한국 의료제도내의 성별구조와 여성의사의 지위 = (The) Gendered structures and status of female doctor in korean healthcare institution

다국어 초록 (Multilingual Abstract)

This study shows why the status of female doctors is lower than that of male doctors in Korean healthcare institutions, in spite of rising number of female doctors.
The purpose of this study is to analyse the relationship between gendered structures and the status of female doctors in Korean healthcare institutions.
Based on feminist perspective, this study first analyses the influences of gendered structures, including as patriarchal culture, division of labor culture, socialization processes in medical schools, apprentice systems of professional training, and informal networks on status of female doctors.
And then, how these gendered structures create the gender typing of specialization in medical training is examined.
Also, the socio-economic status of female doctors is compared with that of male doctors.
In this study, several crucial findings regarding gendered structures are as follows. First, the patriarchal culture and division of labor culture are influential in Korean healthcare institutions.
In general, the male doctors have a higher consciousness of patriarchy and labor culture than do female doctors and gender-segregation is more prominent in consciousness of labor culture than is that of patriarchy.
In-depth interviews reveal that the patriarchal culture appears in the power concentration of chiefs of staff in relationship to doctors, and has an effect on the doctors' attitude towards patients, especially female patients.
The division of labor culture is prominent in Korean healthcare institutions and makes the female doctor select female-friendly departments during residency.
Second, doctors have had different experiences than male doctors at medical school. (1) Female students did well at medical school and were evaluated as good by professors and colleagues.
Sometimes, professors showed them a thoughtful concern. (2) In-depth interviews showed no gender-segregation at school, but some people report experiencing gender-segregation in the survey.
The female students were separated into different practice groups and had fewer practice opportunities.
(3) They had difficulty in the male-centered medical school culture such as playing down and joke, and then had to become accustomed to the culture.
In the male-dominated medical schools, female doctors are designed to take peripheral positions.
(4) The intimacy limited because of small numbers and the competition between them.
Third, female doctors are excluded from male-centered apprentice systems of professional training.
(1) They take a risk when selecting hospitals, and have difficulty of their weak physical characteristics, gender stereotypes in treatment of the male body, criteria of male-centered activity.
(2) They select specific departments of residency because of socialization factors, institution factors(Kim's plan and veteran's extra point institution), and consumer-centered factors.
Additionally commercialism and gender stereotypes make them apply to the relatively lower-income departments and prevent them from majoring in surgery.
(3) As specialists, they are discriminated against at employment of hospitals, faculty appointments, and promotions.
(4) According to the in-depth interviews and surveys, the senior doctors tend to adopt male doctors, because of female doctors' pregnancy and household responsibilities.
Fourth, female doctors participated more frequently in informal meetings than male doctors.
As most of the female doctors had trouble becoming accustomed to the male-dominated culture of drinking, they get accustomed to the environment gradually.
Fifth, there is no evidence of gender typing of doctors, but the majority express the will to adopt male doctors.
The gender typing is prominent in departments, especially in surgery, and in the Director of hospital positions.
Some competitive departments are considered as feminine by female doctors and masculine by male doctors.
Sixth, The status of female doctors is as follows.
(1) Male doctors hold higher positions such as chief of staff(4.3 times), the vice director of a hospital, chief faculty, etc.
(2) Female doctors receive relatively lower-incomes. Compared with male doctor, female doctors have smaller incomes in hospitals, although a larger proportion of them work in hospitals.
(3) Female doctors don't have power in decision making, particularly for purchasing medical facilities.
Finally, this study finds that the lower status of female doctors in Korean healthcare institutions has a close relationship with private factors such as pregnancy and household responsibilities under the influence of patriarchal culture and division of labor culture.

목차 (Table of Contents)

• I. 문제제기 = 1
• II. 여성의사의 지위현황 = 12
• 1. 여성의사 비율 = 12
• 1) 여성의사의 비율 : 양적 성장 = 12
• 2) 연령별 여성의사 비율 : 한국의 젊은 여성의사들 = 23
• 3) 지역별 여성의사 비율 : 대도시에 집중된 한국의 여성의사들 = 24
• 2. 전문과목 = 26
• 3. 직위 및 보직 = 33
• 4. 소득 및 취업형태 = 34
• III. 이론적 배경 = 41
• 1. 여성의사 지위에 대한 역사적 고찰 = 42
• 1) 서구사회에서의 여성의사 배제의 역사적 배경 = 42
• 2) 한국사회에서의 여성의사 지위의 역사적 배경 = 44
• (1) 조선시대 및 일제시대의 여성의사 지위 = 44
• (2) 해방이후 여성의사의 지위 = 47
• 2. 여성 의료전문직에 대한 이론적 접근 = 48
• 1) 사회학적 접근과 그 한계 = 48
• 2) 페미니스트 접근 = 51
• 3. 의료제도 내의 성별구조 = 55
• 1) 가부장제, 성별분업 그리고 의료제도 = 55
• 2) 의과대학 내의 사회화 과정 및 도제제도 = 58
• 3) 비공식적 관계망 = 62
• 4. 성전형화(gender-typing) = 63
• IV. 연구방법 = 66
• 1. 자료수집방법 = 66
• 2. 연구대상 = 67
• V. 연구결과 = 72
• 1. 한국의료제도 내의 성별구조 = 72
• 1) 가부장적 문화와 성별분업문화 = 72
• (1) 의료제도 내의 가부장적 문화 = 72
• (2) 의료제도 내의 성별분업문화 = 75
• 2) 의과대학 내의 사회화 과정과 도제제도 = 84
• (1) 의과대학 내의 사회화 과정 = 85
• 가. 여학생에 대한 태도 = 85
• 가) 공부 잘해야 하는 여학생 = 85
• 나) 수업과정에서의 경험 = 89
• 나. 교육내용 = 93
• 가) 수업내용 = 93
• 나) 실습과정에서의 경험 = 96
• 다. 교육환경 = 98
• 가) 남성중심의 의대문화에 잘 적응해야 하는 여학생 = 98
• 나) 공간구조 = 100
• 라. 여학생들 간 연대감 = 101
• (2) 도제제도 = 103
• 가. 수련의(인턴) 과정에서의 경험 = 105
• 가) 수련병원의 결정 = 106
• 나) 여성이라서 더욱 어려운 일 = 107
• 나. 전공의(레지던트) 과정에서의 경험 = 112
• 가) 공식적 장벽: 킴스플랜(Kim's plan)과 가산점 제도 = 112
• 나) 비공식적 장벽: 인기전공에서 여성이라서 안 되는 이유 = 117
• 다) 외과영역에서의 여성: 여성은 물 밖의 물고기인가? = 120
• 다. 전문의가 된 후 = 124
• 가) 봉직의사로 취업하는 경우 = 124
• 나) 대학병원에서의 교수임용 및 승진 과정 = 127
• 다) 여성후계자 및 여성상사에 대한 의견 = 133
• 3) 비공식적 관계망 = 137
• (1) 모임의 종류와 참석여부 = 137
• (2) 비공식적 모임에서의 경험 = 140
• (3) 비공식적 모임에서의 적응과정 = 142
• 2. 성전형화 = 144
• 1) 의사직에 대한 성전형화 = 145
• 2) 전공과목에 대한 성전형화 = 149
• 3. 여성의사의 지위 및 소득 = 153
• 1) 직위 및 보직 = 153
• 2) 소득 = 156
• 3) 의사결정권 = 161
• VI. 요약 및 결론 = 164
• 참고문헌 = 173
• 부록 = 180
• Abstract = 191

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