How female GPs are disproportionately affected by the employment crisis

Dr Seema Pattni considers the impact of the employment crisis on female GPs

‘Both my job offers have fallen through. I’m really panicking. I’m stuck in limbo trying to decide what to do.’

These are the words of a female GP who I spoke to recently.

The employment crisis in general practice is rife and rampant: 84% of GP locums are struggling to find work; a third have made ‘definite plans’ to change careers; over 60% of job-seeking GPs can’t find work; and the BMA has warned that thousands of newly-qualified GPs may be unemployed this summer due to a nearly ‘non-existent’ job market. Many GPs are also seriously considering relocating abroad as a result of this.

But there are also a whole host of factors which means it will have a disproportionate effect on female GPs. Take the crisis, and then add the pre-existing partnership recruitment bias, glass ceilings and workplace misogyny; you’re left with an influx of female GPs reevaluating their career choices.

Flexible working

General practice has, for a long time, been portrayed and perceived as a more family-friendly career path. Surveys show that this is one of the biggest pull factors drawing doctors into the specialty. Female doctors often explain to me that their reasons for training in general practice are based on practicalities – mostly because of a shorter training programme and an assumption that it caters for better work-life balance.

This is borne out in statistics: GMC analysis shows that female GPs are more likely to seek less than full-time hours and flexibility in work: 61% female GPs compared with 26% male GPs.

Much of this is due to caring responsibilities, which shape women’s careers at all stages, and that includes female doctors. Despite societal changes, women still continue to pick up a bigger share of caring responsibilities for both children and elders. Work by the OECD shows that informal caregivers are predominantly women, comprising two thirds of carers for relatives.

However, the reality of general practice does not match up to people’s hopes and expectations of flexibility and family-friendliness. With soaring workloads, long hours and high stress levels, working in general practice is difficult to navigate around caring commitments.

The employment crisis has brought an extra layer of problems, hitting hardest for those – predominantly female – GPs who are working around their caring responsibilities.

The security of shifts close to home and hours that fit has evaporated. Financial independence and stability have disappeared. And while there are reports of GPs travelling across the country, overnighting in a hotel or moving overseas, this is not a feasible option for most GPs with caring roles at home. These GPs now feel stuck.

Maternity leave

Returning to work after having a child is a complex and challenging process. There is a wide spectrum of feelings surrounding it, ranging from excitement to dread. Everyone is unique in how they experience parental leave. What I have routinely observed however, is doctors deeply reflecting on how their identity intertwines with their roles at work and their role as a parent.

There is obviously a big difference between taking the standard two weeks for paternity leave – a duration on par with a standard annual holiday – and the 12 months available for maternity leave (the intricacies of shared parental leave is beyond the scope of this article).

After such a prolonged time out of work, feelings of fear and self doubt are common for female doctors. They often feel overwhelmed at the prospect of navigating changes and updates to clinical practice, their team and practice policies. There can also be concerns about being overlooked for opportunities.

But with the employment crisis, there are added layers of concern and anxiety around job security and job flexibility. Now there is no longer just the worry of ‘slotting back into’ their old role, but the question as to whether there will still be a role for them at all. In turn, this then makes female doctors feel even less empowered to discuss their needs or to ask for support.

‘Will my job still even be there?’

‘I can be replaced a few months after returning’

‘How can I ask for any flexibility when there are 20 other doctors who would apply for my role?’

‘I can’t make any demands because I can be replaced so easily’

Leaving the profession

Because of the job insecurity these GPs now face, there has been an increase in proactive research into alternative careers. It’s not an easy decision or journey to make but I have found that doctors are more determined about considering other career options, clinical and non-clinical. Tentative contemplation about career change has been replaced with a strong sense of immediacy and seriousness.

This is particularly true of those female doctors who are the higher income earners in their family. There is an urgency to secure more reliable roles, or roles with better income. Doctors are looking towards roles in the private sector, pharmaceutical industry, telemedicine, healthtech consultancy or entrepreneurship.

In response to the employment crisis, a lot of my work with female GPs focuses on strategies for safeguarding financial security, and looking at what career options will help develop a sustainable and fulfilling career.

General practice has always been pitted as a vocation with job security. While this can’t – and shouldn’t – be taken for granted, it is hard to accept a situation with so many highly trained and highly skilled doctors out of work, especially when there is so much patient demand. It’s an agonising reality for everyone involved.

A lot of GPs are sad about the crisis forcing them to change careers. After investing so much time, energy and effort in this path, it is not an easy decision to make. For some GPs though, the outcome of these reflections is that working in general practice has not been meeting their values or aspirations for a long while. They have not been able to practise as they want to or help patients in a meaningful way. And now, because of the crisis, they are barely able to practise at all. For these GPs, the employment crisis presents as a painful but opportune catalyst for change.

Dr Seema Pattni is a GP and careers coach for female doctors. Click here to find out more.