Doctoral Degrees (Political Science)

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Browsing Doctoral Degrees (Political Science) by browse.metadata.advisor "De Villiers, Marietjie"

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    A feminist investigation into the reasons for attrition of women doctors from the South African medical profession and practice : exploring the case of UCT medical school between 1996 and 2005
    (Stellenbosch : University of Stellenbosch, 2011-03) Wildschut, Angelique Colleen; Gouws, Amanda; De Villiers, Marietjie; University of Stellenbosch. Faculty of Arts and Social Sciences. Dept. of Political Science.
    ENGLISH ABSTRACT: This dissertation aims to establish the reasons underlying possible gendered attrition trends in the South African medical profession between 1996 and 2005. Noting the international trend of the increasing feminisation of medical education and the profession, the dissertation illustrates that this is also a reality in our national context, and frames this phenomenon as being plagued by difficulties very similar to those encountered in other traditionally male-dominated fields. The particular relevance for further research and debate is illustrated through the noticed discrepancy between women’s representation in enrolment and graduation at medical schools in South Africa, and their representation in the profession itself. The decision to approach this investigation from a feministorganisational perspective was based on the fact that this would not only be a novel, but indeed also an appropriate, research approach to the study of gendered trends in medical education and the profession within the South African context. The research project thus sets out three main objectives relevant to this investigation. Objective 1 aims to establish the sex composition of the cohort of medical graduates that have not entered, or decided to exit, the medical profession. In terms of this objective, findings show an increasing rate of progression of men into the profession, accompanied by a decreasing rate of progression of women into the profession. Objective 2 attempts to establish the reasons behind sex trends in South African medical schools and in the profession. Thus, in an effort to comprehensively investigate the issues underlying attrition, I employ a mixed-methods approach to the primary data collection and analysis. Firstly, the findings show, through a quantitative analysis of the interview data, that this sample of women felt that both institutional and societal factors influenced a women doctor’s propensity to remain in the profession. Secondly, it is established that whether these respondents felt that they had appropriate role models in the profession was the most important factor in terms of their identification with, and propensity to stay in, the profession. Thirdly, it was also found that the respondents felt strongly that the culture of the medical profession impacts negatively on a woman doctor’s propensity to stay in the profession, but similar to the findings of other studies, this does not bring us closer to an understanding of what that culture constitutes. Thus, lastly, through a qualitative analysis of the interview data I find that the respondents clearly recognise the presence of a gendered substructure in medicine in the South African context, and identify some elements of this structure as most commonly linked to attrition. Objective 3, based on the outcomes of the previous objectives, aims to provide recommendations for the retention of medical doctors in general, and women doctors specifically, in the South African context. It concludes that flexibility1 in the medical profession is paramount to the retention of doctors, and women doctors specifically. This is a difficult challenge to overcome, as central values such as the importance of continuity of care in the medical profession would suggest that providing increased flexibility to medical doctors would impact negatively on patient care. However, it appears that there is increasing recognition amongst scholars, policy makers and medical practitioners themselves of the importance of acknowledging alternative work patterns. On the basis of the outcomes of my research, it is clear that the national gender attrition trends are a cause for concern in terms of resourcing the National Health System against the backdrop of a widely acknowledged shortage of doctors in South Africa and elsewhere. If women doctors do not progress effectively into the system, but form the majority of graduates, this is a tragic loss, as well as a waste of resources during training. This aspect also has policy implications, because it appears that the government, in trying to retain doctors, has increasingly turned to measures that are restrictive (compulsory community service, restrictions on foreign doctors), rather than focusing on ways in which to make doctors want to stay. The dissertation thus closes by suggesting two main areas within which these findings and recommendations would be employed most usefully: 1) medical schools/ training/education, and 2) the medical profession/culture.