Gracia PablosWriting and graphics
Writing and graphics
Updated Friday, March 8, 2024-08:16
Since the incorporation of women into universities and into qualified professions began, their presence has not stopped growing, but the case of health professions is paradigmatic.
In no other has this growth been so rapid and at the same time so slow in terms of positions of responsibility.
In the 2021-2022 academic year, almost
70% of the students graduating in Medicine were women
, a proportion that has remained
stable for almost 20 years
.
The same happens with other degrees in the health field: in that same course, women were 83% of the students graduating in Nursing, 65% in Dentistry and 71% in Pharmacy.
Why this inclination towards the health branch?
In 2010, a BBVA report on the feminization of health professions explained this trend in part due to the public employment nature of this profession in our country, something that makes it more stable and, according to this report, more attractive to women.
And they used that same argument to explain the absence of men, since
they considered that the greater presence of women in Medicine classrooms was due, in part, to their abandonment
, to their disinterest.
"It seems like an arbitrary statement to me," comments Pilar Garzón Guiteria, president of the Official College of Physicians of Ourense, "I
believe that health professions, although the cut-off point continues to influence a lot, are still very vocational
, and I think the vocation even to a certain point he doesn't understand genres".
In fact, in nursing, a profession that has always been predominantly female, we have seen how the male presence grows little by little.
The same happens with research, which cannot be said to have a gender either.
María Casanova-Acebes, researcher at the CRIS Foundation against cancer and CNIO, is clear about this: "
research is a process that consists of exploring, observing and answering questions that will allow us to build and test a hypothesis
; for this, a functioning brain, and we have it as human beings, regardless of gender.
According to data collected by WOMEDS,
they are the ones who tend to obtain more funding or obtain more projects
, especially in independent research, but María Casanova-Acebes is categorical, that does not imply that it is a male field.
Is this feminization positive or negative?
In 2018, a Tokyo medical school admitted that it had manipulated women's scores in admission exams for years, since it seemed impossible for them to combine family (for them, an exclusive role for women) and a profession such as that of a doctor. .
Japan is in fact an exception among OECD countries
when it comes to the percentage of female doctors (23% in 2021), and these types of practices help to understand why.
Not so far away, although a few years before, the then presidents (all men, by the way) of the Societies of Gynecology, Pediatrics and Endocrinology declared that it would not be a bad idea to do something similar in Spain.
These three specialties have a strong female presence and, due to the cuts, they stated that it was very difficult to manage a minimum staff with the handicap of maternity leave.
The truth is that it does not make sense to contemplate the feminization of the health profession from the perspective of good or bad, and this is currently expressed by the Spanish Association of Pediatrics (AEP).
"
The feminization of the health professions is neither a positive nor a negative phenomenon
, nor something to defend or combat, but rather something to live with."
A predominantly female workforce may mean that more attention must be paid to certain measures (not just the famous conciliation, since this affects, or should affect, men and women equally), but all scenarios pose their difficulties, and they are not insurmountable.
"What are we going to do, gender bias?" claims Dr. Pilar Garzón, "because of that rule of three, someone over 55 years of age has a greater number of cardiovascular events and then maybe they can't work either."
The solution involves a
question of management adapted to the circumstances
, "we have to adjust templates based on possible incidents, and it is a real fact that now the highest percentage of doctors who enroll are women of childbearing age," adds Garzón. .
But he does not forget the men either, who in the same age ranges will also take their leave through conciliation.
From the AEP they influence this approach: "Pediatrics departments must adapt and take the lead in defending
an approach to the clinical and academic career that recognizes the role of work/family balance
, so that parents who wish to be at the same time "Maybe excellent parents and extraordinary pediatric doctors don't have to choose between their children and their careers.
The problem is therefore not gender, but the minimum workforce as a result of cuts that leave no room for conciliation.
Glass ceilings for women in healthcare
It is evident that Health, as a whole, relies on the work of women, but their presence decreases noticeably when promoted to positions of responsibility.
It is a pattern that is true throughout the world: the World Health Organization (WHO) estimates that although women make up 67% of the workforce in the health and social care area, they only occupy 25% of leadership roles.
Pilar Garzón is the first president of a Galician College of Physicians, specifically that of Ourense, an interesting milestone if we take into account that the Ourense College recently celebrated its 120th anniversary.
Of the 52 Official Medical Colleges in Spain, only eight currently have a woman at the head
.
At the same time, there are only 13 women presidents in the 35 Medical Societies that are part of the Federation of Spanish Medical Scientific Associations (FACME), a Federation that, by the way, has never been led by a woman.
What is the reason for this underrepresentation?
The first reason that is usually mentioned is conciliation.
Pilar Garzón is the mother of a baby, a task that she combines with her work in the Emergency Department and the management of a College of Doctors, so she does not need anyone to explain to her the difficulties that this entails.
"It
is true that now the conciliation measures we have are much greater
and that more and more male professionals are involved in the development of the family," explains the specialist, "but even so (women) we continue to have a lot of weight in level of family support regardless of the collaboration of the male part."
Another common reason that explains the lower presence of women in management positions looks directly at prejudices, whether they come from them (men tend to select other men) or from themselves.
"
We have some reservations about assuming these positions
," explains the president of the Ourense College, "I think it is a glass ceiling that we have to begin to break and realize that we are tremendously qualified and that we can do that and more things."
And then there is the self-demand:
"We want to continue being the family's support, developing ourselves professionally
and at the level of the positions we have at that time," adds the specialist.
In her specific case, Pilar Garzón affirms that the Ourense Medical College has been working for equality for a long time, to the point that they have already reached a ratio of 60-40 (with a female majority).
They were also one of the first schools that assumed, via statutes, that they should seek parity on the Board.
"
Also to force us to incentivize ourselves
," adds the doctor, alluding precisely to that self-censorship.
Parity on Boards of Directors is something that is studied and taken into account today.
For example, the Spanish Pediatric Association tells us that, although its president is currently a man, some relevant positions such as the presidency of the Spanish Pediatric Foundation or the edition of the magazine Anales de Pediatría fall to a woman. so they expand that analysis beyond the executive committee.
What happens in the field of research?
María Casanova-Acebes explains to us that in the research center to which she belongs there are more women than men on staff, "but
if we stratify by positions of responsibility
," she adds, "the terrain is largely male, in fact
there are only 26 % of women in leadership positions, according to the CSIC women researchers report
.
She is a group leader and claims to have not felt any type of discrimination during her doctorate or postdoctoral studies, although she is aware that it is not the usual trend, "I am a 'rara avis'."
Yes, it is true that something is changing, but it is doing so very little by little.
In fact, the WHO estimates that, if we wait for this transformation to occur on its own, without specific measures involved, equality would not be achieved for 202 years.
"The change will take a few years and will be progressive," explains the CNIO researcher, "
we cannot expect a society to change in a matter of three or five years without important changes
at a structural level and support from administrations that facilitate this transition" .
The General Council of Official Colleges of Physicians, from its Gender and Medical Profession Observatory, carried out a consultation in 2017 that addressed this issue.
When analyzing possible measures to achieve equality, the preferred option by far was to evaluate the resume anonymously: according to abilities, merits and objectives.
And of course, measures related to better conciliation, adapted to the peculiarities of each field.
In the research, for example, Casanova-Acebes talks about the extension of the submission period for calls for women, a measure that in the case of the CRIS Foundation against cancer is already implemented with an extension of three years for each child, "to achieve that real equality that we want in research."
The role of women as bosses
These types of scenarios are what highlight the need for women to join command positions.
Dr. Pilar Garzón explains how, thanks to the work done by the College that she currently presides, a legal and legal advisory project has been implemented regarding measures to protect conciliation, for example.
Crises such as the pandemic also serve to demonstrate the consequences of biased management from a gender perspective.
Several studies show that the incidence of infections was higher among female professionals since they are the ones who held the majority of front-line positions.
Despite this, the protective suits (PPE) were (and are) made for male bodies, something that also increased their exposure to contagion.
Meanwhile,
only three in 10 experts at decision-making tables or in the bylines of academic publications on Covid-19 were women
.
Dr. Garzón, an emergency specialist and pregnant in the middle of the pandemic, explains how this situation was compounded by the fact that at that time it was considered that at the work level there was no added risk for being a pregnant woman and working with infectious patients.
"Coincidentally, it was later seen, starting with the 5th wave, that it did exist and that is why vaccinations were prioritized in pregnant women."
Garzón explains that under normal circumstances there is no reasonable handling of these situations either: "
until week 36 we are not exempt from being on call
, unless you have another type of sick leave, and you are in very stressful situations, you sleep worse, you are more tired, It's much more difficult."
For researcher María Casanova-Acebes, the arrival of women in positions of more responsibility can also lead to the encouragement of other women, to see that it is possible and to share their process.
It is not about displacing men, it is about "equal opportunities to access jobs under the same conditions as men," the researcher clarifies.
Also to add another perspective to the decisions made from those positions.
"I think that, in a certain way,
on a day-to-day basis we are much more pragmatic, perhaps much more open to dialogue
," explains the president of the Ourense College, "I also don't think we have to tend towards complete feminization, I think we have to work equitably."
For this to be possible, Casanova-Acebes is committed, in addition to short-term measures, to a profound change: "
There must be changes in society, so that it is educated from very early stages in equality
, in respect for "the person next to us, without looking at their gender, color, or origin. In science,
the important thing is to establish connections, relate, formulate hypotheses and have an innate curiosity
. The rest is not relevant and should not determine decisions."