A glass ceiling within academic general practice in Western Europe: Career-inhibiting and -facilitating factors for female general practitioners

Introduction

WONCA 2004 in Orlando, Florida, provided the stage for a symposium on “Challenges for Women in Family Medicine”, organized by the WONCA Working Party on Women and Family Medicine. This international symposium provided a review of what women family physicians are doing to confront challenges in education, clinical practice, academia, organizations and leadership [1]. Representing Europe, the results of a unique study on the latter subject were presented.

Researching the glass ceiling in Europe

The glass ceiling is a metaphor for the problems women may face during their career. The aim of this qualitative study was to describe how female general practitioners in Western Europe think about career-inhibiting and -facilitating factors. Using open-ended, semi-structured interviews, 16 academic female general practitioners and two women working in women affairs from seven Western European countries (Austria, Denmark, Germany, Italy, Norway, Sweden and the United Kingdom) were asked to discuss facilitating and inhibiting factors for their own career and for female general practitioners in general.

Results and discussion

The most important result of this study was that there were relevant similarities and differences in the perspectives of women from different European countries concerning the glass ceiling. Remarkably, similarities were mainly found in general statements. All participants agreed on women's preferences being different to those of male general practitioners and therefore causing friction in career paths. Differences in explanations for these preferences were more specific according to country or culture. Respondents from the Scandinavian countries suggested that underestimation by women themselves regarding their skills acts as a career-inhibiting factor. Other studies also suggest that underestimation by women is an important contributor to the glass ceiling [2–4]. Scandinavian women also mentioned that the culture in medicine was not favourable for women to achieve top positions. This phenomenon is described as gender discrimination in society reflected in organizations, resulting in higher esteem for men [5–9]. Respondents from Norway, Germany and the United Kingdom suggested that a lack of skills in women might relate to the fact that women prefer to study subjects which are less valued in dominant research. The finding that women have specific wishes regarding working conditions is in agreement with the literature [5].

Italian and Austrian women strongly emphasized family responsibility as an inhibiting factor for a career, while the Scandinavian participants felt less inhibited by their families. Perhaps because of good child-care regulations, difficulties in combining a career with raising a family did not seem to be a big issue for them. This conflict of interests referred to by Italian and Austrian respondents can be explained by traditional role patterns [10]. Combining professional tasks with those of a mother mostly results in working part time, obtaining less experience in academia and having fewer publications. In the end, female general practitioners are less frequently nominated for higher positions [6], [11]. Italian and Austrian participants added that the speciality of general practice is not (yet) well positioned within medicine. If there are only a few leading positions available, this obviously disadvantages female careers.

Conclusions

In various Western European countries, academic female general practitioners face similar and different kinds of constraints during their careers. Diverse organizational structures, cultural norms and natural resources influence the careers of female general practitioners in each country. Different measures need to be taken in these countries to break the glass ceiling faced by these professionals.

The future

The purpose of qualitative research is “to study things in their natural setting, attempting to make sense of, or interpret phenomena in terms of meanings people bring to them” [12]. In studying the opinions of female general practitioners in Western Europe, interviews are an excellent instrument. However, as this was the first study in this subject taking place in seven different European countries, it was not easy to select and enrol respondents. Having involved only a few women in each country, the results of this study only give us a basic impression. Larger national sample populations and the involvement of male general practitioners would provide a clearer perspective on this subject. Nevertheless, this study reveals some important exploratory findings on the subject of female general practitioners and leadership in Western Europe.