Barriers to and facilitators of women general practitioners' careers: a systematic review.

Background: Despite women comprising 52% of full-time equivalent general practitioners (GPs) in England, a significant gender pay gap persists (15% after adjustments). Further understanding of the barriers and facilitators impacting women GPs' careers is needed.

Aim: To identify and synthesise research evidence exploring barriers to and facilitators of women GPs' careers.

Design & setting: Systematic review of qualitative and quantitative studies. Studies were included of general practitioners conducted in the UK NHS general practice setting.

Method: Review methods followed Cochrane and PRISMA guidelines to systematically search MEDLINE, Embase, HMIC and Google Scholar to identify studies that explored gendered barriers and facilitators to GP careers. An inductive thematic analysis was used to synthesise the evidence.

Results: 21 articles were included in this review, with varied study designs. No relevant intervention studies were identified. There was a lack of recent research evidence; over half of the studies were conducted over 20 years ago. Most met quality criteria, though there were some problems with reporting and adjustment for potential confounders. Studies found barriers at personal, socio-cultural and system levels that inhibit women GPs' careers. While some positive changes have been documented across studies that span some thirty years, many challenges remain.

Conclusion: Despite general practice being a medical specialty where women outnumber men, barriers at personal, socio-cultural and system levels continue to inhibit women GPs' careers.