The gendering of medical specialisms: a study of the specialism career choices by women doctors in the National Health Service (UK)

Recently, more than half of those becoming junior doctors are female, which suggests a feminisation of medicine in the UK and emphasises the need for gender equality in the field. However, women remain the minority in the most ‘prestigious’ medical professions, heightening inequalities and the gender pay gap amongst doctors. It is essential that we understand why women are avoiding certain specialisms. This thesis contributes to the discussion of gendered career paths and career inequality. This study is informed by a theoretical framework drawn from communities of practice and preference theory, focussing on the main factors influencing the career choices of female junior doctors, particularly considering contributing factors at the time of the decision and a consideration of the importance of a work-life balance.

This project is comprised of 28 semi-structured interviews with female doctors who are working or have worked for the NHS between September and December 2020. The findings reveal that at the time of making their specialty decision, women are concerned with actual and potential caring responsibilities, an interest in the specialty, and whether they can ‘see’ themselves in the specialty, looking for a place where they ‘fit in’. Communities of practice had a significant impact on feelings of belonging.

This study informs the understanding of the career decisions of female junior doctors in the NHS, which helps to critically analyse which systems can be improved to increase the number of women in prestigious specialisms in the NHS. The central argument of this thesis is that NHS policy and recruitment needs to consider how they can make all specialisms tenable and attractive to female doctors through encouraging and fostering strong communities of practice.