Training women doctors = waste of money?

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I wouldn't dare bring this question up on the La-la land of Mommd, but maybe it will spark some interesting and 2 sided debates here:

http://www.angryharry.com/esIstheTrainingofWomenDoctorsAWaste.htm

Well, one thing about this particular article that jumps out immediately is that it's British -- the significance being, that they're trying to find a reason why a socialized medical system isn't producing a nice match of supply and demand. Must be the presence of women! Ironically, though, the socialized system is the one in which this question makes the most sense, being specifically designed, and centrally controlled, to produce the maximum society-wide benefit for a minimum investment.

The second thing that jumps out is the number: 60% leave the career field within 10 years. I would love to see the statistics that produced that number, which seems likely to be the result of some very creative and desired-result-directed analysis.

Third, I don't know how their government's investment in medical training and benefit from residents-in-training compares to ours. For that matter, I don't actually know anything about ours on its own -- and this question is really only important when it comes to society-level investment, in other words government subsidies.

So before we can have an intelligent debate, we need to decide
  • Which system (socialized or US) are we considering?
  • Where'd they get that number from, and how bad is the problem really in whichever country we're talking about?
  • What is the government's financial contribution to medical training, and the common benefit produced by residents-in-training, in that system?
 
Yeah, I would be curious to find out if that 60% number is anywhere near correct. My instinct would be to say no, but I don't really know. I would also be curious to know what the percent of men leaving the field (maybe they are taking off in droves as well), before I could make an informed comment.
 
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I was thinking along the same lines as everyone else. From what I have read, physicians in Britain are even more fed up than they are here. Assuming that women are leaving more than men, perhaps it is because they can. At least here, women physicians are much more likely to be married to a working spouse. Maybe the men don't have a financial backup.
 
training women doctors is great from my perspective because it reduces competition in the marketplace

Waste of money for who exactly??? Med schools charge such outrageous fees nowadays that Im sure they are turning a tidy profit on seat, in fact I know they are, probably on the order of 10,000+ per student at a private school per year if the base fees are 30K/year. For a class of 150 that is a 1.5million dollar revenue center.

For women who spend the money, yeah it might be waste. I dont know, if they work long enough to pay off the debt then who cares really. Its when they rack up 150K then immediately drop out of the market with rugrats that things go FUBAR.

LOL@NHS anyway. they are doomed regardless of this.
 
The article while based in England I think is reasonably applicable here in the US.

I brought this issue up on a website for women physicians/premeds and to say the least it wasn't received well.

Personally, I think it's a huge waste of resources to train someone, ANYONE, for a career they won't be in very long. Education is generally very valuable as far as personal develpoment is concerned, but with med school seats being at such a premium I'm not so sure med schools should admit as many women in the prime of their reproductive years into medicine.
And while med schools may be turing a profit creatign physicians, my understanding was that residency slots are financed in part by the federal gov't which means we all "loose money" when a person doesn't practice.

At least here, women physicians are much more likely to be married to a working spouse. Maybe the men don't have a financial backup.
As for women having spouses who can support the families bottom line, I find it interesting that women in jobs far more physically demanding than medicine and who work for far less pay (janitor, fast food cashier, grocery store clerk, ect), manage to balance career and family needs just fine. Many women physicians are married to physicians so I think that makes it a LOT easier to quit medicine altogether which many do. All I'm saying is that if they do that, I think they should reinburse the Gov't in some way ie 10 hours/week at a health clinic for example or with cold hard cash.

I also think that when they quit, they make things a lot harder for those of us who did things to make finding a balance easier, such as have fewer children or choosing "softer" residencys.
 
But without a solid statistic concerning female physicians in the United States, any claim made is a generalization.

I really don't think there is a great percentage of women that leave practice permanently for family reasons. Most likely those that leave do so for a short period of time and come back. Then again, I don't have any statistics to prove my thoughts.

I'm certainly not gonna be one of those women. I've already got children and I plan to work as a physician as long as they'll let me.



The article while based in England I think is reasonably applicable here in the US.

I brought this issue up on a website for women physicians/premeds and to say the least it wasn't received well.

Personally, I think it's a huge waste of resources to train someone, ANYONE, for a career they won't be in very long. Education is generally very valuable as far as personal develpoment is concerned, but with med school seats being at such a premium I'm not so sure med schools should admit as many women in the prime of their reproductive years into medicine.
And while med schools may be turing a profit creatign physicians, my understanding was that residency slots are financed in part by the federal gov't which means we all "loose money" when a person doesn't practice.

As for women having spouses who can support the families bottom line, I find it interesting that women in jobs far more physically demanding than medicine and who work for far less pay (janitor, fast food cashier, grocery store clerk, ect), manage to balance career and family needs just fine. Many women physicians are married to physicians so I think that makes it a LOT easier to quit medicine altogether which many do. All I'm saying is that if they do that, I think they should reinburse the Gov't in some way ie 10 hours/week at a health clinic for example or with cold hard cash.

I also think that when they quit, they make things a lot harder for those of us who did things to make finding a balance easier, such as have fewer children or choosing "softer" residencys.
 
I'm certainly not gonna be one of those women. I've already got children and I plan to work as a physician as long as they'll let me.
I'm with you!

I think admitting certain women over say 35 and/or those done with child bearing, is the best idea around.:thumbup:
 
The article while based in England I think is reasonably applicable here in the US.

I brought this issue up on a website for women physicians/premeds and to say the least it wasn't received well.

Personally, I think it's a huge waste of resources to train someone, ANYONE, for a career they won't be in very long. Education is generally very valuable as far as personal develpoment is concerned, but with med school seats being at such a premium I'm not so sure med schools should admit as many women in the prime of their reproductive years into medicine.
And while med schools may be turing a profit creatign physicians, my understanding was that residency slots are financed in part by the federal gov't which means we all "loose money" when a person doesn't practice.

As for women having spouses who can support the families bottom line, I find it interesting that women in jobs far more physically demanding than medicine and who work for far less pay (janitor, fast food cashier, grocery store clerk, ect), manage to balance career and family needs just fine. Many women physicians are married to physicians so I think that makes it a LOT easier to quit medicine altogether which many do. All I'm saying is that if they do that, I think they should reinburse the Gov't in some way ie 10 hours/week at a health clinic for example or with cold hard cash.

I also think that when they quit, they make things a lot harder for those of us who did things to make finding a balance easier, such as have fewer children or choosing "softer" residencys.

Why do you make the assumption that those who are admitted in the "prime of their reproductive years" will do anything at all with that reproductive ability? They may choose to not do anything at all or accomodate that ability. This is the beauty of the privacy act - YOU CAN'T ASK!!!!

Likewise, men, who are also admitted in the prime of their reproductive years, can also be afflicted by child issues as well. I, myself, know of 2 physician couples who both had child issues & it was the male's career which was more modifiable than the female's to accomodate the child's medical issues. One particular physician has altered his practice for >20 years so he could be the more primary caregiver for his child.

I'm a pharmacist & have been married to a dentist. We've both been in practice for >30 years & have raised two kids (one which is an MSIII). While he has made more money than me, I've worked more hours than he.

Why be so gender biased??? It seems a bit closed minded & frankly, trite & out of date.
 
Why do you make the assumption that those who are admitted in the "prime of their reproductive years" will do anything at all with that reproductive ability? They may choose to not do anything at all or accomodate that ability. This is the beauty of the privacy act - YOU CAN'T ASK!!!!

Likewise, men, who are also admitted in the prime of their reproductive years, can also be afflicted by child issues as well. I, myself, know of 2 physician couples who both had child issues & it was the male's career which was more modifiable than the female's to accomodate the child's medical issues. One particular physician has altered his practice for >20 years so he could be the more primary caregiver for his child.

I'm a pharmacist & have been married to a dentist. We've both been in practice for >30 years & have raised two kids (one which is an MSIII). While he has made more money than me, I've worked more hours than he.

Why be so gender biased??? It seems a bit closed minded & frankly, trite & out of date.

:thumbup::thumbup:
 
The article while based in England I think is reasonably applicable here in the US.

I brought this issue up on a website for women physicians/premeds and to say the least it wasn't received well.

Personally, I think it's a huge waste of resources to train someone, ANYONE, for a career they won't be in very long. Education is generally very valuable as far as personal develpoment is concerned, but with med school seats being at such a premium I'm not so sure med schools should admit as many women in the prime of their reproductive years into medicine.
And while med schools may be turing a profit creatign physicians, my understanding was that residency slots are financed in part by the federal gov't which means we all "loose money" when a person doesn't practice.

As for women having spouses who can support the families bottom line, I find it interesting that women in jobs far more physically demanding than medicine and who work for far less pay (janitor, fast food cashier, grocery store clerk, ect), manage to balance career and family needs just fine. Many women physicians are married to physicians so I think that makes it a LOT easier to quit medicine altogether which many do. All I'm saying is that if they do that, I think they should reinburse the Gov't in some way ie 10 hours/week at a health clinic for example or with cold hard cash.

I also think that when they quit, they make things a lot harder for those of us who did things to make finding a balance easier, such as have fewer children or choosing "softer" residencys.

Arent you still trying to get into medical school? Aren't you also trying to go MD/PhD? how would you feel if people said you were too old to waste resources on like that (since you wouldn't have as long as a career as younger applicants)? You would be offended wouldn't you? I feel offended by your posts as a woman. Just because women carry the children does not make men in their "reproductive years" get off the hook. Who are you to decide what age of females medical schools should or should not let in? That is very very closed minded. Everyone has a unique path and situation. You don't want people to judge you based on yours, then don't do it yourself.
 
Part of me is really pissed of that people assume that if you are a woman of a certain age that you are going to go and have babies and leave the field. That part of me is also pissed at every woman that actually does that, because they make life more difficult for me (by reinforcing the stereotype). The more reasonable part of me understands that people may change their priorities in life for various reasons. I guess if you know in advance that you want to have 14 babies and take a year off for each one, then maybe you should reconsider a career with such a large time commitment for training. But, that said I don't think it is fair to discriminate against women because they may decide to do that in the future.
 
Why do you make the assumption that those who are admitted in the "prime of their reproductive years" will do anything at all with that reproductive ability? They may choose to not do anything at all or accomodate that ability. This is the beauty of the privacy act - YOU CAN'T ASK!!!!.
It's not an assumption it's based on census data.
Likewise, men, who are also admitted in the prime of their reproductive years, can also be afflicted by child issues as well. I, myself, know of 2 physician couples who both had child issues & it was the male's career which was more modifiable than the female's to accomodate the child's medical issues. One particular physician has altered his practice for >20 years so he could be the more primary caregiver for his child
Bringing up men in this type of debate is pretty senseless to me. Why? Because even in today's "modern" times VERY few men take on the primary responsibility of raising kids and are negatively affected by their wives having kids during their training. Put another way, male med students with wives and kids are in almost a good of position family dynamic wise as single male med students/residents. So do I know a dude or two who stayed at home? Yep, I know 2 of all the thousands of people I've met in ~20 years in the medical profession.
I'm a pharmacist & have been married to a dentist. We've both been in practice for >30 years & have raised two kids (one which is an MSIII). While he has made more money than me, I've worked more hours than he.
With all due respect pharmacy and dentistry can't be compared to careers in medicine IMHO. In fact, I know of many women who wanted to become MD's but ultimately went PharmD because of the hours and money. In other words, I haven't seen women dropping out of pharmacy or dental careers due to enormous amount of time those carees have on family time. Perhaps you can share more about that.
Why be so gender biased??? It seems a bit closed minded & frankly, trite & out of date.
One person's gender bias in another gender truth. And as a professional WOMAN who has made family decisions based on my projected carer goals I don't thinkit sounds trite and closed minded at all. I'm concerned, VERY concerned, about how the decisions of women who didn't think things through are not only going to affect me but my daughters as well. Too many people these days seem to only be concerend about themselves.
 
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Arent you still trying to get into medical school? Aren't you also trying to go MD/PhD? how would you feel if people said you were too old to waste resources on like that (since you wouldn't have as long as a career as younger applicants)? You would be offended wouldn't you? .
I wouldn't call it an attempt as my situation is far more complex than that. I'm currently taking classes in BOTH programs. Dam, how does she do THAT?!?!:laugh:

As for being offended, I'm a black woman living in America. If I got "offended" everytime someone said something contray to my own personal beliefs, I'd have given up my US citizenship and moved to another country at birth. So honestly, I wouldn't and don't feel anything about folks who think I'm too old. I'm in a class with about 30 med students and of those, maybe half are dudes. Weight wise, my female 20 something classmates look MUCH "older" than I could gain 20 pounds and look so to me, it's better to BE old than to LOOK old. :laugh::laugh:
Just because women carry the children does not make men in their "reproductive years" get off the hook. .
A couple questions:
1) How many male med students/residents take 6-8 weeks off after their WIVES have babies?

2) How many male medical students/residents feed babies in the middle of the nioght on a regular basis? And I won't even ask about BREAST feeding babies.:laugh:

3) How many make med students call out when the baby gets ill? Needs to get to a doctors appointment?

I think there's "lala land" and reality, and the reality is that MOST men STILL aren't doing their share when it comes to child rearing. Maybe you're husband/finace' is Mr.Mom, but if you havne't even gotten to this stage yet in a relationship, I'd suggest you talk more to people who have and can give you a reality check.
 
It's not an assumption it's based on census data.
Bringing up men in this type of debate is pretty senseless to me. Why? Because even in today's "modern" times VERY few men take on the primary responsibility of raising kids and are negatively affected by their wives having kids during their training. Put another way, male med students with wives and kids are in almost a good of position family dynamic wise as single male med students/residents. So do I know a dude or two who stayed at home? Yep, I know 2 of all the thousands of people I've met in ~20 years in the medical profession.
With all due respect pharmacy and dentistry can't be compared to careers in medicine IMHO. In fact, I know of many women who wanted to become MD's but ultimately went PharmD because of the hours and money. In other words, I haven't seen women dropping out of pharmacy or dental careers due to enormous amount of time those carees have on family time. Perhaps you can share more about that.
One person's gender bias in another gender truth. And as a professional WOMAN who has made family decisions based on my projected carer goals I don't thinkit sounds trite and closed minded at all. I'm concerned, VERY concerned, about how the decisions of women who didn't think things through are not only going to affect me but my daughters as well. Too many people these days seem to only be concerend about themselves.

Are you kidding??? Census data on the numbers of female medical students who ultimately reproduce? The census can't even get the numbers straight on who lives in my community (a very urban one at that). Additionally, my daughter's medical class, in 3 years has had about 20 students come in & go out of her class due to repeating years or having PhD students come back in - how do you classify those???

As for you not considering pharmacy or dentistry the equivalent of medicine - I'm not surprised. That is the WHOLE basis of this forum & why it doesn't work! You women are so wrapped up in your view of medicine you don't see what the rest of us do each & every day. You are not the only ones working overnight call or longer than 24 hours!!!

However - I'm particularly insightful into all 3 professions since I'm married to a dentist & have a medical school daughter. Let me tell you - you may think you all work hard - she's not worked any harder than the rest of us. I'd also venture to add that her career will be started sooner than her father's since starting a dental business from scratch takes about 10 years to make a profit & you have absoutely NO IDEA of the amount of equipment we buy every year which a physician would cringe at (the last purchase was $100K - 30 years after he began!) So - when you can actually compare apples to apples - come back & let me know!

I can share just about anything you want to know about my career. I've been in my business 30 years - have worked every other weekend for that long & have been on call q3-4 days overnight in a hospital for 25 years of that. I worked on both my kids first birthdays, every other Christmas & Thanksgiving sinced I was married & would choose it all over again. Her father is a solo practioner dentist who takes his own call each & every day, unless he's on vacation. He takes call for his colleagues who go on vacation as well.

I raised two kids to be happy, healthy & mature adults - one of which will be your colleague in exactly 22 months. She went into it with open eyes & all the knowledge she gained from her parents. Her father was as equal a parent as I was. He took her to work when she was sick & I had to be in the OR because there was not another pharmacist to do it. I hope she makes her reproductive choice based on what she and her partner want to accomplish in life with all the influences which come into play. Fortunately, she has LIVED the experience of a loving & competent daycare situation - which both her Dad & I worked hard at finding - which, by the way we maintain close personal friendships with.

As for your condesceding comments on time off during childbirth - no, my husband did not take that time - but he took time off during his brain surgery (which was longer than my postpartum recovery) & there were no repercussions on his practice. As for night feedings - when I was on call & not home - he did it - its easy, you pump, refrigerate & he warms. Even a dentist can do that! I took time off for a broken leg (pharmacists can work if they can't stand) & no one looked askance.

My husband has honestly taken our kids to at least half their doctor appointments because his schedule is set by him - mine is not. So, if they're sick....he reschedules patients (or he did when they were little). He's also taken them & picked them up from camps & colleges. He went with her to take a second look at two medical schools across the country & went with her to move - all because my schedule would not allow me the time. I went later that summer & took my 88 yo mother so she could see her graddaughter in the process of becoming a physcian.

I respect your position, but find your post to be patronizing to not just my profession & that of my husbands, but also to the very hard work it took women of my generation to be able to have the benefits you so glibly brush off for those who want to avail themselves of them.

Sorry - you need the reality check, IMO. You are living in a 1950's world which just doesn't exist. But, you get what you want or ask for - if you want a non-involved partner, that's exactly what you'll get. I'm just glad you didn't sit on any of the 10 ADCOMS which accepteted my daughter into their programs because she is in the PRIME of her reproductive life....and fortunately - that is her own DAMN business!!!
 
I wouldn't call it an attempt as my situation is far more complex than that. I'm currently taking classes in BOTH programs. Dam, how does she do THAT?!?!:laugh:

As for being offended, I'm a black woman living in America. If I got "offended" everytime someone said something contray to my own personal beliefs, I'd have given up my US citizenship and moved to another country at birth. So honestly, I wouldn't and don't feel anything about folks who think I'm too old. I'm in a class with about 30 med students and of those, maybe half are dudes. Weight wise, my female 20 something classmates look MUCH "older" than I could gain 20 pounds and look so to me, it's better to BE old than to LOOK old. :laugh::laugh:
A couple questions:
1) How many male med students/residents take 6-8 weeks off after their WIVES have babies?

2) How many male medical students/residents feed babies in the middle of the nioght on a regular basis? And I won't even ask about BREAST feeding babies.:laugh:

3) How many make med students call out when the baby gets ill? Needs to get to a doctors appointment?

I think there's "lala land" and reality, and the reality is that MOST men STILL aren't doing their share when it comes to child rearing. Maybe you're husband/finace' is Mr.Mom, but if you havne't even gotten to this stage yet in a relationship, I'd suggest you talk more to people who have and can give you a reality check.


Umm I don't know what program you are in, but I know for a fact you are not yet in medical schoo (and have not yet gained acceptance to medical school). Perhaps you can let the admcoms know how you feel about this, what do you think? Also, why do you bring up being black? We are talking about women! White, black, green or orange.
You are obv the one in la la land, totally excusing men of their repsonsibilities as parents. I am sure many men would disagree with you on this as well.
So you have children? Are you basically saying that women should only be admitted past the age of 40 with grown children?
 
Are you kidding??? Census data on the numbers of female medical students who ultimately reproduce? The census can't even get the numbers straight on who lives in my community (a very urban one at that). Additionally, my daughter's medical class, in 3 years has had about 20 students come in & go out of her class due to repeating years or having PhD students come back in - how do you classify those???

As for you not considering pharmacy or dentistry the equivalent of medicine - I'm not surprised. That is the WHOLE basis of this forum & why it doesn't work! You women are so wrapped up in your view of medicine you don't see what the rest of us do each & every day. You are not the only ones working overnight call or longer than 24 hours!!!

However - I'm particularly insightful into all 3 professions since I'm married to a dentist & have a medical school daughter. Let me tell you - you may think you all work hard - she's not worked any harder than the rest of us. I'd also venture to add that her career will be started sooner than her father's since starting a dental business from scratch takes about 10 years to make a profit & you have absoutely NO IDEA of the amount of equipment we buy every year which a physician would cringe at (the last purchase was $100K - 30 years after he began!) So - when you can actually compare apples to apples - come back & let me know!

I can share just about anything you want to know about my career. I've been in my business 30 years - have worked every other weekend for that long & have been on call q3-4 days overnight in a hospital for 25 years of that. I worked on both my kids first birthdays, every other Christmas & Thanksgiving sinced I was married & would choose it all over again. Her father is a solo practioner dentist who takes his own call each & every day, unless he's on vacation. He takes call for his colleagues who go on vacation as well.

I raised two kids to be happy, healthy & mature adults - one of which will be your colleague in exactly 22 months. She went into it with open eyes & all the knowledge she gained from her parents. Her father was as equal a parent as I was. He took her to work when she was sick & I had to be in the OR because there was not another pharmacist to do it. I hope she makes her reproductive choice based on what she and her partner want to accomplish in life with all the influences which come into play. Fortunately, she has LIVED the experience of a loving & competent daycare situation - which both her Dad & I worked hard at finding - which, by the way we maintain close personal friendships with.

As for your condesceding comments on time off during childbirth - no, my husband did not take that time - but he took time off during his brain surgery (which was longer than my postpartum recovery) & there were no repercussions on his practice. As for night feedings - when I was on call & not home - he did it - its easy, you pump, refrigerate & he warms. Even a dentist can do that! I took time off for a broken leg (pharmacists can work if they can't stand) & no one looked askance.

My husband has honestly taken our kids to at least half their doctor appointments because his schedule is set by him - mine is not. So, if they're sick....he reschedules patients (or he did when they were little). He's also taken them & picked them up from camps & colleges. He went with her to take a second look at two medical schools across the country & went with her to move - all because my schedule would not allow me the time. I went later that summer & took my 88 yo mother so she could see her graddaughter in the process of becoming a physcian.

I respect your position, but find your post to be patronizing to not just my profession & that of my husbands, but also to the very hard work it took women of my generation to be able to have the benefits you so glibly brush off for those who want to avail themselves of them.

Sorry - you need the reality check, IMO. You are living in a 1950's world which just doesn't exist. But, you get what you want or ask for - if you want a non-involved partner, that's exactly what you'll get. I'm just glad you didn't sit on any of the 10 ADCOMS which accepteted my daughter into their programs because she is in the PRIME of her reproductive life....and fortunately - that is her own DAMN business!!!


:thumbup::thumbup:
two things....path is not taking any call (she is not in med school yet, so definately not a doctor) and is probably in your generation, which is surprising with her close minded one sided matter of fact (and unflexible ) views
 
We've taken a number of unproductive side paths here!

1) Do most men in society place all the burden of child-rearing on the women? I wanted to highlight a good point of sdn1977's:
...you get what you want or ask for - if you want a non-involved partner, that's exactly what you'll get.
So the bottom line for the younger ladies is: marry wisely. What most men in society can be expected to do will matter much less to us than what our own husbands do.

2) Are pharmacy and dentistry "the equivalent of medicine"? For crying out loud, that's (1) a vague and inflammatory question and (2) way above my pay grade. Maybe we should establish an ***Official Pissing-Contest Thread*** somewhere and confine this discussion there. (It might be a better idea just to leave that sort of thing to the men.) I'm just setting out to survive MS-1!!! Trying to prove that once I've done that, and another 6-9 years of training after that, I will be or will not be equivalent to somebody else -- or listening to other people trying to prove it -- is just not on my list of priorities right now.

3) "Does the fact that you don't discuss other medical career fields mean that you're closed-minded and looking down on us?"... Please bear in mind that theoretical threads like this are something of a sideline on this board. Most of us come to get & give practical advice and experience about our own careers, so we tend to phrase questions accordingly. Just because we don't carefully frame verbiage that includes all other careers in the hospital doesn't mean that we can't recognize useful experience contributed by non-MDs. Perhaps we should be slower to attribute offensive motivations to each other.

Now, let me try to summarize the actual progress we've made so far on the original question:
1) We established that we do not have enough data to debate the question directly. As lilnoelle pointed out, we don't even know whether this is a statistical problem in the US or not. Debating the solution to a problem that doesn't exist is not very sensible.
2) Noeljan tried to use a logical technique -- using the same logic to demonstrate something else that we can debate, I have no idea whether there's a rhetorical name for this -- to prove that if women are objectionable due to the cost/productivity ratio, then so are older medical students. Unfortunately that led to an argument.
3) sdn1977 tried to use that same technique regarding men -- just because men currently make fewer sacrifices for their families doesn't mean they always will, so if the cost/productivity ratio is objectionable for women now, then it will also be so for men in the future. Unfortunately, that led to an argument also.

Unless we want some guy showing up and claiming that this thread is proof that women shouldn't be trained as doctors because they're too emotional, we should probably either get back on track or close the thread. I, for one, don't have the time or interest to do the research to make a concrete discussion out of it. I was hoping somebody else would already know something about government financing and male/female attrition rates.
 
As for you not considering pharmacy or dentistry the equivalent of medicine - I'm not surprised. That is the WHOLE basis of this forum & why it doesn't work! You women are so wrapped up in your view of medicine you don't see what the rest of us do each & every day. You are not the only ones working overnight call or longer than 24 hours!!!!!!
I NEVER said that being a pharmacist or Dentist wasn't hard work but your defensive posture in your response reeks of perhpas your personal feeling Pharmacist and or Dentist aren't as smart, talented, whatever else an insecure mind would have you believe, as "real" Doctors are. Maybe you were as a quite a few Docs I've run into believe, a reject from Med school and chose Pharmacy/Dentistry as a "back up", I don't know and I don't really care. With a best friend who's a Doctor (of Pharmacy) and cousins who are Dentists, I've got a pretty good glimpse of what these fields entail. Having said that, you can take you unwarrented opinions about MY feelings of these fields and stuff it!
Umm I don't know what program you are in, but I know for a fact you are not yet in medical schoo (and have not yet gained acceptance to medical school).?
FYI, I HAVE been previously accepted to med school. You how big of an a$$ do you feel like right about now becasue you're certainly WEARING that a$$ title like a champ. Some of you pepole are supposee to be so dam smart but obviously haven't figured out that there's more than one way to be ENROLLED in an ALLOPATHIC med school.
 
Now, let me try to summarize the actual progress we've made so far on the original question:
1) We established that we do not have enough data to debate the question directly. As lilnoelle pointed out, we don't even know whether this is a statistical problem in the US or not. Debating the solution to a problem that doesn't exist is not very sensible..
If SDN depeneded on printed, statistical facts to have a discussion, then I imagine that all the 2 trillion affirmative action threads would NEVER have been started.:rolleyes: I posted a position that SOME people in the world believe and in usuals fashion, the political correct police jumped in. Perhaps people are too PC to say it, but don't fool yourselves into thinking that I'm alone on this viewpoint.
2) Noeljan tried to use a logical technique --.
Yeah right, by talking **** about something he didn't know a dam thing about, ie my NOT having been accepted to med school. Yep that's logical as hell. If you want to use his so called logic about age, then why not for the purposes of being throughly ridiculous, do genetic testing on folks going to med school and exclude those who are predisposed to have a heart attack by age 55 (which will probably be quite a few folks given the obesity epidemic). Better yet, why don't we have a BMI scale for admits to med school. What about excluding black women between the ages of 25-44 because the leading cause of death for that age group is HIV/AIDS? Or let's exclude white males between the ages of 21-24 because the leading cause of death is car acidents? It's real easy for some of you to say that this or that isn't fair but I don't think it's fair that as an example other residents/med students have to "cover" for a surgical resident who decided to have 2 kids in 3 years. What happend to logic in THAT situation?

I've known quite a few women who made the decision to not have ANY kids because they wanted career in medicine. Personally, I think that's THE most selfless thing a person can do but because society has this warped idea of what a "real" life is, ie 2 kids , a husband, a dog, and a house with a picket fense, women are going into fields making unreasonable demands.
And that's NOT fair to women like ME who really thought this med school thing through and didn't do things like matriclue into med school with a family and a dying parent. I WAITED until the time was right for EVERONE who would be affected by my decision, NOT just myself!! And I sure as hell didn't and don't expect people to create special "rules" just or me which irronically is NOT the idea most people around here get when they think about URM's and Medicine. Hmmmmmmmm.

3) sdn1977 tried to use that same technique regarding men -- just because men currently make fewer sacrifices for their families doesn't mean they always will
It's called EVOLUTION dear which essentially means that certain things about men will NEVER be the same as they are for women. What are you people, a bunch of feminist, she-men, who want to go rambo style into Iraq? I don't think women belong in combat there either but if you want to enlist, be my guest. Opps maybe your avatar says it all?:confused:
Unless we want some guy showing up and claiming that this thread is proof that women shouldn't be trained as doctors because they're too emotional, we should probably either get back on track or close the thread.
So what if they do? Are women too soft to have a decent debate? Are people going to shed internet tears? For goodness sakes, no wonder men dominate the world!:rolleyes:
 
I'm with you!

I think admitting certain women over say 35 and/or those done with child bearing, is the best idea around.:thumbup:

Haha, I'm 26.... (But had children relatively young)

I've known quite a few women who made the decision to not have ANY kids because they wanted career in medicine. Personally, I think that's THE most selfless thing a person can do.

Maybe. I could've been one of those women... except how many college age kids do you know that truly know what they want? I thought I did. 6 years later and I honestly can say I didn't have a clue. Some women are smart to wait till they really know themself before they get married/start a family. Others take the plunge when they think they're ready, but rather aren't.

Anyway. All I'm saying is that circumstances aren't always ideal, nor how one would wish they would be. All we can do is do what we can with what we've got.

And when all is said and done, I've got two beautiful children, and eventually will be a doctor. I hope they don't suffer for my choice, but even if I wasn't in med school, I'd have to work because my husband is not well employed. So either way they'd be in a daycare and only seeing me on weekends and evenings.

A couple questions:
1) How many male med students/residents take 6-8 weeks off after their WIVES have babies?

taking 6-8 weeks off is for a medical reason, similar to taking the time off after a gall bladder surgery.

2) How many male medical students/residents feed babies in the middle of the night on a regular basis? And I won't even ask about BREAST feeding babies.:laugh:

Obviously females are the only ones that can give birth and breastfeed. The time spent in 6-8 weeks off due to giving birth is minimal in a course of a career, even if the mother gave birth to as many as four kids. Even if you don't find it minimal, someone has to have children.... are we (humans) just gonna stop reproducing?
Even the time spent up at night feeding an infant is somewhat minimal in the course of things.... the mom (or dad) are sleep deprived for a few months - nothing really, if compared to a typical intern year in residency.

And, yes, I know many dads who wake up in the middle of the night to feed new infants. My husband wasn't one of them because I breastfed.

I think there's "lala land" and reality, and the reality is that MOST men STILL aren't doing their share when it comes to child rearing.

Well, I can only speak for myself, and my husband definitely doesn't, but I still don't see why this means I (or other females like me) are wasting money by attending med school.

What your saying is that women are not spending enough time working to make worthwhile doctors. How is a physician who gets trained at 22, finishes at 30, and takes 5 years off (or 10) to have children more of a waste of money than the woman who starts her family at 25, starts med school at 32, and finishes by the time she's 40?

And I think the woman who takes 5-10 years off to have a family is probably a rarity. I'm guessing most woman who go to med school are pretty career driven individuals and therefore won't take a large break.

And we're just talking about woman, what about the many nontraditionals who come to medicine after another career? Are they also a waste of money?

And how about the many male physicians who start their careers early, intending to retire at 50? I don't know any stats, but I've sure heard a lot of male pre-meds claim that is their desire.


The truth is that we have no way of knowing what individuals are going to do with the career that they are given. Med schools have a weeding out process during the application process and that is about the best we can do as far as avoiding individuals who are undesireable choices to become physicians.
 
I
Some of you pepole are supposee to be so dam smart but obviously haven't figured out that there's more than one way to be ENROLLED in an ALLOPATHIC med school.

Enlighten me. I'm not trying to argue. I'm curious. Tell us about your program.
 
Enlighten me. I'm not trying to argue. I'm curious. Tell us about your program.
Try this one: SMP. Some SMP's require enrollment in allopathic medical schools. Now if you want a list, you'll have to go find that our for yourself.

And FYI, I'm not in an SMP.;)
 
Maybe. I could've been one of those women... except how many college age kids do you know that truly know what they want? I thought I did. 6 years later and I honestly can say I didn't have a clue. Some women are smart to wait till they really know themself before they get married/start a family. Others take the plunge when they think they're ready, but rather aren't..
First, I'm glad to finally be able to really discuss this decently with someone.

There's absolutely nothing wrong with a person not having their life all mapped out. Who does? But there's a LOT wrong with expecting and feeling entitled to having other people work around YOUR choices (not you directly of course).
And when all is said and done, I've got two beautiful children, and eventually will be a doctor. I hope they don't suffer for my choice, but even if I wasn't in med school, I'd have to work because my husband is not well employed. So either way they'd be in a daycare and only seeing me on weekends and evenings...
I hear ya sista', daycare was my BEST friend.
taking 6-8 weeks off is for a medical reason, similar to taking the time off after a gall bladder surgery. ...
I agree but I'm not sure what the point is.:confused:

Well, I can only speak for myself, and my husband definitely doesn't, but I still don't see why this means I (or other females like me) are wasting money by attending med school....
Medical training costs money beyond what you pay in tuition and inmany fields there's a physician shortage maybe even inpart due to all the women docs who quit medicine. It's really a simple mathmatical equation to me.
What your saying is that women are not spending enough time working to make worthwhile doctors. How is a physician who gets trained at 22, finishes at 30, and takes 5 years off (or 10) to have children more of a waste of money than the woman who starts her family at 25, starts med school at 32, and finishes by the time she's 40?...
Easy answer. These aren't the women I'm talking about as far as wasting money is concerned. But these are the women I'm talking about as far as demanding special treatment if they expect to get partner and/or tenure at the same rate as a women who did the same family thing without taking so much time off.
And I think the woman who takes 5-10 years off to have a family is probably a rarity. I'm guessing most woman who go to med school are pretty career driven individuals and therefore won't take a large break.?...
I don't think this is true but I'm basinf my thoughts on what I've read on Mommd.
And we're just talking about woman, what about the many nontraditionals who come to medicine after another career? Are they also a waste of money?.?...
Already addressed.:)
And how about the many male physicians who start their careers early, intending to retire at 50? I don't know any stats, but I've sure heard a lot male pre-meds claim that is their desire.
Perhaps quite a few of them will be working oin their second bimbo-ish wives so I can't imagine how they can afford to quit medicine!:laugh:
 
Medical training costs money beyond what you pay in tuition and inmany fields there's a physician shortage maybe even inpart due to all the women docs who quit medicine. It's really a simple mathmatical equation to me.
:

I agree that medical training costs beyond what we pay in tuition. I'm sure that females and males who quit medicine contribute to the physician shortage. I'm just not sure that females are more guilty than males and would require real solid stats from the US to think so.
Even if women do leave in higher numbers, the number would have to be EXTREMELY significant for me to think females shouldn't be trained as doctors. As it is, perhaps there should be some way to try to weed out individuals that are likely to quit before they retire, but theres no way of knowing who those individuals will be.

Concerning the physician shortage.... Isn't it mostly due to an increase in patients, not a decrease in doctors? It also seems to me that it is a problem of disbursement of doctors (both the apparent dislike of primary care and the avoidance of rural/poor urban areas) rather than a shortage of physicians in general.

Another thing I've heard (I have no evidence) is that females that plan on having a family are more likely to go into pediatrics and family practice than males. Therefore, females are meeting a need that males are not. I guess one could argue that those individuals chose their fields because they are most family friendly (not a bad thing) and are also most likely to leave their field for there family, therefore increasing the shortage, but if males don't want to step in and take their place anyway, I don't see that replacing those female doctors with males will make any difference.
 
I NEVER said that being a pharmacist or Dentist wasn't hard work but your defensive posture in your response reeks of perhpas your personal feeling Pharmacist and or Dentist aren't as smart, talented, whatever else an insecure mind would have you believe, as "real" Doctors are. Maybe you were as a quite a few Docs I've run into believe, a reject from Med school and chose Pharmacy/Dentistry as a "back up", I don't know and I don't really care. With a best friend who's a Doctor (of Pharmacy) and cousins who are Dentists, I've got a pretty good glimpse of what these fields entail. Having said that, you can take you unwarrented opinions about MY feelings of these fields and stuff it!
FYI, I HAVE been previously accepted to med school. You how big of an a$$ do you feel like right about now becasue you're certainly WEARING that a$$ title like a champ. Some of you pepole are supposee to be so dam smart but obviously haven't figured out that there's more than one way to be ENROLLED in an ALLOPATHIC med school.

umm an SMP is not the same as being accepted and enrolled as a medical student, it is a program for people trying to gain acceptance
 
If SDN depeneded on printed, statistical facts to have a discussion, then I imagine that all the 2 trillion affirmative action threads would NEVER have been started.:rolleyes: I posted a position that SOME people in the world believe and in usuals fashion, the political correct police jumped in. Perhaps people are too PC to say it, but don't fool yourselves into thinking that I'm alone on this viewpoint.
Yeah right, by talking **** about something he didn't know a dam thing about, ie my NOT having been accepted to med school. Yep that's logical as hell. If you want to use his so called logic about age, then why not for the purposes of being throughly ridiculous, do genetic testing on folks going to med school and exclude those who are predisposed to have a heart attack by age 55 (which will probably be quite a few folks given the obesity epidemic). Better yet, why don't we have a BMI scale for admits to med school. What about excluding black women between the ages of 25-44 because the leading cause of death for that age group is HIV/AIDS? Or let's exclude white males between the ages of 21-24 because the leading cause of death is car acidents? It's real easy for some of you to say that this or that isn't fair but I don't think it's fair that as an example other residents/med students have to "cover" for a surgical resident who decided to have 2 kids in 3 years. What happend to logic in THAT situation?

I've known quite a few women who made the decision to not have ANY kids because they wanted career in medicine. Personally, I think that's THE most selfless thing a person can do but because society has this warped idea of what a "real" life is, ie 2 kids , a husband, a dog, and a house with a picket fense, women are going into fields making unreasonable demands.
And that's NOT fair to women like ME who really thought this med school thing through and didn't do things like matriclue into med school with a family and a dying parent. I WAITED until the time was right for EVERONE who would be affected by my decision, NOT just myself!! And I sure as hell didn't and don't expect people to create special "rules" just or me which irronically is NOT the idea most people around here get when they think about URM's and Medicine. Hmmmmmmmm.

It's called EVOLUTION dear which essentially means that certain things about men will NEVER be the same as they are for women. What are you people, a bunch of feminist, she-men, who want to go rambo style into Iraq? I don't think women belong in combat there either but if you want to enlist, be my guest. Opps maybe your avatar says it all?:confused:
So what if they do? Are women too soft to have a decent debate? Are people going to shed internet tears? For goodness sakes, no wonder men dominate the world!:rolleyes:


In this "argument" of yours, you actually are providing reasons against your claims. Who are you to say with absoulte certaintly what is right or wrong concerning someones career and choices??
Oh and I was using logic (something you don't seem to do often). You keep spouting off how female docs for the most part are a huge waste of resources. I was using the same logic and asking you, as someone applying to medical school +40 yrs old would be a huge waste of resources?
Mind you I don't think either cases are, but I am using your "logic"
there are people older and younger than me in my class, and they all appear to be great people with different experiences.
 
If SDN depeneded on printed, statistical facts to have a discussion, then I imagine that all the 2 trillion affirmative action threads would NEVER have been started.:rolleyes: I posted a position that SOME people in the world believe and in usuals fashion, the political correct police jumped in. Perhaps people are too PC to say it, but don't fool yourselves into thinking that I'm alone on this viewpoint.
Yeah right, by talking **** about something he didn't know a dam thing about, ie my NOT having been accepted to med school. Yep that's logical as hell. If you want to use his so called logic about age, then why not for the purposes of being throughly ridiculous, do genetic testing on folks going to med school and exclude those who are predisposed to have a heart attack by age 55 (which will probably be quite a few folks given the obesity epidemic). Better yet, why don't we have a BMI scale for admits to med school. What about excluding black women between the ages of 25-44 because the leading cause of death for that age group is HIV/AIDS? Or let's exclude white males between the ages of 21-24 because the leading cause of death is car acidents? It's real easy for some of you to say that this or that isn't fair but I don't think it's fair that as an example other residents/med students have to "cover" for a surgical resident who decided to have 2 kids in 3 years. What happend to logic in THAT situation?

I've known quite a few women who made the decision to not have ANY kids because they wanted career in medicine. Personally, I think that's THE most selfless thing a person can do but because society has this warped idea of what a "real" life is, ie 2 kids , a husband, a dog, and a house with a picket fense, women are going into fields making unreasonable demands.
And that's NOT fair to women like ME who really thought this med school thing through and didn't do things like matriclue into med school with a family and a dying parent. I WAITED until the time was right for EVERONE who would be affected by my decision, NOT just myself!! And I sure as hell didn't and don't expect people to create special "rules" just or me which irronically is NOT the idea most people around here get when they think about URM's and Medicine. Hmmmmmmmm.

It's called EVOLUTION dear which essentially means that certain things about men will NEVER be the same as they are for women. What are you people, a bunch of feminist, she-men, who want to go rambo style into Iraq? I don't think women belong in combat there either but if you want to enlist, be my guest. Opps maybe your avatar says it all?:confused:
So what if they do? Are women too soft to have a decent debate? Are people going to shed internet tears? For goodness sakes, no wonder men dominate the world!:rolleyes:

and finally, I think I know what's going on here. I have seen your posts in the nontrad forums. You are worried about getting into med school, the competition, etc. We all were. You need to realize though, your claims of who is and who is not fit for medicine are very similiar to people who do not get in and attack URMs. I'm surprised, because usually that comes from a more younger inexperienced crowd. I'm in my 20's, a few years older than the typical right out of college med student, and looking back now I can't believe how closed minded I was with some things.
Oh and as far as the husband thing goes, I don't know about you but if my future husband ever EVER acted the way you are describing men are allowed to act....THERE IS THE DOOR!!! We will be a team.
 
We've taken a number of unproductive side paths here!

1) Do most men in society place all the burden of child-rearing on the women? I wanted to highlight a good point of sdn1977's:

So the bottom line for the younger ladies is: marry wisely. What most men in society can be expected to do will matter much less to us than what our own husbands do.

2) Are pharmacy and dentistry "the equivalent of medicine"? For crying out loud, that's (1) a vague and inflammatory question and (2) way above my pay grade. Maybe we should establish an ***Official Pissing-Contest Thread*** somewhere and confine this discussion there. (It might be a better idea just to leave that sort of thing to the men.) I'm just setting out to survive MS-1!!! Trying to prove that once I've done that, and another 6-9 years of training after that, I will be or will not be equivalent to somebody else -- or listening to other people trying to prove it -- is just not on my list of priorities right now.

3) "Does the fact that you don't discuss other medical career fields mean that you're closed-minded and looking down on us?"... Please bear in mind that theoretical threads like this are something of a sideline on this board. Most of us come to get & give practical advice and experience about our own careers, so we tend to phrase questions accordingly. Just because we don't carefully frame verbiage that includes all other careers in the hospital doesn't mean that we can't recognize useful experience contributed by non-MDs. Perhaps we should be slower to attribute offensive motivations to each other.

Now, let me try to summarize the actual progress we've made so far on the original question:
1) We established that we do not have enough data to debate the question directly. As lilnoelle pointed out, we don't even know whether this is a statistical problem in the US or not. Debating the solution to a problem that doesn't exist is not very sensible.
2) Noeljan tried to use a logical technique -- using the same logic to demonstrate something else that we can debate, I have no idea whether there's a rhetorical name for this -- to prove that if women are objectionable due to the cost/productivity ratio, then so are older medical students. Unfortunately that led to an argument.
3) sdn1977 tried to use that same technique regarding men -- just because men currently make fewer sacrifices for their families doesn't mean they always will, so if the cost/productivity ratio is objectionable for women now, then it will also be so for men in the future. Unfortunately, that led to an argument also.

Unless we want some guy showing up and claiming that this thread is proof that women shouldn't be trained as doctors because they're too emotional, we should probably either get back on track or close the thread. I, for one, don't have the time or interest to do the research to make a concrete discussion out of it. I was hoping somebody else would already know something about government financing and male/female attrition rates.

:thumbup: You are right, sorry if this post went off topic at all on my behalf. I feel so much for the pioneer women who went before you and I, and what they had to fight for. It just hits such a nerve inside when people try and attack that.
 
If SDN depeneded on printed, statistical facts to have a discussion, then I imagine that all the 2 trillion affirmative action threads would NEVER have been started.:rolleyes: I posted a position that SOME people in the world believe and in usuals fashion, the political correct police jumped in. Perhaps people are too PC to say it, but don't fool yourselves into thinking that I'm alone on this viewpoint.
Yeah right, by talking **** about something he didn't know a dam thing about, ie my NOT having been accepted to med school. Yep that's logical as hell. If you want to use his so called logic about age, then why not for the purposes of being throughly ridiculous, do genetic testing on folks going to med school and exclude those who are predisposed to have a heart attack by age 55 (which will probably be quite a few folks given the obesity epidemic). Better yet, why don't we have a BMI scale for admits to med school. What about excluding black women between the ages of 25-44 because the leading cause of death for that age group is HIV/AIDS? Or let's exclude white males between the ages of 21-24 because the leading cause of death is car acidents? It's real easy for some of you to say that this or that isn't fair but I don't think it's fair that as an example other residents/med students have to "cover" for a surgical resident who decided to have 2 kids in 3 years. What happend to logic in THAT situation?

I've known quite a few women who made the decision to not have ANY kids because they wanted career in medicine. Personally, I think that's THE most selfless thing a person can do but because society has this warped idea of what a "real" life is, ie 2 kids , a husband, a dog, and a house with a picket fense, women are going into fields making unreasonable demands.
And that's NOT fair to women like ME who really thought this med school thing through and didn't do things like matriclue into med school with a family and a dying parent. I WAITED until the time was right for EVERONE who would be affected by my decision, NOT just myself!! And I sure as hell didn't and don't expect people to create special "rules" just or me which irronically is NOT the idea most people around here get when they think about URM's and Medicine. Hmmmmmmmm.

It's called EVOLUTION dear which essentially means that certain things about men will NEVER be the same as they are for women. What are you people, a bunch of feminist, she-men, who want to go rambo style into Iraq? I don't think women belong in combat there either but if you want to enlist, be my guest. Opps maybe your avatar says it all?:confused:
So what if they do? Are women too soft to have a decent debate? Are people going to shed internet tears? For goodness sakes, no wonder men dominate the world!:rolleyes:


Actually no "she-male" here. I am a former pageant girl and cheerleader (in HS and college) if that's hard to believe:D I am such a girly girly, although I am pretty strong (thanks to years as a gymnast:)
 
umm an SMP is not the same as being accepted and enrolled as a medical student, it is a program for people trying to gain acceptance
Here you go again not knowing what the hell you're talking about. SOME SMP's and post baccs come with a conditional acceptances to medical school.
 
Here you go again not knowing what the hell you're talking about. SOME SMP's and post baccs come with a conditional acceptances to medical school.

haha ok. First, CONDITIONAL does not mean you are definately in. It will depend on your performance (hence the word conditional). Second, you have claimed to be a premed without such "conditions", applying to med school,hoping to get into MD/phd before. Has that changed?
I know EXACTLY what I am talking about. You seem to be the one with a warped sense of reality. Your rapid and baseless judgements about people have been wrong over and over again. For example, see the previous posts. I am done here, you don't even make any sense.
 
I have seen your posts in the nontrad forums. You are worried about getting into med school, the competition, etc. We all were..
Worried about getting into med school again? Ahh yeah, not sure where you got that from perhaps you're mixing up YOUR insecurites with those that quite frankly I don't have. I have a "life" so med school isn't something I EVER worry about perhaps related to my 1) current enrollment and 2) current academic success. Here's some things I DO worry about. I'm worried about having another parent/in law to take care of while in med school. I'm worried about how my daughter is going to do in school taking Chinese as a 6th grader. I'm worried I may be a BRCA 1 carrier. THOSE are examples of "real" worries IMHO.
Oh and as far as the husband thing goes, I don't know about you but if my future husband ever EVER acted the way you are describing men are allowed to act....THERE IS THE DOOR!!! We will be a team.
Where is the smiley that falls on the floor laughing when you need one!:laugh: Do you mean team as in 50-50? Bahhahahahha:laugh:
 
First, CONDITIONAL does not mean you are definately in. .
Well apparently "definitely in" doesn't mean "definitely in" based on the number of med students I've had in classes who flunked med school courses.:rolleyes:
I am a former pageant girl and cheerleader (in HS and college) if that's hard to believe:D I am such a girly girly, although I am pretty strong (thanks to years as a gymnast:)
You're a former pageant girl too? I did a few Miss America prelims back in the day(in Florida). But I passed on Cheerleading to become a Majorette in the marching band (in high school)and a Dancer on a dance team (in college).;)
 
Second, you have claimed to be a premed without such "conditions", applying to med school,hoping to get into MD/phd before. Has that changed?.
First, I'm not a premed. Second, there's an MD/PhD in my future and I have about 11 credits on the MD side and 15 on the PhD side. Third, it's a dam waste to train an 40 something FEMALE MD/PhD, isn't it?:laugh:
 
First, I'm not a premed. Second, there's an MD/PhD in my future and I have about 11 credits on the MD side and 15 on the PhD side. Third, it's a dam waste to train an 40 something FEMALE MD/PhD, isn't it?:laugh:


no, actually I don't think it is a waste. I think it is a great thing when people realize what they want to do, and go for it. I feel that the adcoms do in fact select people with many different experiences to represent the future of the profession. It makes me happy when I see people reach their dreams. I think all people can make contributions in their own way.
 
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=11318996&dopt=Abstract I'm guessing this is what the author of the Daily Telegraph was referring to and she really misread the results. If you have access to the full text I suggest that you read it. The article points out that women leaving medicine usually return. Men also leave the NHS, although it is usually to practice medicine abroad or in Britain, but outside the NHS. Taking the highest numbers for any one time, 3.6% of men were not working in medicine and 12.2% of women were not. The 12.2% number was from women who graduated in 1977 at 5 years after qualification. By 15 years, the number not working was 4.5%. Not quite the jaw dropping number as 60%.
 
First, I'm not a premed. Second, there's an MD/PhD in my future and I have about 11 credits on the MD side and 15 on the PhD side. Third, it's a dam waste to train an 40 something FEMALE MD/PhD, isn't it?:laugh:

I would guess her confusion stems from your other posts you have made stating you aren't an "MS I (yet)", and that you are currently working on a master's degree.

Making assumptions on what someone may do with their future career is a stupid way for med schools to select their class. If a real problem with people leaving the field developed (and I don't believe there is one that isn't related to distribution as opposed to actual numbers), one way to deal with it would be with scholarship programs that cover med school costs in return for service obligations after training (like the military and indian health service programs, but they could be administered at a county level as well). Otherwise, the schools just roll the dice that the people they pick will make good physicians (not guaranteed) and will make a meaningful contribution to the field (which involves more than just being a warm body in the clinic, in my opinion).
 
Everyone is entitled to their opinion & I do respect yours 1Path. I just don't think your path & mine will cross since you really do have, IMO, a very closed minded approach to the multidisciplinary approach to healthcare - ALL aspects of healthcare, no matter who delivers it & the age at which they were trained or the time they took off - to take a sabbatical, have children, travel or teach.

You say you've been accepted to a medical school - great. I've got to say - just from my daughter's experience with interviews at 10 medical schools in the country - a small n for sure....she was asked repeatedly about this in one form or another - how does she view the physician's position in healthcare in the 21st century. Now - your experience perhaps is much broader than hers......she was only accepted at the 10 she interviewed at. But, I am surprised at the perspective you bring since she just had 2 classmates leave for their PhD training & absorbed 3 who have completed their PhDs & have come back to finish their clinical medical years - and those are not the experiences she relates. But - again, I admit, it is hearsay - her relationships with these folks as related to me.

As for my own experience - I was never interested in medicine. When I applied in 1973 - probably before you were born - I had no interest in it, nor do I now. As for my female physician friends - they have varied practice pathways depending on the specialty. Some are partnerships, some are sole practioners & some are employees of medical corporations. All have children & took the appropriate time off for childbirth. Perhaps you don't know quite as much of the practical side of medicine as you claim, but that is just what I'm assuming from your posts - perhaps misguided on my part. Again - you will believe what you will. The reality is what it is, no matter your belief as a premedical student. Thats the beauty of reality - each is unique to ourselves & our situations.

My husband was a biochemist at Harvard before he went to dental school - he has no issues with not being a "real" doctor - but you need to believe in what you want to believe. He's fine just being a dentist & fortunately derives much satisfaction from it.

However....I will say your posts say much about your personal life & professional aspirations, assessments & those of us who choose to make a decision other than yours. Some of us make our choices based solely on what we like (I like drugs - particularly genetics of drug disposition) & many of us have 50-50 partnerships with our spouses - again - choices and negotiations we make. The fact you find that humerous is "telling".

The negativity you show to those who seem to disagree with you (ie - telling me to "stuff it"....just this side of a TOS violation) does seem to indicate some lack of patience & tolerance which is a defining characteristic of any healthcare provider - no matter the field.

Good luck in your endeavors.
 
I would guess her confusion stems from your other posts you have made stating you aren't an "MS I (yet)", and that you are currently working on a master's degree.
Now I wonder exactly how much time you spent looking into this. Dude, you MUST geta life! I thought derm path residents had better things to do.:laugh::laugh: So are you gonna verify my credit hours earned next?? Just an FYI, Medical Histology isn't on the list of required courses for a graduate degree in Pharmacology.;)
 
no, actually I don't think it is a waste. I think it is a great thing when people realize what they want to do, and go for it..
Going for "it" is great. Going for it and expecting others to bend the rules for you is not great but rather selfish. I don't see men asking for special favors in medical careers and perhaps many don't need to (so much for that 50-50 relationship). Maybe women wouldn't need to either if they made smarter reporductive choices or had to deal with the consequences of the reproductive choices they do make.
The negativity you show to those who seem to disagree with you (ie - telling me to "stuff it"....just this side of a TOS violation) does seem to indicate some lack of patience & tolerance which is a defining characteristic of any healthcare provider - no matter the field..
Let's be clear here. I specifically showed "negativity" toward you because it absolutely enrages me that Non MD types think folks interested in becoming a physician or who already are, believe the MD is the greatest degree of all, MD's work harder than everyone else, MD's are smarter than everyone and the list goes on and on. Of course the problem is that, I have NEVER, EVER said ANY of that nor do I think it to be true. Of all the people on SDN, I'm one of the few who thinks that ANYONE with a doctoral level degree should be called doctor. That you somehow assumed I thought otherwise speaks to the unspoken resentment many people seem to have toward MD types. Then you "cover" your comments with borderline insults (telling me I lack patience/tolerance to be a healthcare provider) then go off and file a formal TOS complaint. Is this type of behavior anyway to have a debate? If I had a dollar for everytime I heard HERE that I wouldn't make a good healthcare provider, I'd have enough to pay for my AMCAS applications. I don't know many practicing MD's who spend much of their day on the in forum pages on the internet, so exactly what do my comments HERE have to do with the practice of medicine??? I work with patients from a variety of backgrounds EVERYDAY, a proper venue for exercising "patience and tolerance". And I'm certain that if I did in fact have problems with "pateince and tolerance", the adcom members I occcasionally work with would have had me fired by now. As it stands, I'm more than "holding it down" in the clinic, although I'm still looking forward to completing a pathology residency.

Final thing is that I think people take things said on forum pages way too seriously. Usinf "stuff it" was as much in reverence to Dolly Parton as to make a point. But it certainly wasn't to insult anyone. Trust me, I'm sure we could all come up with a truly insulting way to tell someone to "stuff it" using other choice words.
 
Everyone is entitled to their opinion & I do respect yours 1Path. I just don't think your path & mine will cross since you really do have, IMO, a very closed minded approach to the multidisciplinary approach to healthcare - ALL aspects of healthcare, no matter who delivers it & the age at which they were trained or the time they took off - to take a sabbatical, have children, travel or teach..
You really are mixing apples and orangatuans here. Taking a sabatical, taking SOME time off for having children, isn't the issue here. The primary issue here is 1) Women who quit medicine for good and 2) Women who make what I deem are over the top demands to accomodate their personal choices.
I've got to say - just from my daughter's experience with interviews at 10 medical schools in the country - a small n for sure....Now - your experience perhaps is much broader than hers......she was only accepted at the 10 she interviewed at. .
It's a well known fact that high SES and having a parent (in her case 2) with the letters "Dr" in front of their name makes for a HUGE advantage over everyone else applying to med school for a variety of reasons. But that's best left discussed in another thread.

So sure, I think we're all impressed with 10acceptances. But personally, I'm even more impressed with 10 acceptances from a person who's from the ghetto of Boston or the back woods of small town Tennessee.
As for my own experience - I was never interested in medicine. When I applied in 1973 - probably before you were born - I had no interest in it, nor do I now.
Don't let the Ipod playlist fool ya, I'm a Fabulously Forty and have been working in and around medicine for the last 19 years (started in 1988). TONS of things pepper my viewpoint of medicine from working with poor, uninsured HIV + patients to being a Fellow at the #1 research institution in the world, the NIH. I've had a ton of time to observe women "Dr's" as I defined above, balancing family and career. So I can honestly say that these past few years, I've observesd more selfish, destructive for ALL women, behavior from working women "dr's" now than I EVER have. And at the rate things are going, it's only going to get worse for those of us who make smarter family/career decisions.
 
Now I wonder exactly how much time you spent looking into this. Dude, you MUST geta life! I thought derm path residents had better things to do.:laugh::laugh: So are you gonna verify my credit hours earned next?? Just an FYI, Medical Histology isn't on the list of required courses for a graduate degree in Pharmacology.;)

It took about two minutes, and I did it because I was curious about the comments that were going back and forth. I don't know where you got the derm path resident thing from (it would take about 30 seconds to see that I just started surgical residency). Knowing someone's background helps to place their comments in perspective. I believe someone already posted the info that shows that your original assumptions (that women are leaving medicine for good in droves) were incorrect. That you still seem so angry towards women making over the top demands (such as what I am not sure), makes it seem like you feel you have been personally affected by this. After having been through the med school admission process, as well as residency applications in a field not typically welcoming to women, I realize that schools and programs aren't as worried about whether women are going to drop out to pop out a bunch of babies as you seem to think they are. Sure some programs are still in the dark ages, and I was asked about children at a program or two, but the majority are not going to exclude an entire gender because they MIGHT decide to have babies, and this MIGHT end up affecting their career.

I am curious what you are actually advocating. Should women be excluded from training in the medical field? Should they be allowed in only if they sign a contract to work at least x number of hours for at least x number of years? Perhaps only those who have been sterilized should be allowed in.

If you are really just trying to say that people should be considerate of those around them and try not to impose on them for their own needs, I can understand that. It just isn't really possible to force anyone to do so, and it isn't always possible to make every life decision based on how it affects everyone else.
 
It took about two minutes, and I did it because I was curious about the comments that were going back and forth. I don't know where you got the derm path resident thing from (it would take about 30 seconds to see that I just started surgical residency). .
My bad!:)
I believe someone already posted the info that shows that your original assumptions (that women are leaving medicine for good in droves) were incorrect. .
Where exactly did I post that women were leaving in droves?? Man I swear, SDN is the ONLY forum page I regularly participate on where the members ad-lib the post of others, especially those they disaree with.:rolleyes:
That you still seem so angry towards women making over the top demands (such as what I am not sure), makes it seem like you feel you have been personally affected by this. After having been through the med school admission process, as well as residency applications in a field not typically welcoming to women, I realize that schools and programs aren't as worried about whether women are going to drop out to pop out a bunch of babies as you seem to think they are. Sure some programs are still in the dark ages, and I was asked about children at a program or two, but the majority are not going to exclude an entire gender because they MIGHT decide to have babies, and this MIGHT end up affecting their career..
You may have finished med school and currently be in residency, but obviusly you haven't been in an academic setting very long. Ever wonder WHY there aren't very many TENURED women in academia? Probably not because I'm guessing that med school was your first experience with all that.

And I'm wondering, do you ever think about why surgery "not welcoming to women". Interestingly, I don't see folks making those kinds of statements when looking at say the number of Native Americans in a surgical residency. If I said, "surgery is not welcoming for blacks" all hell would break loose.

I know a black female surgeon VERY well. She has 3 kids. She has a husband that stays at home. SHE is a role model for how to get your training, and not ask for "special" treatment every 5 minutes. And I've NEVER heard her say that "surgery isn't welcoming" to blacks and/or women.

Children "MIGHT" affect your carrer??Jeez a weez, I can tell that you are definitely NOT a Mom yet because if you were you'd know that having kids DEFINITELY affects your career even if you have a SAHD AND a nanny.
I am curious what you are actually advocating. Should women be excluded from training in the medical field?.
Ummm no, I'm not excluding myself from a career in medicine.:)
Should they be allowed in only if they sign a contract to work at least x number of hours for at least x number of years?.
I think a good start would be a requirement to practice for at least 20 years total AND for a certain number of hours to allow for part-time employment. Why not have a work requirement? The military does it ALL the time.
Perhaps only those who have been sterilized should be allowed in..
Or those who have had so many STD's that they had to have their "hot tubes" removed. :rolleyes:Come on, we were doing so well with intelligent exchanges before.
 
I too am trying to understand your solution to the issue presented. Is this it?

To indicate ahead of time that the applicant will work at least 20 years with no greater than (fill in the blank) number of years of part-time work?

Do you want this on AMCAS, during the interview, on the offer of acceptance?
 
To indicate ahead of time that the applicant will work at least 20 years with no greater than (fill in the blank) number of years of part-time work??
No not quite. I can't be any more clear than I was in a previous post.:confused:
Do you want this on AMCAS, during the interview, on the offer of acceptance?
None of the above. You'd sign this document on the first day of med school. Additional info provided on that form would include the consequences of quiting medicine including a requirement to pay back twice what it cost to train you with interest.

To address another point in this thread, I believe someone mentioned that young people don't always know what they want to do. Well, my very easy solution to that which I've previously stated on SDN is to ONLY admit people after they: 1) Reach a certain age and 2) Have had a "real" job with benefits, and 3) Can prove that they can survive without Mommy's and Daddy's "payroll". 4) Have served the disadvantaged in some capacity. Perhaps if people were admitted when they were say 28+ (perhaos an exception for future surgeons), there wouldn't be as many women dropping out of medicine.
 
Ok, I'll throw some more references out for discussion as think the first article has questionable "valid" statistics.

The work lives of women physicians results from the physician work life study. The SGIM Career Satisfaction Study Group.

McMurray JE, Linzer M, Konrad TR, Douglas J, Shugerman R, Nelson K.

Department of Medicine, University of Wisconsin, Madison 53705, USA. [email protected]

OBJECTIVE: To describe gender differences in job satisfaction, work life issues, and burnout of U.S. physicians. DESIGN/PARTICIPANTS: The Physician Work life Study, a nationally representative random stratified sample of 5,704 physicians in primary and specialty nonsurgical care (N = 2,326 respondents; 32% female, adjusted response rate = 52%). Survey contained 150 items assessing career satisfaction and multiple aspects of work life. MEASUREMENTS AND MAIN RESULTS: Odds of being satisfied with facets of work life and odds of reporting burnout were modeled with survey-weighted logistic regression controlling for demographic variables and practice characteristics. Multiple linear regression was performed to model dependent variables of global, career, and specialty satisfaction with independent variables of income, time pressure, and items measuring control over medical and workplace issues. Compared with male physicians, female physicians were more likely to report satisfaction with their specialty and with patient and colleague relationships (P <.05), but less likely to be satisfied with autonomy, relationships with community, pay, and resources (P <.05). Female physicians reported more female patients and more patients with complex psychosocial problems, but the same numbers of complex medical patients, compared with their male colleagues. Time pressure in ambulatory settings was greater for women, who on average reported needing 36% more time than allotted to provide quality care for new patients or consultations, compared with 21% more time needed by men (P <.01). Female physicians reported significantly less work control than male physicians regarding day-to-day aspects of practice including volume of patient load, selecting physicians for referrals, and details of office scheduling (P <.01). When controlling for multiple factors, mean income for women was approximately $22,000 less than that of men. Women had 1.6 times the odds of reporting burnout compared with men (P <.05), with the odds of burnout by women increasing by 12% to 15% for each additional 5 hours worked per week over 40 hours (P <.05). Lack of workplace control predicted burnout in women but not in men. For those women with young children, odds of burnout were 40% less when support of colleagues, spouse, or significant other for balancing work and home issues was present. CONCLUSIONS: Gender differences exist in both the experience of and satisfaction with medical practice. Addressing these gender differences will optimize the participation of female physicians within the medical workforce.

Publication Types:

* Research Support, Non-U.S. Gov't


PMID: 10886471 [PubMed - indexed for MEDLINE]

******************************************8
Gender in medicine &#8211; an issue for women only? A survey of physician teachers' gender attitudes
Gunilla Risberg,corresponding author1 Eva E Johansson,1 G&#246;ran Westman,1 and Katarina Hamberg1
Int J Equity Health. 2003; 2: 10.

Background
During the last decades research has disclosed gender differences and gender bias in different fields of academic and clinical medicine. Consequently, a gender perspective has been asked for in medical curricula and medical education. However, in reports about implementation attempts, difficulties and reluctance have been described. Since teachers are key persons when introducing new issues we surveyed physician teachers' attitudes towards the importance of gender in professional relations. We also analyzed if gender of the physician is related to these attitudes.

Method
Questionnaires were sent to all 468 senior physicians (29 % women), at the clinical departments and in family medicine, engaged in educating medical students at a Swedish university. They were asked to rate, on five visual analogue scales, the importance of physician and patient gender in consultation, of physician and student gender in clinical tutoring, and of physician gender in other professional encounters. Differences between women and men were estimated by chi-2 tests and multivariate logistic regression analyses.

Results
The response rate was 65 %. The physicians rated gender more important in consultation than in clinical tutoring. There were significant differences between women and men in all investigated areas also when adjusting for speciality, age, academic degree and years in the profession. A higher proportion of women than men assessed gender as important in professional relationships. Those who assessed very low were all men while both men and women were represented among those with high ratings.

Conclusions
To implement a gender perspective in medical education it is necessary that both male and female teachers participate and embrace gender aspects as important. To facilitate implementation and to convince those who are indifferent, this study indicates that special efforts are needed to motivate men. We suggest that men with an interest in gender issues should be involved in this work. Further research is needed to find out how such male-oriented endeavours should be outlined.
 
Leaders in American surgery: where are the women?
Jonasson O.

American College of Surgeons, Chicago, Ill, USA.

PMID: 12075183 [PubMed - indexed for MEDLINE]

**********************************
Am J Surg. 2005 Jul;190(1):141-6.Click here to read Links
Why are women deterred from general surgery training?
Park J, Minor S, Taylor RA, Vikis E, Poenaru D.

Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada R3A 1R9. [email protected]

BACKGROUND: This study explored the factors contributing to the low application rates to general surgery (GS) residency by female students and compared perceptions of GS between students and female surgeons. METHODS: We distributed surveys to final-year students at 4 medical schools and nationwide to every female general surgeon in Canada. RESULTS: Of students who were deterred from GS, women were less likely than men to meet a same-sex GS role model and more likely to experience gender-based discrimination during their GS rotation (P < .05). Female students had the perception that GS was incompatible with a rewarding family life, happy marriage, or having children, whereas female surgeons were far more positive about their career choice. CONCLUSIONS: Both real and perceived barriers may deter women from a career in GS. Real barriers include sex-based discrimination and a lack of female role models in GS. There are also clear differences in perception between students and surgeons regarding family and lifestyle in GS that must be addressed.

***********************************************
1: Arch Surg. 2006 Nov;141(11):1086-94; discussion 1094.Click here to read Links

Erratum in:
Arch Surg. 2007 Feb;142(2):197.

Influences on medical student career choice: gender or generation?
Sanfey HA, Saalwachter-Schulman AR, Nyhof-Young JM, Eidelson B, Mann BD.

Department of Surgery, University of Virginia, Charlottesville, VA 22908-0709, USA. [email protected]

HYPOTHESIS: We hypothesized that increased enrollment of female medical students and different priorities of the current generation of students would be important influences on the declining interest in surgical careers. DESIGN: Students scored statements on surgical careers on 5-point Likert scales regarding agreement and whether these statements encouraged them to pursue a career in surgery. Data were analyzed using the Mann-Whitney U test. Qualitative comments were iteratively coded using a constant comparative method. SETTING: Nine US medical schools. PARTICIPANTS: A Web-based survey on the Association for Surgical Education server was e-mailed to medical students. A total of 1300 of the 1365 respondents stated their sex. MAIN OUTCOME MEASURES: The survey asked questions pertaining to surgical life, surgical residency, surgeons as influence, equity, family, and other influences. RESULTS: A total of 680 (52%) of the 1300 respondents were male. Men and women disagreed about whether surgeons lead well-balanced lives (68% and 77%, respectively) and saw this as a deterrent. A total of 35% of women (3% men; P<.001) were discouraged by a lack of female role models. Compared with students unlikely to study surgery, lower percentages of male (74% vs 65%) and female students (85% vs 58%) likely to study surgery agreed that career choice was influenced by their decision to have a family (P=.01 for men, P<.001 for women). Of medical students who agreed that their skill sets were compatible with surgical careers, similar percentages were likely (30% men vs 24% women) and unlikely (49% men vs 54% women) to study surgery. All differences between men and women were less apparent when students likely to study surgery were compared with students unlikely to study surgery. CONCLUSIONS: The decision to have a family was a more significant influence for women than men, but family and lifestyle priorities were also important to male students, supporting our hypothesis that generation and gender are both important influences on career choices.

PMID: 17116801 [PubMed - indexed for MEDLINE]

*****************************************************************
Am J Surg. 2006 Nov;192(5):695-8.Click here to read Links
Family issues affecting women in medicine, particularly women surgeons.
Straehley CJ, Longo P.

PMID: 17071209 [PubMed - indexed for MEDLINE]

******************************************************************
 
Best link I've found so far, which can address the biases in the first article posted on this thread:

1: BMC Health Serv Res. 2006 May 5;6:55.Click here to read Click here to read Links
The generation and gender shifts in medicine: an exploratory survey of internal medicine physicians.
Jovic E, Wallace JE, Lemaire J.

Department of Sociology, University of Western Ontario, London, Ontario, N6A 5C2, Canada. [email protected]

BACKGROUND: Two striking demographic shifts evident in today's workforce are also apparent in the medical profession. One is the entry of a new generation of physicians, Gen Xers, and the other is the influx of women. Both shifts are argued to have significant implications for recruitment and retention because of assumptions regarding the younger generation's and women's attitudes towards work and patient care. This paper explores two questions regarding the generations: (1) How do Baby Boomer and Generation X physicians perceive the generation shift in work attitudes and behaviours? and (2) Do Baby Boomer and Generation X physicians differ significantly in their work hours and work attitudes regarding patient care and life balance? Gen Xers include those born between 1965 and 1980; Baby Boomers are those born between 1945 and 1964. We also ask: Do female and male Generation X physicians differ significantly in their work hours and work attitudes regarding patient care and life balance? METHODS: We conducted exploratory interviews with 54 physicians and residents from the Department of Medicine (response rate 91%) and asked about their perceptions regarding the generation and gender shifts in medicine. We limit the analyses to interview responses of 34 Baby Boomers and 18 Generation Xers. We also sent questionnaires to Department members (response rate 66%), and this analysis is limited to 87 Baby Boomers' and 65 Generation Xers' responses. RESULTS: The qualitative interview data suggest significant generation and gender shifts in physicians' attitudes. Baby Boomers generally view Gen Xer physicians as less committed to their medical careers. The quantitative questionnaire data suggest that there are few significant differences in the generations' and genders' reports of work-life balance, work hours and attitudes towards patient care. CONCLUSION: A combined qualitative and quantitative approach to the generation shift and gender shift in medicine is helpful in revealing that the widely held assumptions are not necessarily reflective of any significant differences in actual work attitudes or behaviours of Boomer and Gen X physicians or of the younger generation of women entering medicine.
 
Contrary to belief, women are moving up the ranks of medicine as well:

1: N Engl J Med. 2000 Feb 10;342(6):399-405.Click here to read Links

Comment in:
N Engl J Med. 2000 Feb 10;342(6):426-7.
N Engl J Med. 2000 Jun 15;342(24):1839-40.
N Engl J Med. 2000 Jun 15;342(24):1839; author reply 1840.
N Engl J Med. 2000 Jun 15;342(24):1839; author reply 1840.
N Engl J Med. 2000 Jun 15;342(24):1839; author reply 1840.

Women physicians in academic medicine: new insights from cohort studies.
Nonnemaker L.

Center for the Assessment and Management of Change in Academic Medicine, Association of American Medical Colleges, Washington, DC 20037, USA. [email protected]

BACKGROUND: I conducted a study to determine whether women who graduate from medical schools are more or less likely than their male counterparts to pursue full-time careers in academic medicine and to advance to the senior ranks of medical school faculties. METHODS: The rates of advancement to the ranks of assistant, associate, and full professor for all U.S. medical school graduates from 1979 through 1993 and for all members of U.S. medical school faculties from 1979 through 1997 were studied. Cohorts were defined on the basis of the year of graduation from medical school, track (tenure or nontenure), and academic department. Within each cohort, the number of women who advanced to a senior rank was compared with the number that would be expected on the basis of parity between men and women, and 95 percent confidence intervals were calculated. RESULTS: Women were significantly more likely than men to pursue an academic career. During the study period, 634 more women became faculty members than expected. The numbers were higher in the older cohorts than in the younger cohorts. The numbers of women who advanced to the ranks of associate and full professor were significantly lower than the expected numbers. This was true for both tenure and nontenure tracks, even after adjustment for the department. A total of 334 fewer women advanced to associate professor than expected, and 44 fewer women advanced to full professor than expected. CONCLUSIONS: Disparities persist in the advancement of men and women on medical school faculties. However, the numbers of women physicians at all levels of academic medicine are increasing.

PMID: 10666431
 
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