Medical Education 1992, 26, 21-26
Career perspectives of women and men medical students C. J. KRUIJTHOF, C. D . VAN LEEUWEN, P. VENTEVOGEL, H. E. VAN DER HORST & G. VAN STAVEREN Department of General Practice and Nursing Home Medicine, Faculty ofMedicine, V~ijeUniversiteit, Amsterdam
Summary. In spite of the increasing number of women medical students, in many specialties the number of women actually working as doctors still lags behind the number of men working in the same profession. To define factors contributing to this discrepancy 646 medical students at the Vrije Universiteit in Amsterdam were surveyed. A questionnaire was used to obtain information about the difference between women and men medical students concerning their outlook on a future career as combined with domestic responsibilities. The questionnaire covered the items motives and career preference, barriers to reaching the profession of first choice, career planning and the combination of domestic responsibilities and a medical career. The results of this survey indicate that there are still important differences between women and men students in career perspectives. These differences need attention from medical students as well as teaching staff.
doctors. To this day the number of women working as doctors still lags behind the number of men working in the same profession. Also, there is a considerable underrepresentation of women in certain medical disciplines. Since the average performance of women during medical education is often better than or a t least equal to that ofmen (Leeson & Gray 1978; Baneke 1987), there must be other reasons to explain this discrepancy between education and professional activity. The literature offers some explanations: ( 1 ) Differences in career preferences based on different motives. Women have other career preferences than do men and therefore make different choices during their education (Rhodes 1989). Although McGrath & Zimet (1977) interpret the results of their study among US medical students as indicating that the women/men differences in specialty choice are tending to fade, results of other, more recent studies contradict this view. Women students show a preference for paediatrics, for example, while men tend to choose the traditional male specialties, e. g. surgery (Zimny & Shelton 1982; Egerton 1983; Bergquist et al. 1985). According to some authors women seem to have a more idealistic approach than men and are less often influenced by the prospect of a good income or of prestige (Van Staveren 1976; Frey 1980a,b). Therefore, different motives may lead women to choose careers different from those chosen by men. This explanation, however, only accounts for the stagnation in the flow of women into specific careers. (2) Higher built-in barriers for women than for men. Another point ofview is that there are mcxe built-in barriers for women in the informal
Key words: *career choice; students, medicall *psychol; *specialties, medical; career mobility; sex factors; social responsibility; family; attitude of health personnel Introduction The number of women students and the women to men ratio in medicine has been increasing in recent years. The number of women actually working as doctors, however, does not correspond with the number of graduated women Correspondence: C. J. Kruijthof, Department of General Practice and Nursing Home Medicine, Faculty of Medicine, Vrije Universiteit, Van der Boechorstraat 7, 1081 BT Amsterdam, The Netherlands.
21
organization and circuits of the medical profession. I t is still difficult for women to get into the ‘prestigious‘ specialties. Flagrant forms of discrimination against ~ o n i e nare replaced by more subtle tvays to keep wonicn out of import a n t posts. T h e Linderrepreseiitntioii o f w o m e n in medicine (and especially in the ‘higher’ echelons of medicine) is therefore mainly due to informal selection mechanisms in the medical sphere. Pcoplc w h o have strategic positions in the medical hicrarciiy and dccidc about the entry of n e employees ~ (the so-called ‘gatekeepers’) tend to choose people with characteristics similar t o their owm. As most of these gatekeepers are men m d one of the tacit criteria for selection t o important posts is sex, this mechanism disadvatirages w o m e n (Lorber 1984). A report by the KNMG (Royal Dutch Medical Association) points o u t that women have to deal with specific problems in realizing a professional career as a doctor, e.g. difficulties with being admitted to professional training, problems with Jrrangcmcnts for working during pregnancy and financial problems (KNMG 1983). (.?) Itiirneri develop j&ev activities aimed at ,ii/iievitL,y a professional medical cawer thari do mcti. According to Rhodes (1989). the most appropriate strategy for w o m e n w h o wish to combine a family and a nicdical career may be to keep their options open. Therefore one could assume that woiiicn arc engaged in fewer activities directed specifically towards a medical career than men. 14) T / cI corn b iriariow c!jdornestic vesporisibilit ies arid ctirwr dcrrrands. Combining a full-time medical career and bearing the responsibility for domestic tasks and taking care o f a partner and children is a challenge far more c o m m o n for w o m e n than for m e n doctors. Since professional medicine imposes exhaustive Lvork schedules o n practitioners in most specialties, this combination of domestic responsibilities and professional career demands is a problem that looms large (Gordon 1980; Hcrniann 1984; Lorber 1984; Rhodes 1989; Vcnnix 1989). I n order to define factors contributing to the underrepresentation of w o m e n in the medical world, a group o f medical students at the Vrijc Univcrsiteit in Amsterdam were surveyed. The purpose of this survey was to find whether during the pcriod wonieii spend a t the medical faculty predictive indications could be found for
the dcscribcd stagii,ition of t h c n u m b e r ot’ working wonicn doctors. Attcntion was paid to the expectations students have about their future. especially concerning their mcdical carccr in combination with their domestic rcsponsibilitics. W h a t barriers do students cspcct they will have t o deal with in achieving their preferred career arid what arc their views concerning the simul t aiieou s m a nag c n i c ~ti o f h ousehol d and career? Based on the vic\\-s dcscribcd atmvc the qncstion \vas broken d o ~ v nas folloxv\: What arc the differences between women and men medical students conccrning: (1) occupational preferences arid motives; (3) expected future barriers in realizing those occupational preferences; (3) career planning activities; a n d (4) ideas about combining domestic responsibilities with a professional medical career?
Methods In 1989 a questionnaire that covered the four items mentioned above was sent to 646 medical s t u d c m of the Vrije Univcrsiteit in Amsterdam (319 w o m e n and 327 men). To include different categories of students the sample was composed as follows: first-year students (207), preclinical students (179) and clinical students (260). Since the investigation was transversal conclusions about tendencies from first-year t o clinical students can only be m a d e tentatively. T h e response rate was 75.7”/1,. In each category women responded more often than men. Thc average response rate of wo111c11 w a s 859%. while the response rate of men lvas 65.7%. A result \vas considered significant if the I’ value w a s less than o r equ:il t o 0411.
Results
.\loti
LW
Asked for h o w they r a t e various factors when they are considering a future occupation, the women respondents emphasize more than d o the meti respondents:
(1) the possibility o f using communicative skills;
Caveevpevspectives ofwomen and men medical students
23
801 70
60
50 40
30 20
16.4
10
0 General practice
Clinical specialties
=Female
Students
Social Medicine
Remainder
Male Students
Figure 1. Professional preference.
the possibility of equalizing the numbers of women and men doctors; and ‘idealistic’ considerations, while men emphasize more than do women: income; the possibility of using technical skills; and the social position connected with a profession.
The motives Of students can be said to focus more strongly on a humanitarian/idealistic orientation while those of men focus more on a technical/scientific/financialorientation. Career prefvence
between the numbers of women and men preferring a career in any one of these sections are not very marked (Fig. 1). However, if the section ‘clinical specialties’ is broken down into its constituent specialties, some important differences can be seen. The specialties paediatrics and gynaecology are more popular among women than among men: 16.6% ofthe women have a preference for paediatrics as opposed to 3.3% of the men. The percentages for gynaecology are 8.5% and 0.5% respectively, significantly men than prefer surgery as a profession: 5.9% of the women choose surgery and 19.7% of the men do so (Fig. 2).
When we make a rough distribution of the medical professions into four main categories, namely general practice, clinical specialties, social medicine and the remainder, differences
Barriers to reaching the profession ofjirst choice Men and women students tend to see lack of employment, and particularly lack of training
20
15 10
5 n Y
Paedlatrlcs =Female
Figure 2. Clinical specialties
Gynaecology Students
Surgery Male Students
c._I. Krrrl;rhofct dl Table 1. Ohst.rcics o n the \vdy to a
i i i t u r e c.ireer
Mc'ln
Wotn c'I1
Mcii
3.2 2.1 2.0 I 0
3.2 1:. 2.6
2.5
1 .o
Lick of training ticilitics Working hours l ~ i l c kof ernploymriit Selection bdscd 011 sex K.iising children
Missing observations: 5 Scale 1-4: I not wen .IS 7
xi
obstaclr. 4
fcicilities, as major obstacles. Wonieii see niorc obstacles in their occupational fiiturc than men. More than men they emphasize (1) extremely long working hours, (2) selection based 011 sex and (3) the raising o f children as negative influences 011 future career options. These results are shown in Table 1.
CII).CCY
VdlUZ
=
-___
13
srroiisl\ seen .is
,in
obst'icle
t o bc taced in the future, we could not detect any extra cfforts that they nindc o r plnnncd to makc during their medical education to compensate for these extra difficulties.
(Jombiriation c~fhorrreholdr u ~ ~ [ ) ' i s i h i l i t i rid s
tncdirnl c m i w
plannin'Q a r l i v i l i c s
We measured anticipation o f future obstacles by asking students:
(1) whether being informed about cniploynicnt is iniportant to them; (2) how they undertake the search for inforrnation; and (3) what action they undcrtakc to increase their chances of achieving their preferred occupation. Men students answer more often than wonieii that being well informed is important. N o difference was measured, however, in the number o f sources of information used. Also, although wonien secni to be aware of difficultics
We distributed a set of questions to ask thc students to take a look into the future and to think o f themselves as doctors. combining their jobs with family life. One of the questions dealt with the issue o f childcare and rearing responsibilities when both partners have a j o b and the arrival o f a child must be planned for. W h o will reduce the time they spend a t work? The results arc shown in Table 2. A majority o f both women and nien students indicate thdt both parents arc equally responsible for finding a solution for thc subscqucnt problem o f chiidcare and rearing. The remaining, sniallcr part of the sample shows significant difference in opinion: women feel more rcsponsible for family life than do nic'ii and arc more prepared to give LIP their careers for its sake.
Table 2. Who will bear the consequences ot'having 'I child?
Wornt-I1 11
( A ) Mainly oneself (B) Mainly the partner (C) Together
42 11 21 1
TO? A 1
264
Missing observations: 21 1~-value?-tail test: 0.00
Mcn -(1 I
:o
1.5Y
4.2 79.9 100
Jl
1
51 157
21 I9
11.5 24.4
-13.1 I00
Career perspectives of womeYI and men medical strrdents
Conclusions and discussion Returning to the four questions we posed in the Introduction we can formulate four conclusions. (1) Women and men medical students do differ in motives and career preferences. (2) Both women and men expect considerable difficulties in obtaining the preferred job, but women expect more barriers than do men. (3) We could not measure women/men differences with regard to activities aimed at increasing the chance of finding a job. The assumption that women students are less successful in finding a job because they are engaged in fewer career planning activities during medical school than men is not supported by our findings. (4) A great majority of women and men students answered that both sexes should take on an equal share of the domestic responsibilities. Within the remaining minority women feel more responsible for family life and tend to sacrifice working hours for its sake. The question ofwhether the results for the greater part ofthe sample indicate a real change in the womedmen relations or are merely the result of lip service to a hypothetical ideal remains unanswered. In this study data are presented about the outlook of medical students on their future career as combined with their domestic responsibilities. Further research is needed to assess the real barriers that women and men students encounter in realizing their preferred career. Further research is also needed to answer the question of whether the majority of medical students really will take on an equal share of domestic responsibilities or have only paid lip service to some hypothetical ideal. It would be interesting to examine the realities of the professional and the domestic life of students after graduation and to compare these results with the results we found in o u r survey. We therefore recommend a follow-up survey of the generation still studying at the Vrije Universiteit now after these students have graduated. Although we have found that both women and men expect to encounter obstacles in reaching a professional career as doctors and women do so
25
more than men, we could not measurc differences in activities carried in preparation to overcome these expected barriers. Regarding these results it would be wise for women students to engage in more activities to compensate for the expected extra difficulties, but more is to be said. These results also lead us to the firm recommendation that medical schools need to inform their students about circumstances on the labour market in general, for instance about the chances of finding employment, and about the extra difficulties for women in particular. Planners in the field of medical education should be more sensitive to gender-related problems so that effective strategies for eliminating obstacles for women students can be developed. Medical schools play a role not only in the transfer of medical skills, knowledge and scientific insights, but also play a part in transferring the values and attitudes of the so-far predominantly male medical ‘culture’. The influence of teachers as role models in maintaining womenmen relations in this respect is important. There are still only a few women teachers in medical faculties and thus only a few role models for women students to identify with. An encouraging sign of a possible shift towards a less gender-biased policy of medical school staffs was the holding of a congress ‘CaniZres/BarriCres’ (Careers/Barriers) recently by the Board of the Medical Faculty of the Vrije Universiteit in Amsterdam. The aim of this congress was to inform students about obstacles they might encounter and chances they might have after medical school. Special attention was paid to the position of women doctors. The students in our survey were unanimous in their condemnation of extremely long working hours and in their fear of unemployment. We recommend to all staff of medical schools that they care for their ‘product’ and see to it that working hours are more reasonably standardized and that unemployment is diminished. This would imply taking an active role in political discussions about these topics.
References BanekeJ.J. (1987) Studiesucces, persoonlijkheid m stress bij genreskuride studenterr. PhD dissertation, Universiteit van Amsterdam, Amsterdam.
Hcrgquist 5 . K . Iluchac B . W . , Schdin V . A . , Zastrow J F., Harr V.L. K BorowicckiT. (19x5) Perceptions of f r e ~ h n i a nnicdical
Career perspectives of women and men medical students C. J. KRUIJTHOF, C. D . VAN LEEUWEN, P. VENTEVOGEL, H. E. VAN DER HORST & G. VAN STAVEREN Department of General Practice and Nursing Home Medicine, Faculty ofMedicine, V~ijeUniversiteit, Amsterdam
Summary. In spite of the increasing number of women medical students, in many specialties the number of women actually working as doctors still lags behind the number of men working in the same profession. To define factors contributing to this discrepancy 646 medical students at the Vrije Universiteit in Amsterdam were surveyed. A questionnaire was used to obtain information about the difference between women and men medical students concerning their outlook on a future career as combined with domestic responsibilities. The questionnaire covered the items motives and career preference, barriers to reaching the profession of first choice, career planning and the combination of domestic responsibilities and a medical career. The results of this survey indicate that there are still important differences between women and men students in career perspectives. These differences need attention from medical students as well as teaching staff.
doctors. To this day the number of women working as doctors still lags behind the number of men working in the same profession. Also, there is a considerable underrepresentation of women in certain medical disciplines. Since the average performance of women during medical education is often better than or a t least equal to that ofmen (Leeson & Gray 1978; Baneke 1987), there must be other reasons to explain this discrepancy between education and professional activity. The literature offers some explanations: ( 1 ) Differences in career preferences based on different motives. Women have other career preferences than do men and therefore make different choices during their education (Rhodes 1989). Although McGrath & Zimet (1977) interpret the results of their study among US medical students as indicating that the women/men differences in specialty choice are tending to fade, results of other, more recent studies contradict this view. Women students show a preference for paediatrics, for example, while men tend to choose the traditional male specialties, e. g. surgery (Zimny & Shelton 1982; Egerton 1983; Bergquist et al. 1985). According to some authors women seem to have a more idealistic approach than men and are less often influenced by the prospect of a good income or of prestige (Van Staveren 1976; Frey 1980a,b). Therefore, different motives may lead women to choose careers different from those chosen by men. This explanation, however, only accounts for the stagnation in the flow of women into specific careers. (2) Higher built-in barriers for women than for men. Another point ofview is that there are mcxe built-in barriers for women in the informal
Key words: *career choice; students, medicall *psychol; *specialties, medical; career mobility; sex factors; social responsibility; family; attitude of health personnel Introduction The number of women students and the women to men ratio in medicine has been increasing in recent years. The number of women actually working as doctors, however, does not correspond with the number of graduated women Correspondence: C. J. Kruijthof, Department of General Practice and Nursing Home Medicine, Faculty of Medicine, Vrije Universiteit, Van der Boechorstraat 7, 1081 BT Amsterdam, The Netherlands.
21
organization and circuits of the medical profession. I t is still difficult for women to get into the ‘prestigious‘ specialties. Flagrant forms of discrimination against ~ o n i e nare replaced by more subtle tvays to keep wonicn out of import a n t posts. T h e Linderrepreseiitntioii o f w o m e n in medicine (and especially in the ‘higher’ echelons of medicine) is therefore mainly due to informal selection mechanisms in the medical sphere. Pcoplc w h o have strategic positions in the medical hicrarciiy and dccidc about the entry of n e employees ~ (the so-called ‘gatekeepers’) tend to choose people with characteristics similar t o their owm. As most of these gatekeepers are men m d one of the tacit criteria for selection t o important posts is sex, this mechanism disadvatirages w o m e n (Lorber 1984). A report by the KNMG (Royal Dutch Medical Association) points o u t that women have to deal with specific problems in realizing a professional career as a doctor, e.g. difficulties with being admitted to professional training, problems with Jrrangcmcnts for working during pregnancy and financial problems (KNMG 1983). (.?) Itiirneri develop j&ev activities aimed at ,ii/iievitL,y a professional medical cawer thari do mcti. According to Rhodes (1989). the most appropriate strategy for w o m e n w h o wish to combine a family and a nicdical career may be to keep their options open. Therefore one could assume that woiiicn arc engaged in fewer activities directed specifically towards a medical career than men. 14) T / cI corn b iriariow c!jdornestic vesporisibilit ies arid ctirwr dcrrrands. Combining a full-time medical career and bearing the responsibility for domestic tasks and taking care o f a partner and children is a challenge far more c o m m o n for w o m e n than for m e n doctors. Since professional medicine imposes exhaustive Lvork schedules o n practitioners in most specialties, this combination of domestic responsibilities and professional career demands is a problem that looms large (Gordon 1980; Hcrniann 1984; Lorber 1984; Rhodes 1989; Vcnnix 1989). I n order to define factors contributing to the underrepresentation of w o m e n in the medical world, a group o f medical students at the Vrijc Univcrsiteit in Amsterdam were surveyed. The purpose of this survey was to find whether during the pcriod wonieii spend a t the medical faculty predictive indications could be found for
the dcscribcd stagii,ition of t h c n u m b e r ot’ working wonicn doctors. Attcntion was paid to the expectations students have about their future. especially concerning their mcdical carccr in combination with their domestic rcsponsibilitics. W h a t barriers do students cspcct they will have t o deal with in achieving their preferred career arid what arc their views concerning the simul t aiieou s m a nag c n i c ~ti o f h ousehol d and career? Based on the vic\\-s dcscribcd atmvc the qncstion \vas broken d o ~ v nas folloxv\: What arc the differences between women and men medical students conccrning: (1) occupational preferences arid motives; (3) expected future barriers in realizing those occupational preferences; (3) career planning activities; a n d (4) ideas about combining domestic responsibilities with a professional medical career?
Methods In 1989 a questionnaire that covered the four items mentioned above was sent to 646 medical s t u d c m of the Vrije Univcrsiteit in Amsterdam (319 w o m e n and 327 men). To include different categories of students the sample was composed as follows: first-year students (207), preclinical students (179) and clinical students (260). Since the investigation was transversal conclusions about tendencies from first-year t o clinical students can only be m a d e tentatively. T h e response rate was 75.7”/1,. In each category women responded more often than men. Thc average response rate of wo111c11 w a s 859%. while the response rate of men lvas 65.7%. A result \vas considered significant if the I’ value w a s less than o r equ:il t o 0411.
Results
.\loti
LW
Asked for h o w they r a t e various factors when they are considering a future occupation, the women respondents emphasize more than d o the meti respondents:
(1) the possibility o f using communicative skills;
Caveevpevspectives ofwomen and men medical students
23
801 70
60
50 40
30 20
16.4
10
0 General practice
Clinical specialties
=Female
Students
Social Medicine
Remainder
Male Students
Figure 1. Professional preference.
the possibility of equalizing the numbers of women and men doctors; and ‘idealistic’ considerations, while men emphasize more than do women: income; the possibility of using technical skills; and the social position connected with a profession.
The motives Of students can be said to focus more strongly on a humanitarian/idealistic orientation while those of men focus more on a technical/scientific/financialorientation. Career prefvence
between the numbers of women and men preferring a career in any one of these sections are not very marked (Fig. 1). However, if the section ‘clinical specialties’ is broken down into its constituent specialties, some important differences can be seen. The specialties paediatrics and gynaecology are more popular among women than among men: 16.6% ofthe women have a preference for paediatrics as opposed to 3.3% of the men. The percentages for gynaecology are 8.5% and 0.5% respectively, significantly men than prefer surgery as a profession: 5.9% of the women choose surgery and 19.7% of the men do so (Fig. 2).
When we make a rough distribution of the medical professions into four main categories, namely general practice, clinical specialties, social medicine and the remainder, differences
Barriers to reaching the profession ofjirst choice Men and women students tend to see lack of employment, and particularly lack of training
20
15 10
5 n Y
Paedlatrlcs =Female
Figure 2. Clinical specialties
Gynaecology Students
Surgery Male Students
c._I. Krrrl;rhofct dl Table 1. Ohst.rcics o n the \vdy to a
i i i t u r e c.ireer
Mc'ln
Wotn c'I1
Mcii
3.2 2.1 2.0 I 0
3.2 1:. 2.6
2.5
1 .o
Lick of training ticilitics Working hours l ~ i l c kof ernploymriit Selection bdscd 011 sex K.iising children
Missing observations: 5 Scale 1-4: I not wen .IS 7
xi
obstaclr. 4
fcicilities, as major obstacles. Wonieii see niorc obstacles in their occupational fiiturc than men. More than men they emphasize (1) extremely long working hours, (2) selection based 011 sex and (3) the raising o f children as negative influences 011 future career options. These results are shown in Table 1.
CII).CCY
VdlUZ
=
-___
13
srroiisl\ seen .is
,in
obst'icle
t o bc taced in the future, we could not detect any extra cfforts that they nindc o r plnnncd to makc during their medical education to compensate for these extra difficulties.
(Jombiriation c~fhorrreholdr u ~ ~ [ ) ' i s i h i l i t i rid s
tncdirnl c m i w
plannin'Q a r l i v i l i c s
We measured anticipation o f future obstacles by asking students:
(1) whether being informed about cniploynicnt is iniportant to them; (2) how they undertake the search for inforrnation; and (3) what action they undcrtakc to increase their chances of achieving their preferred occupation. Men students answer more often than wonieii that being well informed is important. N o difference was measured, however, in the number o f sources of information used. Also, although wonien secni to be aware of difficultics
We distributed a set of questions to ask thc students to take a look into the future and to think o f themselves as doctors. combining their jobs with family life. One of the questions dealt with the issue o f childcare and rearing responsibilities when both partners have a j o b and the arrival o f a child must be planned for. W h o will reduce the time they spend a t work? The results arc shown in Table 2. A majority o f both women and nien students indicate thdt both parents arc equally responsible for finding a solution for thc subscqucnt problem o f chiidcare and rearing. The remaining, sniallcr part of the sample shows significant difference in opinion: women feel more rcsponsible for family life than do nic'ii and arc more prepared to give LIP their careers for its sake.
Table 2. Who will bear the consequences ot'having 'I child?
Wornt-I1 11
( A ) Mainly oneself (B) Mainly the partner (C) Together
42 11 21 1
TO? A 1
264
Missing observations: 21 1~-value?-tail test: 0.00
Mcn -(1 I
:o
1.5Y
4.2 79.9 100
Jl
1
51 157
21 I9
11.5 24.4
-13.1 I00
Career perspectives of womeYI and men medical strrdents
Conclusions and discussion Returning to the four questions we posed in the Introduction we can formulate four conclusions. (1) Women and men medical students do differ in motives and career preferences. (2) Both women and men expect considerable difficulties in obtaining the preferred job, but women expect more barriers than do men. (3) We could not measure women/men differences with regard to activities aimed at increasing the chance of finding a job. The assumption that women students are less successful in finding a job because they are engaged in fewer career planning activities during medical school than men is not supported by our findings. (4) A great majority of women and men students answered that both sexes should take on an equal share of the domestic responsibilities. Within the remaining minority women feel more responsible for family life and tend to sacrifice working hours for its sake. The question ofwhether the results for the greater part ofthe sample indicate a real change in the womedmen relations or are merely the result of lip service to a hypothetical ideal remains unanswered. In this study data are presented about the outlook of medical students on their future career as combined with their domestic responsibilities. Further research is needed to assess the real barriers that women and men students encounter in realizing their preferred career. Further research is also needed to answer the question of whether the majority of medical students really will take on an equal share of domestic responsibilities or have only paid lip service to some hypothetical ideal. It would be interesting to examine the realities of the professional and the domestic life of students after graduation and to compare these results with the results we found in o u r survey. We therefore recommend a follow-up survey of the generation still studying at the Vrije Universiteit now after these students have graduated. Although we have found that both women and men expect to encounter obstacles in reaching a professional career as doctors and women do so
25
more than men, we could not measurc differences in activities carried in preparation to overcome these expected barriers. Regarding these results it would be wise for women students to engage in more activities to compensate for the expected extra difficulties, but more is to be said. These results also lead us to the firm recommendation that medical schools need to inform their students about circumstances on the labour market in general, for instance about the chances of finding employment, and about the extra difficulties for women in particular. Planners in the field of medical education should be more sensitive to gender-related problems so that effective strategies for eliminating obstacles for women students can be developed. Medical schools play a role not only in the transfer of medical skills, knowledge and scientific insights, but also play a part in transferring the values and attitudes of the so-far predominantly male medical ‘culture’. The influence of teachers as role models in maintaining womenmen relations in this respect is important. There are still only a few women teachers in medical faculties and thus only a few role models for women students to identify with. An encouraging sign of a possible shift towards a less gender-biased policy of medical school staffs was the holding of a congress ‘CaniZres/BarriCres’ (Careers/Barriers) recently by the Board of the Medical Faculty of the Vrije Universiteit in Amsterdam. The aim of this congress was to inform students about obstacles they might encounter and chances they might have after medical school. Special attention was paid to the position of women doctors. The students in our survey were unanimous in their condemnation of extremely long working hours and in their fear of unemployment. We recommend to all staff of medical schools that they care for their ‘product’ and see to it that working hours are more reasonably standardized and that unemployment is diminished. This would imply taking an active role in political discussions about these topics.
References BanekeJ.J. (1987) Studiesucces, persoonlijkheid m stress bij genreskuride studenterr. PhD dissertation, Universiteit van Amsterdam, Amsterdam.
Hcrgquist 5 . K . Iluchac B . W . , Schdin V . A . , Zastrow J F., Harr V.L. K BorowicckiT. (19x5) Perceptions of f r e ~ h n i a nnicdical
