Dani Garavelli: Hypocritical oafs

IF DR Brian McKinstry had set out to make himself a hate figure among his female colleagues, he could scarcely have chosen his words more effectively. The problem with the medical profession, the West Lothian GP said, in an article in the British Medical Journal last week, is that there are just too many women in it. Female medical students now outnumber male medical students by about three to two and that, he insists, spells disaster.

All those pesky girls outshining the boys with their superior exam results and interview techniques – they're a real nuisance, eh? What do they do with their medical degrees when they get them? Not snap up all the highest-paid posts in the most prestigious fields, that's for sure. No, mostly they leave the jobs of neuro or heart surgeon to the men, while they opt for the more lowly "family-friendly" specialisms such as primary care and psychiatry.

And male doctors just hate having to take up the slack. What they'd really like is more competition for the top posts so they would have less chance of securing them for themselves. Who are they trying to kid?

Even within their chosen fields, apparently, women doctors are more of a hindrance than a help. Maternity leave and demand for flexible working hours places a burden on surgery opening hours and plays havoc with consistency of care, according to McKinstry, a senior research fellow at Edinburgh University.

Worse still, women GPs seem incapable of confining their nurturing to their extra-curricular activities. According to McKinstry they take longer to deal with their patients because they will insist on communicating. All those precious minutes frittered away talking to sick people, when they should be shunting them in and out of their surgeries as quickly as possible.

"I think patients feel better for having a longer appointment, but I don't know to what extent that is going to have an effect on disease prevention and helping people get over illness quicker," McKinstry says. I daresay he is flummoxed. But you don't need a medical degree to understand patients are more likely to accept advice from someone who isn't checking their watch every few minutes, and that coping with the aftermath of a serious illness is easier if someone takes time to acknowledge what you are going through.

Of course, all this propaganda is grist to the mill for bitter old chauvinists who cannot cope with the thought of women outperforming men in any sphere. "We're finally starting to see the consequences of 'equality' and 'freedom'," as one commentator put it. "Not content with screwing up family-home life, thus creating a knock-on effect in society, we are now seeing the detrimental results in the workplace."

The thing is that – if you strip away the anti-female rhetoric – you can see McKinstry has a point. There are gender-related problems within the medical profession that need attention. If more women cannot be persuaded to carry out research, teaching, training and committee work, the profession as a whole will suffer.

But is McKinstry seriously suggesting medical schools should accept less able male students to even up numbers? Or that women who have worked hard to overcome centuries of prejudice should be penalised, instead of praised, for their efforts? The fact that girls are doing better than boys is a legitimate cause for concern, but the answer lies in working out how to raise the boys' standards, not in lowering those demanded by the profession.

It seems to me that, while McKinstry is right to highlight the issue of gender imbalance in the NHS, he is coming at the problem from such a skewed angle any solution he proposes is bound to be distorted. Take the issue of women "opting" for family-friendly specialities over surgery. Here are some statistics: only 25% of consultants, 10% of consultant surgeons and 4% of consultant neurosurgeons are women.

It's a shocking situation, but who's to blame? Is it really lazy women doctors who can't cope with the long working hours? Or is it a male-dominated hierarchy that has allowed a macho culture to prevail in certain fields? And why is the field of academic medicine so unappealing to women? Is it the lack of on-site childcare facilities, or is it more that female researchers are consistently undervalued?

In 2004, the BMA commissioned a report into this under-representation and found not only were women who wanted to go into academic medicine hindered by an old boys network which recommended suitable candidates for promoted post, but they were paid less than their male counterparts. Worse still, their job descriptions often included the "administration roles" the men did not want because they took time away from research.

In his piece for the BMJ, McKinstry accepted some of the problems he was highlighting were caused by long-term discrimination against women within the medical profession, while others were the result of the continuing social expectation that mothers rather than fathers should care for children.

So why isn't he calling for the medical profession to get its finger out and tackle that, then? Why isn't he insisting it makes posts in male-dominated fields more accessible to women by eradicating all the macho posturing and introducing flexible working hours that do not impinge on patient care?

Because the alternative – scapegoating women for problems that are caused by long-standing prejudice and a lack of creativity – is not just offensive, it's dangerous. It puts everything women have achieved at risk by handing ammunition to those who would like to see them back at the kitchen sink.