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Medical industry in Japan has barriers against female doctors (Pt. 1)

A surgical procedure is performed using a robot in this Dec. 20, 2017 file photo. (Mainichi)

TOKYO -- The alleged backdoor admissions and sexual discrimination against female applicants at Tokyo Medical University have raised a big question: Are these practices widespread in the medical world in Japan? A Mainichi Shimbun examination of the industry indicates that walls stopping women from becoming or continue to work as physicians do exist.

There are 30 private medical schools that accept both men and women like Tokyo Medical University across Japan. Of them, the numbers of applicants and the sex ratios of successful test-takers are available for 13 universities in entrance examinations for the 2017 or 2018 academic years. In all of those schools, more men were admitted than women. Only four universities had either same or higher ratios of successful female applicants than the ratios of women among all test-takers. The remaining nine universities had higher ratios of successful male applicants than the proportions of men among total applicants.

The ratio of successful female applicants was substantially lower than the proportion who took the tests at several schools such as Tokyo Medical University and St. Marianna University School of Medicine, among others. Conversely, Kanazawa Medical University and Kyorin University had higher ratios of successful female applicants.

A university official said the school has "no intention" of reducing the number of female students. "We make sure that our entrance examinations are carried out in a transparent way by revealing the scores to unsuccessful applicants," explained the official.

Of the students admitted to the university in the 2018 academic year, 68 percent were female among those recommended by designated schools, and the ratio was 90 percent among applicants with backing from non-designated educational institutions. The percentage of women students who actually enrolled in the medical school in that year stood at 39 percent.

Akira Takebayashi, who heads the Promedicus preparatory school for medical school applicants, revealed that there were cases in which multiple high-performing female students were not successful in Tokyo Medical University entrance exams while they passed tests for schools that are more competitive than the Tokyo school. "People around them say those cases don't feel right," said Takebayashi. He said he never heard about entrance exam score manipulations done by schools other than Tokyo Medical University.

Promedicus schools accept about 100 students, and their male-female ratio is about 50/50. "If score manipulation is actually done, that action tramples on the desire of female students hoping to become doctors," Takebayashi said. "I want to believe that such a practice does not exist at other universities."

Meanwhile, a person close to Tokyo Medical University says other universities face situations similar to those surrounding the school that allegedly prompted the Tokyo education facility to commit those questionable practices.

Private medical school graduates tend to attend resident programs and work at hospitals affiliated with their universities. Those hospitals tend to turn down female doctors who take leave or resign due to marriage or childbirth, and their affiliated universities are likely to accept more male applicants than women, according to the individual. "Hiring doctors in place of (leaving female physicians) is not easy. Our society does not have an environment for working women. It is a structural problem, and we have no choice (other than turning down female applicants)," the person said.

Tokyo Medical School received a total of 80 million yen in subsidies from the education ministry from fiscal 2013 and 2015 for its program to encourage women researchers to continue working after having children. That period includes the year when the medical school allegedly conducted illicit acts in its entrance examination.

A senior education ministry official commented, "The school said they were supporting women while they turned down some women applicants. That's a double standard. Depending on the results of the school's internal investigation about those allegations, we may have to expand our probe (to other universities)."

(Japanese original by Kim Sooryeon, Kenichi Mito and Takuya Izawa, City News Department)

This is the first part of a series.

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