A number of Canadian doctors are bristling over a U.S. article about the increasing proportion of female obstetricians and gynecologists — not for celebrating the fact that more women are entering the surgical specialty, but for giving voice to those who lament it.
A recent highly-discussed L.A. Times article says that male doctors are "disappearing" from gynecology, and reports that some doctors (mostly male) are worried if numbers keep dropping, "it could weaken the field overall."
Canada, too, has seen increasing numbers of women in the field of OB-GYN. According to data from the Canadian Medical Association, 58 per cent of Canada's licensed OB-GYNs in 2017 were women. The proportion has been rising steadily over the years, up from 50 per cent just five years earlier in 2012, according to figures provided to HuffPost Canada by the Royal College of Physicians and Surgeons of Canada.
And it looks like those numbers will only continue to increase, as the proportion of female OB-GYN trainees has increased from 74 per cent in 1997 to 84 per cent in 2016, according to data from the Canadian Post-M.D. Education Registry that was also provided by the Royal College.
"Gender has nothing to do with capability"
The question of whether the increasing proportion of female OB-GYNs could affect the specialty as a whole shouldn't even be a question, Dr. Marla Shapiro, former president of the North American Menopause Society and a professor in the Department of Family and Community Medicine at the University of Toronto, told HuffPost Canada in a phone interview.
"We now recognize, thankfully so, that women and men are equally capable when it comes to the field of medicine, and equally capable of being trained in whatever specialty they choose," Shapiro said.
"Why should there be a difference in terms of the gender of practitioner, and the quality of the care? I don't even know why that question exists. I think gender has nothing to do with capability, and nothing to do with quality of care."
"The ultimate collision of medicine and gender politics."
The L.A. Times article reported that 59 per cent of the U.S.'s gynecologists are now women. That's up from 7 per cent in 1970. And only 17 per cent of OB-GYN residents in the U.S. are men, the article noted.
"Some men fear the falling number of male OB-GYNs could eventually lead to them being excluded from the specialty. They believe this is not only unfair, but also has subtle ramifications that go beyond patients' comfort on the examination table," the L.A. Times reported, calling it the "ultimate collision of medicine and gender politics."
Some of the possible ramifications mentioned by people interviewed in the article include: lower quality of care due to lack of diversity and the inability to make as many advances in the field without varied perspectives and approaches to problem solving.
"If you exclude 50 per cent of people from anything, think about how much you've lost," Dr. Saketh Guntupalli, a gynecological oncologist at the University of Colorado, told the L.A. Times. "You might lose the next person who's going (to) find a cure for cancer."
Canada's doctors have opinions on the topic
To the men who say there are too many women in OB/GYN I say, "Boo fucking hoo" https://t.co/Wr2TbqRbvx— Jennifer Gunter (@DrJenGunter) March 9, 2018
Female OB-GYNs had a lot to say on the matter, many pointing out the gender discrepancies that exist in other specialties (for instance, neurosurgeons are predominantly men), highlighting the gender wage gap (female doctors in the U.S. make 74 cents for every dollar a man makes, according to CNN), and bringing up other inequalities and biases that still exist in the medical field.
Dr. Joanne Sivertson, an OB-GYN and the president of the Saskatchewan Medical Association, tweeted that she was once told (by a male specialist) that it "was unfortunate that mostly women were entering the specialty because 'the profession will lose all respect.'"
When I was a med student considering O&G, a renowned male perinatologist told me it was unfortunate that mostly women were entering the specialty because "the profession will lose all respect"— SMA President (@joannesivertson) March 9, 2018
This was in 2003
This. Is. Not. Ok https://t.co/sfpA8VlB89
Canadian born and trained OB-GYN Dr. Jennifer Gunter provided a scathing response on her popular blog (which she often uses to debunk medical content on the internet), where she said that women OB-GYNs face systematic oppression, bias, lack of role models during their training, and then tend to make less money than their male colleagues.
"I have not read any think pieces on how the dearth of women in the areas of medicine that are still male dominated, such as neurosurgery, affects advances. No one there seems to worry that the lack of woman brain hampers much of anything," Gunter wrote.
"When there hasn't been a male president of (The American College of Obstetricians and Gynecologists) for 10 years, and all OB/GYN textbooks are written by women, and no one asks me if I am a nurse or forgets to call me doctor when they introduce me at a professional function, and when women out earn men in OB/GYN and have 80 per cent of the leadership positions, and when opinion pieces about the dearth of women in surgery and the excess of women in pediatrics fill our newspapers, and when men are asked about their procreation plans at interviews, I will be concerned that OB/GYN has developed a gender diversity problem."
Nearly half of Canada's doctors are female ... but the same isn't true for surgeons
In 2017, 41 per cent of Canada's 83,159 active doctors were women, according to the Canadian Medical Association. That's up from 28 per cent in 2008, according to the Canadian Medical Association Journal News (CMAJ News). While the gender shift is especially prominent in family medicine, it's happening across all specialties, CMAJ News reported.
"While it can be hard to tease out cause and effect, research suggests that women practise differently, and patients appear to be benefitting. Female physicians are also challenging the profession's unrealistic demands on their time," CMAJ News wrote.
But, other than obstetrics and gynecology, the proportion of women entering surgical specialties for their post-medical school training remains low. In 2017, only 18 per cent of neurosurgery trainees were female, according to the Canadian Medical Education Statistics. Just 20 per cent of cardiac surgery trainees were female, and only 22 per cent of those training in urology were female.
It's "critical" to support women in surgical specialties
In 2017, only 28 per cent of Canada's surgical specialists were women, according to the Canadian Institute for Health Information (these numbers don't include residents). More than half of the female surgeons were OB-GYNs. The least female-populated specialties were urology (10 per cent), cardiac surgery (10.3 per cent), cardiothoracic surgery (10. 6 per cent), and neurosurgery (11.1 per cent).
It's "critical" to support women in surgical specialties, including obstetrics and gynecology, Shapiro told HuffPost Canada. There has been a bias against women in surgery, the belief being that they would leave their specialty to have babies and take a valuable training position from a male physician who posed no threat of that, she said.
"Women should not be penalized because they may leave at some point for a given period of time to have their own children. That doesn't mean that they're not going to come back and be as excellent as they were before they left," Shapiro said.
"We have to support them to be able to not feel that they're not welcome in that specialty or cannot be as good because of their gender. Gender has nothing to do with it."
Also on HuffPost: