Gender disparity in medical profession

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There is a consensus amongst our people that educating women would lead to increase in women workforce, notwithstanding the patriarchal ethos of society. However, the facts suggest otherwise even if we look at the healthcare profession which is highly coveted in Pakistan. According to research, 70 % of the medical students are girls but out of those only 20-30 % practice medicine after graduating. It is a huge underutilisation of national resources as heavy subsidies are offered by the state to public medical colleges. Dr Ishrat Husain in his book “Governing the Ungovernable” rightly observes “It costs the state Rs 5 million to produce a medical doctor and the majority of those admitted to medical colleges are girls because they are able to secure places on merit through open competition”. Besides the wastage of national resources, because of those unemployed female doctors, seats are lost for those girls and boys who wish to continue in the profession but fail in getting admission in medical colleges due to high merit. In addition to that, it creates an absence of lady doctors, particularly, in rural areas and the female doctors that stay unemployed do not contribute to national economic growth.

The major reason behind this drop-out rate is the phenomenon of “Doctor Bride”. This refers to those female doctors that succeed in getting a good marital match because of the social prestige of medical profession but discontinue working after their marriage. If a female doctor does continue her medical practice, she has to first perform her duties as a doctor and then go back home for her “Second Shift” of household chores, nurturing children, being an obedient daughter in law and a caring wife. Usually, the second shift acts as a huge deterrent whilst taking precedence over a woman’s professional life, resulting in even the willing individual quitting her job. Getting help from paid babysitters, amidst the shortage of day-care-centres, is mostly frowned upon by in-laws, albeit with no rationale. Due to female doctors not practicing, some people tend to argue that there should be a 50 % quota system for men and women in admission process to save the national resources as men would nonetheless continue in the medical profession. Firstly, this cannot be done as the constitution of Pakistan states in clause 2 of article 25 that “There shall be no discrimination on the basis of sex”. Secondly, this would sow the seeds of further gender disparity in medical profession. Thirdly, the admission process should logically be based on merit not gender.

However, there is a solution that may seem viable. There should be an agreement or bond mandatory for every student at a public medical college to sign before the start of formal education. The agreement should have a condition that makes it compulsory for medical students to practice for 5-10 years after graduating. In case of non-compliance, the medical license of the individual should be revoked. The newly graduated doctor may be exempted from mandatory practice if he or she is willing to pay the fee of his or her medical education and training i.e., Rs 5 million.  As a result, only those female medical students who are willing and in this case, sadly, those girls who have families that are willing and supportive enough to let them continue in profession would study on government expenditure. Seats and opportunities would not be forgone during the admission process. As the agreement is for all genders, it would not cause any discrimination. Husbands and in-laws would eventually get used to their wives and daughters’ in-laws working during the mandatory 5-10 years period as most of the family members would neither be willing to pay Rs 5 million nor have their “Doctor brides” lose their licenses as it would lower their social stature. It would have a salutary effect on society and push the culture to let the female doctors work as the women would have a valid, though an unnecessary, excuse in front of their families to work. It is pertinent to mention here that it would not only be rewarding for the female doctors but would also help towards better national economic growth. The national resources that would be saved through this step and generated through economic growth as a result of this step may be used to set up day-care-centres to assist female medical doctors during their work hours.

If such a policy is opted by the government, then it should be the responsibility of policymakers and intelligentsia that it is followed in both letter and spirit. However, such policies have their limitations and change of societal norms that restrict the women from working is the sine qua non for this intricate issue. Some critics of this agreement might say that even if the female doctors are not practicing, they would at least be educated. According to them, this would help in grooming of upcoming generation as Napolean Bonaparte said, “Give me an educated mother, I shall promise you the birth of a civilized, educated nation”. But what makes us think that an unemployed female doctor would nurture the future generation any better than an unemployed woman who has a Master’s degree in another discipline which is not as heavily subsidised by the state as medical profession?