might have had before.

‘In the end you want to have a happy life and if you're working it's important to maintain your home life and that often means you have to sacrifice some of your work ambitions.'

Dr Beth McCarron-Nash

In July this year Dr Beth McCarron-Nash became the first female GPC negotiator elected since Dr Judy Gillie in 1991 – and only the second female negotiator in the GPC's history. But she claims she does not feel the weight of history is on her shoulders.

‘I feel it's important to have a negotiating team that is reflective of modern general practice as a whole. I come from a very different background than the traditional, typical negotiator – being a woman and of a younger generation.

‘We do need to improve representation. But I don't think because there are 60% of women in general practice there GPC needs to be 60% women – that's not the way to go. We're there to represent everybody – not individuals.

‘But I think the fact that I am a women sends a very positive message to general practice. It shows that the GPC is taking the change in the profession's demographics seriously and wants to reflect that.

‘In all my roles at the BMA they have been very supportive – I went back to doing BMA work when my little boy was 5 weeks old. They even ran a crèche – I don't think there are many employers or organisations that would give that level of support.

‘Still, it takes a lot of commitment to take yourself away from your family and go for these sorts of roles. It's easier to say "I have more important things to worry about at home" and put other roles on a back burner at a time, in their 30s and 40s, when men can start to consolidate their careers.

‘All you can do is try and encourage people to stand for things and try and make the playing field as level as we can. Yes it's difficult, but it's such an important issue that we need to hear your voice.'

'I feel it is important to have a negotiating team that is reflective of modern general practice' Dr Beth McCarron-Nash THE PARTNER: Dr Fiona Cornish

- GP in Cambridge
- Has four teenage children
- Also works as a doctor in a boarding school and at Cambridge University
- Treasurer of the Medical Women's Federation

THE SALARIED GP: Dr Ruth Chapman

- Salaried GP in East Sheen, South West London
- Has two children under ten
- Is actively involved in medical education
- Also works as a GP tutor

THE NEGOTIATOR: Dr Beth McCarron-Nash

- GP in Hipton, Devon
- One son aged four
- Masterminded the GPC's high profile Support Your Surgery campaign
- Has held several roles at the BMA, including Junior Members' Forum chair and deputy chair of the sessional GPs' committee and GP trainees' sub-committee

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