Female NHS consultants closing the ‘gender promotion gap’

Researchers have found that the number of women becoming hospital consultants has increased dramatically, narrowing the ‘gender promotion gap’ with men.

The rise was driven by an unusually high number of vacancies in the NHS as older consultants decided to retire during the pandemic, the researchers said. They compared the “significant shift” to women taking up industrial jobs during World War II.

Professor Carol Woodhams and colleagues from the University of Surrey Business School and the University of Cyprus studied data from 10,485 junior doctors in training in the NHS from 2017 to 2023.

Physicians in training, or assistant physicians, undergo at least six years of training in a specific field before they are eligible for a position as a consultant.

The research, presented to the British Academy of Management on Thursday, found that from 2017 to 2023, 43% of British-trained male junior doctors were promoted to consultant at the end of their training, compared with just 25% of British-trained women. But the chances of promotion increased for both men and women after March 2020, to 56% for British men and 48% for women.

This shift was “remarkable,” Woodhams said The Observer. “Normally you don’t get that kind of significant shift. It can happen, but it’s not typical. I’m starting to think of it as being similar to the reserve army of labor during both world wars – in times of crisis, that reserve army moves.”

The NHS, like many other organisations, is trying to encourage more women into work. Such structural changes usually take a long time to take effect, Woodhams said, “but a crisis like Covid can have unexpected and quite large effects”.

Woodhams was the lead researcher on the NHS’s 2020 Mend The Gap report, which found a gender pay gap of 24% for hospital doctors and 33% for GPs. Women are more likely to work part-time and men are more likely to hold senior roles.

The report shows that women are much more likely to experience parenthood penalties, as they take time off work to care for their children, which has consequences for their development.

“Women have to work harder, work longer and be better to show they can get promoted,” Woodhams said. “But the structures of medicine also discriminate against women indirectly. It takes a consultant 19 years to reach the top of the pay scale, after about 10 years of training. So if you’ve taken time off to look after children, you’ve lost about four years. So the gender pay gap is the largest of any profession in the country.”

That could change, as the 19 different parts of the pay scale have been reduced to five since the report, Woodhams said.

According to Dr Isabel Stockton, senior research economist at the Institute for Fiscal Studies (IFS), employing more female advisers could improve outcomes for female patients.

“There’s a lot of recent research in the U.S. that shows better outcomes when women are treated by women,” Stockton said. “So there’s reason to think that this matters, particularly in a profession like medicine, beyond the sort of general case that we obviously want everyone to have equal opportunities in all sorts of different professions.”

IFS research in April showed that some areas of medicine are much more likely to be male-dominated. In 2019, only 7% of trauma or orthopaedic consultants were women, compared to 77% of palliative care consultants.

Some types of medical specialties can be “greedy work,” Stockton added, citing Nobel laureate Claudia Goldin’s work on how some high-paying jobs require extremely long hours and can’t be done by people with caring responsibilities.