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Wednesday February 18th, 2009

Women hold only 13% of top posts in hospitals

Dra. Pilar Arrizabalaga

The proportion of women who study medicine and who hold posts in resident programs for medical specialization has increased considerably in the past 3 decades. They currently represent 50% of practicing doctors and more than 80% of recently qualified doctors. A study published in the  Journal of Medical Ethics and carried out in Hospital Sant Pau and Hospital Clínic, Barcelona shows that the proportion of women holding positions of responsibility in these hospitals represents only 13%, a figure which has remained constant between 2002 and 2006. The study was carried out by Dr. Amparo Santamaría of the hematology department of Hospital Sant Pau and Dr. Pilar Arrizabalaga of the nephrology department of Hospital Clínic, Barcelona, as first and second authors, respectively.

The study involved an analysis of the proportion of men and women in the highest positions of medical staff and their level of professional promotion in both hospitals. This type of promotion has been regulated for the past 10 years by a system of professional recognition that allows doctors with permanent contracts to achieve promotion independently of the hierarchy—the usual route. When opting for this system, candidates are evaluated based on clinical work, research and teaching merits.

Analysis of the data shows that there are differences between women and men in the proportion of both temporary positions (50% of women with temporary contracts compared to 22% of men in the same situation) and permanent positions. Because a permanent contract is required in order to be promoted professionally, fewer women can opt for this system. Furthermore the study highlights the fact that 87% of the highest positions in the hierarchy of the hospitals are held by men and that the data are almost identical in both hospitals. The study also shows that, although the proportion of women hired in the hospitals increased by 10% over the 4 years covered by the study, the differences remained constant in this same period.

Thus, the results obtained from 2 independent institutions show significant differences in the medical positions held by men and women; these results are probably representative of other hospitals in Spain and Europe. Furthermore, it was shown that professional promotion of female doctors is far slower and takes place later. These data provide a new perspective for promoting equality in the practice of medicine and ensuring the presence of both men and women in positions of responsibility in the medical profession.

Journal of Medical Ethics

Upper panel: sex distribution of medical doctors in both hospitals, the Hospital de la Santa Creu i Sant Pau and the Hospital Clínic de Barcelona, in 2006. Lower panel: sex distribution of medical doctors at the Hospital Clínic de Barcelona in 2002 (triangle) and in 2006 (square). Men are shown in black and women are shown in white.

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