Female Doctors in Conflict: How Gendering Processes in German Hospitals Influence Female Physicians’ Careers

Abstract

In German medicine, there is a gap between the increasing number of female medical students and the backlog of women at different turning points of their career. In hospitals, which can be regarded as ‘gendered organizations’, female doctors are confronted with structural discrimination, which is interpreted as gendering processes. In a qualitative, longitudinal study with twenty female physicians who were interviewed three times over the course of 5 years, discriminatory processes were shown on two levels. First, female physicians were categorized as females, and their gender role rather than their professional role as a physician was emphasized. Second, if they were (expectant) mothers, they became even more stereotyped as a female. This stereotyping occurred by reinforcing the conflict between the role of a mother and the role of a professional. It is shown how the women themselves, organizational peculiarities of hospitals, job conditions, and behaviours of male staff members may all contribute to maintaining vertical gender inequality in medicine.

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Notes

  1. 1.

    Compared to other countries, women's access to a medical school in Germany in 1899 was granted late [10].

  2. 2.

    The results presented herein are derived from the qualitative part of an interdisciplinary study which was part of the project KarMed “Physicians’ Career Paths and Career Interruptions during and after Postgraduate Medical Education” at the University of Leipzig and the University Hospital Hamburg-Eppendorf.

  3. 3.

    See Guide for Interviews in Annex.

  4. 4.

    The snowball principle is a procedure for the conscious selection of a sample, after which selected cases address new cases, etc., which then enter into the sample.

  5. 5.

    The sample included only female physicians who were born and raised in Germany. The sample did not include doctors who had immigrated to Germany in the first generation, who worked in rural areas, who left their profession permanently or who had abandoned employment. We have not recorded the number of hospitals in which the doctors have ever worked. Participants were selected from whole Germany, therefore it can be assumed that there are no specific geographic features that could influence the interviews and their results.

  6. 6.

    Because qualitative data work closely with the language of the participants, the results of qualitative analysis are usually presented using verbatim quotes. These results have been translated literally but not analogously.

  7. 7.

    References from the interviews are given in brackets as follows: DC I, II, III refers to first, second, third or fourth interview; two letters, e.g., PJ, are an acronym for the interviewee.

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Acknowledgments und Funding

The project received funding from Bundesministerium für Bildung und Forschung (BMBF) and Europäischer Sozialfonds der Europäischen Union (ESF) (promotional references for the subproject in Leipzig are 01FP0801/01FP0802 and 01FP1243/01FP1244). The authors are responsible for the content of the publication.

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Correspondence to Swantje Reimann.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Annex: Guide for Interviews I to IV with Dual-Career Couples (DC)

Annex: Guide for Interviews I to IV with Dual-Career Couples (DC)

First Interview (DC I)

  1. 1.

    Thanking for the participation, introduction of the interviewer, the method and the use of the recording.

  2. 2.

    Project presentation: This is a collaborative project of the University Hospital Hamburg-Eppendorf and the University of Leipzig. In Leipzig, we conduct interviews and would like to know how female doctors who are in a partnership or are married and are working as doctors perform their personal and professional life.

  3. 3.

    “Please describe your professional life, how do the structures look like, the working hours, where there are problems and complications. Please describe an average working day, e.g. yesterday, from morning till night, how did it look out, when did you get up, and how did you see all day?”

  4. 4.

    “What would be your goal/wishes for the future? When you think of yourself in 10 years, where do you see them?”

  5. 5.

    Additions?

Objectives: To find out via narratives of the participants (also by asking additional immanent questions) about:

  • Job details, like concrete working conditions, working structures, organization, daily routines, working schedule, planning

  • Details of relationship/family life, like kids, everyday life, communication, agreements, organization, planning

  • Are there conflicts, where is satisfaction, which goals and wishes

Second Interview (DC II)

  1. 1.

    Thanking for renewed participation

  2. 2.

    “How is your professional and private situation, what has possibly changed in the one and a half years, in the time since the last interview, what has remained the same?”

  3. 3.

    “Please tell how you came to the medicine.”

  4. 4.

    “Please describe how you grew up.”

  5. 5.

    Additions?

Objectives: To clarify changes and constant factors since the last interview—in work and private life.

  • Additional questions about partnership, children, organization of everyday life and child caring, household and accommodation, etc., and their evaluation in the eyes of the interviewee

  • Additional questions about autobiographical data in retrospect (e.g. parents, childhood, university education, relationships, parental role)

  • Additional questions about job situation, career status, tasks, etc., and their evaluation in the eyes of the interviewee

Third Interview (DC III)

  1. 1.

    Thanking for renewed participation.

  2. 2.

    “Please tell and describe what has developed with you professionally and privately since the last interview a year and a half ago and what has remained the same?”

  3. 3.

    Additions?

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Reimann, S., Alfermann, D. Female Doctors in Conflict: How Gendering Processes in German Hospitals Influence Female Physicians’ Careers. Gend. Issues 35, 52–70 (2018). https://doi.org/10.1007/s12147-017-9186-9

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Keywords

  • Conflicting gender role
  • Female doctors
  • Gendered organization
  • Vertical segregation