Japanese women doctors and society

So recently there was a brouhaha over the Japanese medical school which altered exam scores to keep women out.

The deception and falsification of results is certainly a bad thing, among other things because it affects the integrity of the admissions process.

One cannot say that there is no merit to the school's motivation, though. Per the Time article, "women tend to quit as doctors after starting families, causing hospital staffing shortages".

Japanese female doctors leaving the profession is blamed on the work environment and Japanese society. Even if we took this as the only or overwhelming reason for Japanese female doctors quitting the profession*, it is not clear that it is a medical school's job to change these things (even if it had the power to do this in the first place - which it doesn't).

Not uncoincidentally, Singapore until 2002 imposed a quota on female medical students, for similar reasons. And in Pakistan more than 70% of medical students are women - but only 23% of registered doctors, suggesting that there is a great waste of resources in training female medical doctors; this also has serious implications for their healthcare system.

If one wants to not waste resources and/or benefit society - while still not having any gender discrimination, there're some alternatives.

Medical schools could overbook like airlines. If you expect 50% of women to leave, assuming 50% of your intake is female, boost intake by 25% (simplifying assumption: no men leave). Of course there may be capacity issues in ramping up intake. And this doesn't solve the wastefulness issue. Plus you may over/under plan and end up with too many/few spots.

Remove all subsidies for medical education. If students bear the cost of their education they'll be less likely to drop out of the profession, and the taxpayer won't waste money training doctors who won't stay. Of course you get other problems then, like fewer poor families producing doctors, this making medicine look elitist and the ideal of meritocracy being compromised, but you can't have everything.

Have a bond for doctors to recover the cost of their education. Yet, you can't make it so long that it's prohibitive. And after the bond they can still quit and society still loses out (though less so since they've already worked a while).

So there're no easy answers.

Of course, the politically palatable option (and this most likely outcome) is to continue to heavily subsidise medical education while not having restrictions on intake. As the cost is borne by the taxpayer it is semi-invisible, and most people will be happy.


* - It is notable that even in the US, significantly more women than men leave medicine. And while in Estonia the percentage of women doctors is in the high 70s, in Norway and Sweden they're only around 40% - and in Russia and Eastern Europe a majority of practicing physicians are female (despite - or perhaps because - there is more gender inequality there).