Fix the difficulties confronting female doctors

The manipulation of entrance exam scores at Tokyo Medical University, exposed in an in-house probe by lawyers commissioned by the university, is an appalling act that contravenes the principle of fairness required of an institution of higher education. The former top officials of the university, who have been charged with bribing a senior education ministry bureaucrat, played leading roles in the series of malpractices, including the padding of the test scores of applicants who suited the university’s business interests. That the university had also systematically deducted points from the exam scores of female applicants for years, as the lawyers say, is clearly gender-based discrimination.

Internal affairs minister Seiko Noda has indicated that the government will probe whether other universities with medical schools have similarly discriminated against female applicants in their entrance exams.

The practice reportedly took place at Tokyo Medical University since the mid-2000s in an effort to reduce the number of female students at the medical school. The given logic was that women doctors tend to resign or take long leaves due to marriage or childbirth, creating staffing shortage at its affiliated hospitals. Such a concern from the viewpoint of hospital management does not justify discriminating against women in their education opportunities. Whether the entrance exam malpractice is an isolated case at Tokyo Medical University should be thoroughly examined.

The entrance exam malpractice first came to light in the alleged bribery of the education ministry bureaucrat. The top officials of the university are accused of seeking the bureaucrat’s help in receiving a government research subsidy in return for padding the scores of the bureaucrat’s son in the school’s entrance exam last spring. The in-house probe revealed that the bureaucrat’s son was one of 19 applicants whose scores were inflated to ensure their entrance into the medical school in the past two years. Reportedly, this practice had been going on since 1996, as university officials came under pressure from alumni to increase the number of their children gaining admission, and as the university began to rely on donations from alumni to bolster its finances.

Meanwhile, the university has uniformly deducted points from the entrance exam scores of female applicants as well as male applicants who were taking the exam for the fourth time or more since at least 2006. The discrimination against female applicants was reportedly motivated by the university’s concern that if the number of female students at its medical school increased and the women went on to become doctors at its affiliated hospitals, staffing shortages could emerge. Rumors that similar discrimination has been practiced at other universities in entrance exams for their medical schools for the same reason should be investigated.

The medical profession in Japan indeed remains a male-centric community. Women accounted for 21 percent of all doctors at the end of 2016. The ratio is the lowest among OECD members and just about half the OECD average. The ratio of female students at medical schools across the country rose from 18 percent in 1987 to 30 percent in 1997 but has remained around that level over the past two decades.

Behind the slow increase in the number of female doctors is said to be the environment in hospitals and other medical institutions in which doctors work excessively long hours, making it difficult to adequately balance the demands of their job with the needs of their family. A 2016 probe by the Health, Labor and Welfare Ministry showed that doctors in their 20s hired at hospitals work an average of 55 hours a week. In addition, male doctors spend 16 hours and female doctors 12 hours on standby for emergency calls or nighttime duty. In a survey by the Japan Medical Association of about 10,000 female doctors, 25 percent of the respondents said they work more than 60 hours a week — roughly the same ratio as male doctors. Around 90 percent of them think that they need an improved work environment or support for child rearing in order to keep working as doctors.

A study group at the health ministry in February compiled a set of measures to reduce the doctors’ workloads, such as shifting some of their duties to nurses. It also called for the introduction of flexible ways of work for female doctors so they can continue to work while raising children.

If the work environment makes it tough for female doctors to keep working, the answer is to change that environment, not to restrict opportunities for women aspiring to be doctors. The probe into the entrance exam scandal at Tokyo Medical University should shed light on the problems confronting female doctors and promote efforts to resolve them.