Kiyoko Kato: Current state of female doctors in Japanese Obstetrics and Gynecology

The current state of female doctors in Japanese Obstetrics and Gynecology

「日本の産科婦人科における女性医師の現状」

Kiyoko Kato, Professor, Department of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu University

加藤聖子、教授。九州大学大学院医学研究院。生殖病態生理学

The Ludwig Boltzmann Forum on Women’s development and leadership was held on Monday 16 May 2016 in Tokyo in honor of Dame Carol Black’s visit to Japan.

View the full workshop program here.

(Summary of Professor Kiyoko Kato’s keynote written by Gerhard Fasol)

Kiyoko Kato, Professor
Department of Gynecology and Obstetrics
Graduate School of Medical Sciences
Kyushu University

Japanese Obstetrics and Gynecology: improving medical care requires gender equality – higher numbers and higher retention of women medical doctors

  • 18% of medical doctors in Japan in 2008 are female, 82% are male. Back in 1976 only about 10% of medical doctors were female
  • Medical school: in 1976 about 13% of medical students were women, this ratio increased up to about 35% peaking around the year 2000, and subsequently decreases slowly to around 32% in 2008.

Thus the ratio of women medical doctors are slowly increasing in Japan.

The M-curve

About 90% medical doctors enter employment after graduation, remain employed at that level until about 35 years after graduation, when employment ratios slowly decrease due to retirement.

For women medical doctors, the employment ratio curve is M-shaped, with a minimum at about 76% employment approximately 11 years after graduation, at an age around 36 years, after this minimum many women medical doctors enter employment again, reaching similar employment ratio’s as men about 35 years after graduation.

62% of women medical doctors leaving their employment do this because of pregnancy, child birth or child care (80% in case of women younger than 45 years age).

Obstetrics and gynecology medical doctors older than 40 years are predominantly men, while doctors younger than 40 years are predominantly women

For medical doctors aged 40 years and over, obstetrics and gynecology specialists are predominantly men: women obstetricians and gynecology make up less than 10% of doctors at higher ages.

This ratio is reversed for obstetricians and gynecologists younger than 40 years of age: women outnumber male doctors, below 30 years age, women doctors outnumber men nearly by a factor of 2.

There is a clear trend: older medical doctors in the obstetrics and gynecology field are predominantly male, while below the age of 40 years, women dominate by an increasing ratio.

Kyushu University Hospital: Professor Kiyoko Kato is the one and only woman Full Professor of Medicine

Kyushu University has 135 female doctors, and 81.5% are on part-time contracts, only 18.5% have full time employment.

Ratio of women at different levels of the career pyramid:

  • Part-time intern doctors: 36.3% are women
  • Part-time doctors: 30.1% are women
  • Full-time doctors: 8.6% are women
  • Assistant Professors: 22 women vs 187 men (11.8% are women)
  • Lecturers: 1 single woman vs 48 men (2%)
  • Associate Professors: 1 single woman vs 31 men (3%)
  • Full Professors: 1 single woman vs 24 men = Professor Kiyoko Kato (4%)

Only one single woman has achieved promotion into each of the higher ranks of Lecturer, Associate Professor and Full Professor, indicating that any women at all in these higher academic medical Professor ranks are rare exceptions rather than the rule (no mention here of still higher ranks, such as Hospital Directors, Deans, Heads of Department, or University President).

Professor Kiyoko Kato then explained her own career, where she spent time studying in the USA, gave birth to her first child in the USA, and then to her second child after returning to Japan. She had to cope with several challenges, e.g where one of the hospitals she worked was shut down. Finally Professor Kiyoko Kato was appointed Full Professor at Kyushu University Medical School.

Professor Kiyoko Kato proposes that three issues need to be solved:

  • improve the work environment during pregnancy and child bearing
  • re-integration assistance: re-education and support after leave of absence
  • remove obstacles to career improvements

Improve the work environment during pregnancy and child bearing: the “Kyushu University Perinatal period cradle net project” 「周産期ゆりかごネットプロジェクト」

With support from the Ministry of Education, Culture, Sports, Science and Technology (MEXT), Kyushu University created the “Kyushu University Perinatal period cradle net project” (2013 – 2017). In Japanese 「周産期ゆりかごネットプロジェクト」, the website is here:
http://www.med.kyushu-u.ac.jp/yurikago/
and an overview of the project can be found here:
http://www.med.kyushu-u.ac.jp/yurikago/data.html

As the websites show, the “Kyushu University Perinatal period cradle net project” is carefully designed, structured and provides a depth of support for women medical doctors to give birth and pursue their career. Women doctors are given part-time positions in the out patient department after returning from leaves of absence.

So far seven women doctors have taken advantage of this program, and several have been assisted to return to full or part-time employment, two are still absent because of a second pregnancy. Part-time work in the outpatient department assisted them to return back to full time employment. Experiencing the hospital as a patient during birth also provided valuable experience.

Re-integration assistance: re-education and support after leave of absence. The Kyushu University Kirameki Project.

To support re-integration after absence, Kyushu University created the “Kirameki Project” (Kirameki = glitter, shine). The Kirameki Projekt is described on the website here:
https://www.kyudai-kirameki.com/

2007-2009 the Kirameki Project helped female medical workers, female doctors, dentists and nurses to re-integrate after leave of absence.

From 2010 the program (“Kyushu University Hospital Kirameki Project”) was expanded to support continuation of the career for doctors, dental doctors, nurses for both men and women, because of delivery, child care, or disease / medical leave.

The aims of the project are to promote women doctors, dentists, and nurses who would have to resign their positions due to family reasons including marriage, children, husband’s job transfer etc, and to help them pursue their career after marriage.

Activities of the Kirameki Project are:

  • survey the problems of women doctors, dentists and nurses after marriage
  • recruit qualified but “hibernating” female medical personnel
  • learning programs
  • promote “high spirits”, encourage
  • on the job training in the out-patient department

Structured programs of the Kirameki Project:

  • Administrative: refresher program
  • Reestablishment: getting back to work program
  • Suspension/leave: web based education
  • Medical specialist: continuing specialist medical education
  • Marriage, child-care: continuing education
  • Residents, newcomer nurses: basic training
  • Students: gender equality education

Remove obstacles to career improvements

Assist women researchers after child birth and during child rearing: support attending international conferences, support system for hiring research assistants and technicians for research support.

Construct a support system:

  • Return support after child-care leave: day nursery, team medical care including emergency mutual help system, flexible working time, e.g. 9-5 work day
  • Improvement of career: system of supporting female researchers during child bearing and child rearing, grants for female researchers to support technicians

Professor Kiyoko Kato’s wishes and expectations for female doctors

  • responsibility and awareness
  • gratitude to all who helped
  • contribution to medical progress
Ludwig Boltzmann Forum on Women’s development and leadership
Ludwig Boltzmann Forum on Women’s development and leadership
Ludwig Boltzmann Forum on Women’s development and leadership
Ludwig Boltzmann Forum on Women’s development and leadership
Ludwig Boltzmann Forum on Women’s development and leadership
Ludwig Boltzmann Forum on Women’s development and leadership
Ludwig Boltzmann Forum on Women’s development and leadership
Ludwig Boltzmann Forum on Women’s development and leadership
Ludwig Boltzmann Forum on Women’s development and leadership
Ludwig Boltzmann Forum on Women’s development and leadership

Notes

Summary of Professor Kiyoko Kato’s keynote written by Gerhard Fasol, view the full workshop program and summaries of all other keynotes here.

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