[The professional and private situation of male and female physicians entering postgraduate medical education in Germany]

[Academic Careers in Medicine: a Sex-Related Analysis of Career Goals]

AIM OF THE STUDY

For female and male physicians of the clinical-academic mid-level staff, working conditions as well as the attitude towards profession and career play a decisive role. For years, there has been an increasing proportion of women in medicine. Despite this increase, a significant sex incongruence is still evident, especially in academic medicine. The aim of this work was to analyze current opinions of female and male physicians on sex-related aspects for career.

METHODS

By means of an online survey, medical mid-level staff from university and peripheral hospitals were asked about professional biographical as well as career-related topics and the data analyzed in terms of the sexes.

RESULTS

Compared to their male counterparts, female physicians had lower career goals and mainly aimed to qualify as senior physicians. Women planned to have families and raise children earlier in their careers. Men were more likely to have their professional careers in mind during the same time period. Although only just under 47% of respondents considered an academic career to be worthwhile, 65% continued to rate the acquisition of an academic title highly. When evaluating equal treatment by superiors, female physicians tended to feel disadvantaged in their professional careers compared to male physicians. Thus, physicians rated the treatment by their respective superiors as characterized by the quality of the work (44% for both genders of superiors) or dependent on sympathy (female superiors 30%; male superiors 24%). Female physicians, however, saw a preference for male colleagues in 37% of male superiors.

CONCLUSION

Despite a significantly larger proportion of women in medicine for decades, there is still an incongruence in sexes in favor of men in management positions. The professional and private goals of women and men differ significantly depending on their age decade. The academic career per se is increasingly losing importance, although the acquisition of academic degrees still seems to be desirable. Therefore, to improve the future of academic medicine, significant structural changes are needed to enable projectable career paths (e. g., tenure track, assistant professorship, young medical professionals model) for mid-level academic staff.

Analyse des Einflusses der zunehmenden Feminisierung im Gesundheitswesen auf die Urologie

Hintergrund und Fragestellung

Ziel dieser wissenschaftlichen Arbeit war es, Genderaspekte und Trends in Klinik, Forschung und Niederlassung in der Urologie zu analysieren. Dabei lag der Fokus auf der Objektivierung des genderspezifischen Wandels im Fachgebiet „Urologie“ zum aktuellen Zeitpunkt und in der Zukunft.

Material und Methoden

Es erfolgte eine digitale Umfrage bei urologischen Ärzt:innen in Deutschland über das Portal SurveyMonkey©, welche über den E‑Mail-Verteiler der Deutschen Gesellschaft für Urologie e. V. (DGU) und des Berufsverbands der Deutschen Urologen e. V. (BvDU) an alle eingetragenen Mitglieder verschickt wurde. Es wurden Basisdaten im ambulanten und stationären Sektor erhoben, sowie geschlechtsspezifische Daten in Bezug auf Arbeitsplatzverteilung, Ziele, Zufriedenheit und Gründe für berufliche Entscheidungen.

Ergebnisse

Die Auswertung von 398 Antworten ergab, dass urologische Kolleg:innen in der Niederlassung seltener weiblich (23,6 %) und deutlich älter (mittleres Alter 53 Jahre) waren als im stationären Sektor (Frauenanteil 47,2 %, mittleres Alter 43 Jahre). Niedergelassene Vertragsärzt:innen waren mehr Männer (49,4 %) als Frauen (29,9 %) und die Niederlassung wurde von mehr Männern als Berufswunsch angegeben (28,1 % vs. 22,8 %). Die Gründe für die Niederlassung lagen bei Frauen häufiger im familiären Bereich als bei den Männern (Hauptgründe gute Gelegenheit oder Berufswunsch). Frauen arbeiteten häufiger Teilzeit (27,0 % vs. 11,5 %) und strebten häufiger eine Karriere als Oberärztin an (29,1 % der Frauen, 9,4 % der Männer). Entsprechend war der Wunsch nach einer Habilitation oder Professur bei den Frauen häufiger als bei den Männern (20,5 % vs. 15 %). Signifikant mehr Urologinnen sahen eine Ungleichheit bei den beruflichen Aufstiegschancen (59,7 % vs. 17,5 %, p < 0,001) und 73,3 % (vs. 18,5 % der Männer, p < 0,001) empfanden ihr Geschlecht als Ursache einer Benachteiligung. Dies führte zu einer signifikant geringeren Zufriedenheit von Frauen mit ihrem beruflichen Status (p = 0,008), sowie einem geringeren Gefühl der Wertschätzung (p < 0,001).

Schlussfolgerung

Um die Urologie zukunftsfähig zu machen ist es essenziell, Genderaspekte noch stärker zu berücksichtigen. Der eingeschlagene Weg, der nächsten Generation von Urolog:innen ein modernes Fachgebiet zu bieten, in dem alle Ärzt:innen unabhängig von ihrem Geschlecht gerne arbeiten, wertgeschätzt werden und Chancengleichheit herrscht, sollte unbedingt weiter verfolgt und intensiviert werden, um die Urologie für die Zukunft gut aufzustellen.

Zusatzmaterial online

Die Online-Version dieses Beitrags (10.1007/s00120-022-01931-3) enthält eine Tabellarische Darstellung der vollständigen Umfrageergebnisse „Genderaspekte in Klinik und Niederlassung“.

Women in surgery: a web-based survey on career strategies and career satisfaction

Women represent the majority of medical students in several countries. In any surgical specialty and above all in surgical leadership positions, women still remain disproportionally underrepresented. The objective of this study was to investigate female surgeons’ career advancement and satisfaction with training. A standardized questionnaire was devised and sent out via the web-based survey tool SurveyMonkey^® to female surgeons in the German federal state of North Rhine-Westphalia. A total of 125 completed questionnaires were analyzed (response rate 40.8%). Female surgeons are at least largely (76%) satisfied with their surgical training. Increased time (>5 h/week) as the principal surgeon in the operating room significantly stimulates the satisfaction with the surgical training (86% vs. 68%, p = 0.0384). At the participants’ current workplace, the heads of departments are predominantly male surgeons (91%). Respondents not satisfied with their surgical training prefer a female head of department more frequently (24% vs. 2%, p = 0.0085). The majority of the respondents themselves aspire to become a consultant surgeon (56%), while only 12% intend to become a head of a department. Female surgeons aiming at leadership positions work overtime (≥50 h/week) significantly more frequently (81% vs. 57%, p = 0.0041). Favoritism of male colleagues is perceived by 34%. Respondents who do not perceive any preferential treatment are significantly more satisfied with their surgical training (88% vs. 57%, p = 0.0004). In conclusion, female surgeons seem positive about their career choice, once in the surgical profession, and aptly fill upcoming positions. Women interested in surgery are likely to pursue a surgical career despite the alleged workload, demonstrating the importance of professional self-fulfillment among female surgeons.

[Working hour preferences of female and male residents : Developments over 4 years of postgraduate medical training in Germany]

OBJECTIVES

This article addresses developments regarding working hours and working hour preferences of residents undergoing postgraduate training in Germany and analyses if, and for what reasons, full-time or part-time working models are preferred.

METHODS

The source of data is the KarMed study, which is based on yearly postal surveys carried out among graduates of the year 2008/2009 from seven medical faculties in Germany. The interviews took place during the entire postgraduate training period. Response rates were 48% in the first year, with subsequent rates of above 85%. For analysis, descriptive statistics and regression models were applied.

RESULTS

There is a considerable discrepancy between the actual and the preferred working hours of residents undergoing postgraduate training. Postgraduate training is mostly linked to full-time contracts, usually with additional overtime, even though a considerable proportion of doctors prefer a part-time position. More female residents want to work part-time than male doctors. The same applies for the period after medical specialism: in particular, female doctors with children, female doctors trained in former Western Germany states, and those seeking an occupation in outpatient care request part-time contracts for their professional future. A similar trend has been increasingly observed over the years for male doctors.

CONCLUSION

Despite the huge number of residents requesting part-time contracts - during postgraduate training and afterward - the reality is still far behind this model. It is apparent that measures should be taken for both genders. Those measures should facilitate the implementation of the favored working-time model.

Career intentions of female surgeons in German liver transplant centers considering family and lifestyle priorities

PURPOSE

Women represent up to 60 % of students entering the medical profession in many countries in the world. However, the proportion of women to men is not accordingly balanced among surgical residents and especially in leadership positions in surgery. Therefore, we investigated the career goals as well as family and lifestyle priorities of female surgeons in German liver transplant centers.

METHODS

A standardized questionnaire was developed using the web-based survey tool SurveyMonkey®. Questionnaires were distributed electronically to 180 female surgeons in 24 German liver transplant centers. A total of 81 completed questionnaires were analyzed.

RESULTS

Female surgeons in German liver transplant centers are eager to assume leadership positions and do not wish to follow traditional role models. After finishing training, most female surgeons plan to continue working at a university hospital. About 80 % of the respondents intend to continue working full time and wish to combine career and family.

CONCLUSIONS

This is the first survey on career intentions of female surgeons in Germany. In the face of gender changes in the medical profession, we were able to demonstrate that female surgeons are willing to fill leadership positions. Individual and institutional creative modifications are necessary if the advancement of women in surgery is to be promoted.