Women and professional degrees

Great Debates
1

(The thread title is more vague than I’d like, but I had a hard time summing it up.)

The owner and sole pharmacist of our clinic’s attached pharmacy had a stroke a while back. His wife was telling me today that they’re having a hell of a time finding a relief pharmacist to cover while he is recuperating, because there’s a severe shortage of pharmacists in Kentucky.

“And you know why, don’t you?” she said. “It’s the women. All these women are getting their pharmacy degrees, working for two or three years, then having babies and quitting. If they weren’t taking up those spots, it might not be so bad.”

Now I don’t blame this phenomenon for the shortfall; my guess is that we’re just not graduating enough pharmacists, period. But I can think of half a dozen women off the top of my head who took just exactly the path she describes out of pharmacy school. There were a couple of women in my med school class who said all along that they wanted to quit when they had kids. (It isn’t just the mommies dropping out, of course; I’ve given a lot of thought to whether I want to still be doing what I do ten years from now.)

The fact is that all of those pharmacists, and all of us doctors, were trained at least partially at the state’s and the nation’s expense. Each of them had a spot in a class that might have been taken by someone who did that job eighty hours a week for forty years. And whether or not they are to blame, a shortfall does exist for the tasks they’ve been trained to do.

1.) So is a person who gets a professional degree (particularly from a state school) in an underserved profession morally obligated to use it? 2.) Is it wrong to take a spot in a professional school if you don’t intend to make a full career out of it? 3.) Should the schools try to keep such people out?

4.) And a more interesting debate, perhaps: let’s say that we did a study and we found that between maternity leave, reduced hours for child care, and those who quit entirely, the average female pharmacy school graduate works half as many hours as a pharmacist over her lifetime as the average male graduate. Is that a reason to favor men in the admissions process?

And, finally, 5.) can this phenomenon be blamed for the shortfall in these high-demand professions?

2

My thoughts:
1.) Not really. Situations change, and we have to allow for that.
2.) If you don’t intend to use it at all, or very briefly, then no, that’s not right. Who’s to say what a “full career” involves, though?
3.) If someone said, plainly, that he knew he’d only be using his degree for a few years (if at all), then I think an admissions committee would be justified in giving his spot to someone else, even if the other candidate were less qualified.
4.) No. If you ask me, this is a feature, not a bug. Having more women in the health care professions has made it more acceptable for those professionals (even the men) to live more normal lives, devote more time to their families, etc. There is still an old guard that thinks every doctor or pharmacist should be working 100 hours a week, but they’re fading fast. (Not that it’s gone completely; when I talk about going part time in a few years to write a book, people look at me like I’ve got two heads.)
5.) No. Even if every health care professional graduate worked full time his or her entire life, it wouldn’t meet the demand. (Whether the demand is justified is another debate.)

3

Well the answer to 3) is definitely “no”. Unless you plan on forcing students to sign a contract as part of their enrolment paperwork, or simply banning women of childbearing age, how would you go about it?

4

Your mistake is that you’ve bought into the paradigm.

Incidentally, I’m informed by a pharmacist friend that spots go begging in pharmacist school. So it’s not like they’re turning people away.

5

To muddy the waters a bit, I’m going to throw this out:

How would you account for those people who go to professional school who have no intention whatsoever of practicing that profession? For example, someone could go to pharmacy school to become a drug rep or a researcher. Would you deny spots to those people?

And to answer the question raised in the OP, retail pharmacy can be difficult under the best of circumstances. It doesn’t appeal to a lot of people, and jobs sometimes go unfilled because they’re not as desirable as hospital jobs.

Robin

6
  1. Yes
  2. Yes
  3. Absolutely
  4. Well, I think that it shouldn’t be illegal to ask if someone plans to take off a few or more years to have kids. Both mothers and fathers, I think, have a reasonable expectation for a year or two off over the course of their careers to help bring up kids, write the great American novel, or construct of a paper-mache model of the Brooklyn bridge, but I draw the line at plans to retire completely and permanently at the age of 30.
  5. Not entirely, and certainly our society needs to shake up its medical education and provider model to be much more efficient, but it’s a significant part of the problem.

For private schools, whatever, but for the public universities that educate the majority of MD’s in this nation, they aren’t seeking out good med-students, they’re in the business of minting doctors. Medical school shouldn’t be entered into lightly or for the purpose of satiating a personal interest or curiosity, it should be done so with the view of serving the community and state paying for 75% of that degree as a physician in some capacity or other. That doesn’t necessarily need to involve 100 hour weeks, but it’s not philosophy or the classics, people.

I don’t think that this necessitates sexism in admissions by any means, simply asking people what their intentions are for the long term of their career. I don’t see the justification for admitting someone that intends to retire at 30 to have kids when there are plenty of qualified females that are willing to put in a solid 40 years are available. MD admissions is not lacking in any way for applicants at this point, so I think that it’s reasonable to try to ascertain the commitment level of applicants.

Similarly, I question the wisdom of admitting 42 year olds to medical school.

7

If they’re going to serve the community that’s providing that education in some manner, I’m fine with it. Researcher that will help to produce new pharmaceuticals? Absolutely.

Drug rep? I see that as a position that serves more to distort the drug market and serve the interests of a drug company rather than the community providing the PharmD education, but at least it fills some role in the provision of medical care.

8

I was thinking there about people who are explicit about it, who say up front that they only want to work until the kids come along in a few years. Of course, if spots were denied on that basis, people just wouldn’t talk about it anymore. Beyond that, you’re right–there’s no good way to do it, even if you think it should be done.

This may be the case in some places, but not in Kentucky.

That’s a good question. Those people would actually be using their degrees, so it’s hard to imagine keeping them out. But if you had a serious deficit of practicing pharmacists, and a pharmacy school candidate told you that he fully intended to be a drug rep, one could argue that the school should give his spot to someone else.

9

What percentage of women with professional degrees leave their professions? What percentage of men do? How many of these were funded by the federal government or the state? In which cases were the class sizes limited? Sorry, but we really just don’t have enough information to decide to start treating women like third class citizens again.

I honestly don’t know any women physicians who are not practicing or teaching in med school.

I received federal money in the form of a loan while I was going through school and I entered one of the professions. For each of the first five years that I worked in the profession, ten percent of the total loan was cancelled. That was a good incentive, but I would have stayed anyway.

How about equal pay for women as an incentive? Equal opportunities to advance perhaps? On site daycare centers? Equal participation by male partners in child care responsibilities and homemaking responsibilities?

10

Equal pay and European style maternity leave would do a lot to get more women who would comeback after having children.

11

My first reaction to the sitiuation described by the OP is that a woman who was on the “mommy track” might be a particularly good candidate for a temporary, fill-in position. She might work for a few weeks/months while her kids are in school, then be home with them during the summer. She might work for a while until she’s ready to have kids, knowing that the position isn’t permanent anyway. She might use such a position to ease back into the profession after her kids are grown and no longer need her to stay home for them.

It’s my understanding that professional training (med school, pharmacy school) requires quite a bit of time and effort, as well as money. Wouldn’t the student herself be best able to decide whether, even if someone else was paying for it, all that time and effort was worth it if later she was going to quit or take a break to have kids?

12

How about people who seek professional degrees and discover during the course of their studies that they do not desire to work as a licensed member of that profession, but finish anyway? Sometimes one doesn’t discover that they wouldn’t be happy working in a profession until one has already begun the training process - but doesn’t feel comfortable for whatever reason dropping out.

According to the law school from which I graduated, some 15 - 20% of their graduates never practice law at all, for even a single day. That percentage does not count those who are unable to pass a bar examination - it only counts people who finish law school, take and pass a bar exam, and then never practice a day.

Granted the percentages at my law school are somewhat higher than the national average, for a variety of reasons (it’s a strongly public-interest oriented school, a certain percentage of the students and therefore graduates are Jesuit priests studying for essentially purely academic purposes, etc). However, I know at least four people in my graduating class who attended law school, and then chose not to practice even after passing a bar examination. I’m one of them.

Granted, there isn’t any appreciable shortage of lawyers, but the personal factors that go into people deciding not to practice law (or to do so for only a short period of time) are probably much the same as the personal factors that lead to a similar result for pharmacists or physicians. High stress, ridiculous schedule, toll on personal life, etc.

13

I see an opportunity here for Kentucky to solve the problem.

Scholarships for pharmacy students, with the stipulation that you have to work in retail pharmacy in the state for x number of years to repay the benefit.

How many might stick around afterward? I hear nice things about Kentucky.

14

(bolding mine)

Your statements are at odds with each other. Either there just aren’t enough graduates, or the schools are overwhelmed with applications but not all of the chosen go on in that profession. In the first instance, people who practice for just a few years are still contributing more than they would have if they hadn’t enrolled in the program at all. In the latter instance, the schools should get their acts together and expand their programs to meet demand, instead of turning away people who might still do some good, even if for a limited time.

In any case, I don’t think a school has any business telling a student they cannot attend a program.

The financial angle could play a role, but I wonder if you could clarify for me what you mean when you say that the students “were trained at least partially at the state’s and the nation’s expense.” Is government funding directly subsidizing their education? Are you talking about student grants? It would help to know. FWIW, I have no objection to the gov’t paying tuition in exchange for a certain number of years of service.

The insistence that women are to blame in this sort of situation because they take off time for child-rearing and such is just old-fashioned sexism, IMO. I’m in a male-dominated professional/academic field, myself, and I see such attitudes wielded all the time by the older generations. Very little is ever said about the men who leave the profession, though, because it’s assumed that they must have a good reason. With women, the accusation of frivolity is one of the first that gets hurled out.

Asking people their intentions is absolutely sexist, because the response will be disproportionally skewed toward women having to say they will take time off for child-rearing. And who said anything about “retirement at 30”? What’s to stop people from taking a break for 5-10 years and then coming back? Would doing so really make them less worthy in your eyes?

I couldn’t disagree more. I’d rather have a doctor for 20 years who was passionate because they came to their calling at a point in life where they knew what the career alternatives were, than have a doctor for 40 years who went through the motions because they were in it for the money or whatever.

15

You’re also talking about recruiting people to Kentucky.

Do you have any statistics to show that professional shortages are fueled by female professionals leaving the workplace to become SAHMs…I mean, beyond your personal observations and the observations of a woman who may, if hailing from an older generation, be slightly biased?

You reference a “couple” of women in medical school-I’ve always understood there to be thousands of med school applicants for what amounts to a very, very limited number of spots per class (my sister went to Northwestern, where for a pretty small class, they reserve a solid portion for the 7 year HPME kids…which means that if you weren’t in their 7 year program, you weren’t competing for a 100 seats, you were competing for 80).

If you’re getting your loans written off by agreeing to work in some rural backwater, whatever your profession, and you skip out on that obligation, you should be made to disgorge the benefits. At my job, the Feds are willing to pay off about 25% of my federal loans if I sign contracts agreeing to work for X number of years-I chose not to because of that little “and if you leave you have to pay us back every dime” clause. I’m going to assume any sort of loan forgiveness for working in some nondesirable locale program will have the same clause.

So I really don’t see the issue-

a) I’m still not convinced professional shortages are fueled by women taking off for child care based on personal conjecture

b) Not terribly certain about the pharmacology industry but if med schools want more doctors for a shortage, then start admitting MORE people instead of making people go through 3 rounds of applications to make it in

c) If people are skipping out on their underserved communities contracts they’re likely going to be breaking contracts. Contracts that disincentivize skipping out.

16

a) What’s to stop someone from lying and saying “no, I don’t plan to have children”-even if you were allowed to ask that question? My impression of doctors has always been that they’re the sciencey version of lawyers. Sure, you’ll get a few people who’ll blurt out the truth, but most are ambitious & intelligent and will just tell people what they want to hear. Most people who apply to any program are trying to tell admissions officers what they want to hear (some being better at it than others)

b) Are you then planning on making people sign contracts promising not to have children? And we’re talking state schools, right? That might be…problematic. And expensive.

17

Cite, Please?

My Opinion:

  1. No. Why would they be obligated? If the state paid for the education, then maybe they should be obligated for a while (ala Northern Exposure). But otherwise, no way!

  2. No.

  3. No. If there are people who are getting an education in X, but don’t plan on using the education, then the wages for that profession will go up and more people will seek admission to programs which teach X and the market will stabilize…

Hypothetical: What if someone wanted to learn X so they could become a teacher, should we not let them into the program?

Who would judge if the motives for learning are pure enough.

  1. Not in my opinion. What if we found that Hispanics tended to work more overtime hours in their careers than Asians, would this be a reason to favor Hispanics in the admission process? (Note, just inserting random groups here, not trying to make any statements about Hispanics or Asians).

  2. No, I doubt it. It probably is just not that attractive of a career. My guess is that it is similar to nursing, mediocre pay with bad hours, lots of risk of litigation, no support or loyalty from employers, etc… The pay in nursing does not seem to keep up with the demand due to outside pressure to keep medical costs down, thus people don’t want to be nurses and tend to leave this career. I imagine there are similar cost pressures with pharmacies (especially with the pressure from international/internet based businesses.)

Now for my question (for threemae primarily), people in the US on student visas are not going to serve the US population with the education they are receiving. In fact, they may harm the US population through outsourcing. Regardless, should we not allow them entry into our schools?

Finally a comment: this whole discussion strikes me as somewhat communist… "We must educate people who will serve the state, if you don’t serve the state you are not entitled to education.

18
  1. No.A graduate earned the degree, through work and by paying tuition, and can make whatever use of it they wish. Say a man graduates and discovers he hates the field. Should he be forced to stay in it?
  2. No. No one can possibly tell what will happen in their life upon entering a school. A woman who intended to have children might turn out to be infertile, or never get married and not want to be a single mother. A man might get called to the priesthood or something.
  3. No, for the reasons above.
  4. If on the average graduates of a class work for a certain number of years, and if this is not enough to meet demand, then the number of graduates should be increased. If the graduating class is designed to create an artificial shortage, the graduates can’t really be blamed for contributing to it. An exception is if there is some limit to the number of spots. In California public colleges get a certain amount of money per student. Nursing students cost significantly more than this, so financial considerations have led to a shortage of nursing spots and thus nursing graduates. Of course this can be corrected by the legislature.
19

I was wondering about the “statistics” myself. Surely, a person with a scientific education can provide some actual evidence!

Concerning women who leave any job (not just “profession”) for child-rearing: Most of them get back into the job market, eventually. Sometimes they time their 2.3 kids & go back as soon as the kids are in school. Sometimes, their circumstances change.

20

Would you admit people who had a higher risk of heart failure? What about someone who had a higher risk of breast or prostrate cancer?

It seems to me that your logic dictates that we should preferentially admit people who are healthier and can work longer for society…