Almost 40% of all specialist registrars who hold national training numbers in medical specialties are women.1 Little is known about their career intentions, and specifically on how they plan to cope with the competing pressures of family and career when they become consultants. Questions on this issue were therefore included in a recent national survey of specialist registrars.
Participants, methods, and results
The Royal College of Physicians sent a questionnaire in December 1999 to all 2495 trainees in England, Wales, and Northern Ireland holding national training numbers in medical specialties. Replies were received from 1362 (55%), of whom 1311 answered the question, would you like a part time (eight sessions or less) post when you become a consultant? They had five options: “yes—definitely,” “yes—probably,” “yes—possibly,” “no—probably not,” and “no—definitely not.” The number and percentage of women (n=541) giving each response were 83 (15%), 105 (19%), 186 (34%), 120 (22%), and 47 (9%), and those of men (n=770) were 19 (2%), 34 (4%), 117 (15%), 265 (34%), and 335 (44%). A total of 1309 answered the question about whether they would consider a “job share” consultant post at some stage in their career, and had the same response options. The number and percentage of women (n=537) giving each response were 64 (12%), 100 (19%), 247 (46%), 95 (18%), and 31 (6%), and those of men (n=772) were 11 (1%), 26 (3%), 157 (20%), 241 (31%), and 337 (44%). The table shows the number and percentage of men, women, and all specialist registrars in the major specialties who replied “yes” to the questions on working part time and job sharing. These comprised 69% and 77% of women, 22% and 25% of men, and 41% and 46% of all respondents. The proportions responding positively in the specialties varied markedly, depending mainly on the gender ratio of trainees, from about 25% of those in cardiology to 75% of those in palliative medicine.
Comment
More than 40% of all specialist registrars in medical specialties (about 75% of women and 25% of men) are considering working part time as consultants. Whether those who expressed an interest in part time work actually take up such posts depends on many factors, including whether specialist part time jobs become available. Yet feedback from focus groups has confirmed that most women trainees envisage working part time when they have young families, and that an increasing proportion of men seek greater participation in family life and perhaps a more balanced lifestyle. These results are entirely consistent with other recent surveys of trainees and consultants.2–4 The financial imperative to work full time is reduced if both partners in a relationship hold professional posts. Additionally, the availability of women (and men) to take up consultant posts is often compromised by the need to be close to their partners' place of work, especially as about half of women trainees have partners who work in medicine.2
The impact of these factors on the future supply of consultants is obvious and potentially devastating, particularly in specialties with a high proportion of female trainees. Yet no allowance has been made for this in the calculations of the Specialist Workforce Advisory Group. In the light of the findings of this survey plans to reduce the totals of national training numbers in some major specialties may be badly misguided. Many more part time consultant posts will be needed to use the skills of women and men who seek part time work, and correspondingly more trainees will be required to maintain an adequate supply of consultants in future years.
Table.
Positive responses to part time working or job sharing as a consultant. Values are numbers (percentages) of specialist registrars who answered “yes—possibly,” “yes—probably,” or “yes—definitely” when asked whether they would consider a part time post (⩽8 sessions) or a job share when they became a consultant
| Specialty | Women
|
Men
|
All
|
|||||
|---|---|---|---|---|---|---|---|---|
| Part time | Job share | Part time | Job share | Part time | Job share | |||
| All specialties | 374/541 (69) | 411/537 (77) | 170/770 (22) | 194/772 (25) | 544/1311 (41) | 605/1309 (46) | ||
| Cardiology | 7/31 (54) | 8/13 (62) | 31/118 (26) | 24/119 (20) | 38/131 (29) | 32/132 (24) | ||
| Dermatology | 31/39 (79) | 28/39 (72) | 11/29 (38) | 8/29 (28) | 42/68 (62) | 36/68 (53) | ||
| Endocrinology | 24/43 (56) | 29/43 (67) | 8/52 (15) | 9/52 (17) | 32/995 (34) | 38/95 (40) | ||
| Gastroenterology | 32/47 (68) | 35/47 (74) | 31/132 (23) | 25/135 (19) | 63/179 (35) | 60/181 (33) | ||
| Geriatric medicine | 47/66 (71) | 52/66 (79) | 16/68 (24) | 21/68 (31) | 63/134 (47) | 73/134 (54) | ||
| Genitourinary medicine | 19/24 (79) | 22/24 (92) | 3/13 (23) | 4/13 (31) | 22/37 (59) | 26/37 (70) | ||
| Haematology | 37/50 (74) | 37/50 (74) | 6/34 (18) | 12/34 (35) | 43/64 (51) | 49/58 (58) | ||
| Infectious diseases | 4/8 (50) | 7/9 (78) | 6/21 (29) | 12/21 (57) | 10/29 (34) | 19/30 (63) | ||
| Medical oncology | 15/24 (63) | 18/24 (75) | 8/30 (27) | 10/30 (33) | 23/54 (43) | 28/54 (52) | ||
| Neurology | 14/22 (64) | 16/22 (73) | 7/51 (15) | 11/50 (22) | 21/73 (29) | 27/72 (38) | ||
| Palliative medicine | 38/43 (88) | 36/41 (88) | 3/12 (25) | 6/12 (50) | 41/55 (75) | 42/53 (79) | ||
| Renal medicine | 13/27 (48) | 20/26 (77) | 9/42 (21) | 10/42 (24) | 22/69 (32) | 30/68 (44) | ||
| Respiratory medicine | 22/38 (58) | 26/37 (70) | 16/91 (18) | 24/91 (26) | 38/129 (29) | 50/128 (39) | ||
| Rheumatology | 36/46 (78) | 39/45 (87) | 9/41 (22) | 12/41 (29) | 45/87 (52) | 51/86 (59) | ||
Acknowledgments
I thank Joan Welch for inputting the data, Drs Fiona Gordon, Catherine Nelson-Piercey, and Stuart Bennett for help in designing the questionnaire, and Clive Constable and other colleagues at the Royal College of Physicians for enthusiastic support.
Footnotes
Funding: Royal College of Physicians.
Competing interests: None declared.
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