Girlpower?

"So have we made it worse? Us women?" said the intern to me.

Medicine will always be busy and under-resourced. It used to be that faculties had quotas for how many girls are allowed to enter medicine (about 30%). The rationale was that girls tend to leave the public service earlier to raise their families.

With the lifting of this quota, more girls are entering the medical workforce. Girls get better grades pre-university and boys tend to excel later in life. Just look at my M'sian friends - the minimum mark for boys to get a scholarship to study medicine is roughly 8 points below that of girls. But girls still dominate in getting scholarships. As a result, most undergraduate cohorts have a female to male ratio of 3:1. Currently my cohort is made up of 70% females.

Gone were the days when a patient automatically assumed that the male entering the room is the doctor and the female - the nurse. (Though some patients assume I'm a nursing student - guess that will still take a while before they start to realise I don't automatically fall into the submissive category.)

As a result, job-sharing and part-time work has become quite popular in medicine. But it does not come without its pitfalls. Job-sharing means that two doctors share one post and sometimes the continuity of care is affected. It also means doctors take longer to complete specialty training programs. And when they do, a proportion of them will likely want to work part-time or move into private practice. The senior medical workforce is slowly becoming female. Do they have the time to give back to the public system to teach and train junior doctors?

Yes, medicine will always be busy and under-resourced. But are we making it worse?

The feminisation of the medical workforce has implications. There are some positive aspects. Women tend to 'tend and befriend' or 'nuture'. We may make better psychiatrists or paediatricians. And why not, better surgeons. We shed a different light to the much traditioned persona. I for one would much prefer a female obstetrician. But I'm not about to volunteer being on-call for nights and rush to the woman in labour.

Specialties such as radiology, ophthalmology and dermatology become immensely popular. And why not - its a 9 to 5 job and there are rarely emergencies.

The rates of suicide and divorce are higher amongst the medical profession. And medicine isn't getting any easier. Expectations have risen.

We should live longer and better. There should be a cure for everything. Doctor, isn't there something else you can do? Clinics should open on weekends and after hours. Let's MRI the patient in case we miss something.

The threat of litigation is very real. Every doctor here will get sued at least once. It is not a matter of if, it is a matter of when.

So have we made it more difficult? Us women?

I will be honest. I want a family. And well six kids if I can afford it. But part of me know I am being idealistic. How can I afford that and work full-time? Medical training isn't merely 5 years. It takes roughly a total of 10-12 years. And that is just to become a junior consultant. Is one willing to forgo the costs and sweat involved to quit medicine early in life? Not to mention, for many students here - forgoing taxpayers' money?

What is the medical system doing to cope with all of these changes? What are the long-term implications in terms of patient care? Should we revert back to having a gender quota? Should we just have a graduate entry for medicine or a mature age entry (say above the age of 25)?

Do we have a right to complain if work gets too busy? Should we then not have a life? Become a DINK (double income no kids) maybe? Or a SINK?

I once said this to someone, "You know education in the modern world - it's quite deceptive. We are told to excel and work hard to achieve our dreams (well at least that's what my parents told me). We taste what it is like to rise up the ranks, travel and be empowered both financially and status-wise. We want more. How can one not want it all? But sometimes it is just too difficult - and sacrifices need to be made. This may mean having smaller families or children at a later age. Or settling for a less demanding specialty or working in administration or education. Or employing a nanny or maid to help with the house and caring for the kids."

Of course not all women want the career and family. But a good proportion, I like to think, still do. I'm not sexist. But just trying to be pragmatic about the reality that the medical culture is changing fast and we need to start looking for solutions. And perhaps society too should start changing its perception.