Gender Disparity and Competition Among Medical Fields in Japan

According to the article titled “The Tokyo Medical University entrance exam scandal: lesson learned” written by Greg Wheeler, many Japanese medical universities claimed that they had guided their students toward the objectives of professional ethics and social morality. The article takes a prestigious medical school named Tokyo Medical University (TMU) as the main character. TMU declared that all its graduates had acquired “the practical skills and ethical outlook required of a doctor” (Tokyo Medical University n.d.a). Conversely, it had been found manipulating the entrance examination scores of certain groups of its applicants, including females and applicants who had previously failed the examination three times at least.

The misconduct was caused by the strong prejudice against those applicants. TMU’s reputation had subsequently been damaged as its action of exam manipulation was published in Japan and abroad afterward. This medical school spared no effort retrieving the public’s trust (Wheeler, 2018).

As a matter of fact, not only the applicants but also the students who already had enrolled in medical schools were treated unpleasantly. During September 2003 to January 2004, there was a cross-sectional questionnaire survey aiming to assess Japanese medical students’ experiences of abuse during their clerkships. The result indicated that most of the medical students had been verbally abused. Furthermore, both male and female students had gone through the period of being sexually harassed (14.6% of male students, 54.1% of females). The existence of gender discrimination was verified among medical fields as well (Nagata?Kobayashi et al., 2006). It is astonishing to discover that Japanese students had encountered various immoral and unequal treatment regardless of their status.

In addition, both the worries about domestic responsibilities and the experiences of gender discrimination affected female physicians’ decisions on how long they would stay within their professional fields. The article mentioned that since female physicians were believed to have a short-term professional career, medical schools started concerning the population of women successfully enrolling in the university, causing the misconduct of score manipulation. The number of women entering the medical fields has been raising throughout the world. However, it doesn’t guarantee that the physician workforce has increased. The article pointed out the reason why female physicians tended to have insufficiently short medical careers was because of their concerns about domestic responsibilities. They preferred to get married and to have children instead of practicing medicine long-term. According to the statistics provided by the article, the ratio of female doctors to the total number of physicians was twenty-one to seventy-nine, supporting the belief of not having a long-term dedication among female doctors (Wheeler, 2018). In fact, this tendency was correlated to gender disparity as well. A previously conducted cross-sectional study based on surveys of graduates from thirteen private medical schools in Japan revealed that compared to full-time workers, part-time workers had statistically higher perception of gender-based career obstacles (Nomura & Gohchi, 2012) as the perceptions of disparity lowered self-confidence, making it harder to accomplish one’s full potential in medicine (Carr et al, 2003). It seems that the concerns about families and the experiences of gender discrimination were hidden behind the trends of short-term career.

The medical schools are commonly regarded as the most prestigious of all university programs in Japan (Wheeler, 2018). In addition to their reputations, the following content is going to discuss the other two reasons leading to fierce competition for entering those medical schools. An article introducing medical school system in Japan indicated a trend that there was a strong link between graduation background and professional career among Japanese graduates, meaning their professional career was greatly influenced by which universities they attended and graduated from. Thus, this trend reinforced the intensity of admission to medical schools (Tokuda, Hinohara, & Fukui, 2008). The second one was caused by low quantities of medical schools. To date, there are 80 undergraduate medical schools in Japan, including 51 public schools and 29 private ones, representing approximately one medical school for every 1.6 million people (Kozu, 2006). Consequently, the reputation of Japanese medical schools, the correlation between graduation background and future career, and the number of medical schools result in a competitive phenomenon among high school graduates who want to enter medical schools in Japan.

In conclusion, the practice of gender discrimination is commonly considered to be worse in Japanese society (Wheeler, 2018). Although the experience of gender discrimination or abusive treatment has commonly existed among students in medical schools in Japan, the concept of fighting against those actions is not familiar to Japanese yet. These serious issues absolutely need to be aware and resolved.

References

1. Carr, P. L., Szalacha, L., Barnett, R., Caswell, C., & Inui, T. (2003). A “Ton of Feathers”: Gender Discrimination in Academic Medical Careers and How to Manage It. Journal of Women’s Health, 12(10), 1009–1018.
2. Kozu, T. (2006). Medical Education in Japan. Academic Medicine, 81(12), 1069-1075.
3. Nagata?Kobayashi, S., Sekimoto, M., Koyama, H., Yamamoto, W., Goto, E., Fukushima, O., … Fukui, T. (2006). Medical Student Abuse During Clinical Clerkships in Japan. Journal of General Internal Medicine, 21(3), 212–218. https://doi.org/10.1111/j.1525-1497.2006.00320.x
4. Nomura, K., & Gohchi, K. (2012). Impact of gender-based career obstacles on the working status of women physicians in Japan. Social Science & Medicine, 75(9), 1612–1616.
5. Tokuda, Y., Hinohara, S., & Fukui, T. (2008). Introducing a new medical school system into Japan. Ann Acad Med Singapore, 37(9), 800-2.
6. Tokyo Medical University (n.d.a) Policy statements. http://www.tokyo-med.ac.jp/english/admission/med/policy.html. Accessed 21 Aug 2018
7. Wheeler, G. (2018). The Tokyo Medical University entrance exam scandal: lessons learned | International Journal for Educational Integrity |. Retrieved February 19, 2019, from https://edintegrity.biomedcentral.com/articles/10.1007/s40979-018-0039-4

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