Originally published here.

The demographic profile of the pharmacy profession hassignificantly changed. In 1964, 19% of registered pharma-cists were female. Recent register data (2017) show thatthe majority of registered pharmacists in Great Britain(GB) are female (61.9%),[1–3]as well as in the UnitedStates of America (USA)[4]and Canada.[5]The ethnicprofile of the profession in GB has also changed signifi-cantly. In 1975, Black, Asian and Minority Ethnic(BAME) groups accounted for 15% of registered pharma-cists.

In 2017, 49% of registered pharmacists whoreported their ethnic origin (49 520/55 209) were from aBAME group. The majority of BAME pharmacists identifythemselves as Asian with Indian Asians being predomi-nant.[1,2,6]While the growing representation of both women andethnic minorities in pharmacy may be an example ofoccupational integration,[7,8]women pharmacists’employment patterns continue to mirror the gendereddivision of labour.[6,9]There is debate as for whether thepersistence of this gender dichotomy in pharmacy andelsewhere is linked to gendered employment choices, ororganisational and structural constraints Pharmacy is also segmented along ethnic lines, withBAME groups, particularly Indian pharmacists, over-represented in the community sector and as self-employedcontractors.

Studies have identified personal preferencesfor business ownership as largely responsible.[17–19]Whilea cultural bias for self-employment in Asian cultures maybe underpinned by a preference to avoid discriminationand increase occupational mobility,[19]there is limitedevidence that ethnic-based discrimination is a factor inpharmacy as in other professions such as medicine.[20]Empirical work to date has focused little attention onthe position of BAME women pharmacists. In the past,ethnic differences between women have largely been unex-plored due to small sample sizes[21]This is no longer thecase; 45% of women pharmacists are now from a BAMEgroup.

In urban areas such as Manchester, the majorityof women pharmacists are from a BAME group (59%)[1]The statistics suggest that irrespective of ethnic origin,gender divisions persist in pharmacy.[8,21]The employ-ment choices of White and BAME women are not homo-geneous, with White women being significantly morelikely to work part-time than BAME women. BAMEwomen, such as men pharmacists, are also under-repre-sented in hospital pharmacy and are more likely to workin the community.

While gender segregation is prevalent in both the com-munity and hospital sector, research shows that whenwomen mirror the work patterns of men and work full-time, they are more likely to ‘break the glass ceiling’.[23,24]However, the employment patterns of BAME womenpharmacists highlight an important paradox; BAMEwomen are significantly more likely to work full-timethan their White counterparts, but are significantly lesslikely to occupy management positions.[21,25]However,this finding was reported at a time when analysis of indi-vidual ethnic groups was not possible.

Analysing BAME women pharmacists as a homogeneous group is mislead-ing as not all BAME women are under-represented inmanagement positions.[22]In community pharmacy, Blackand Chinese women (irrespective of dependent status) aresignificantly more likely to occupy management positionsthan White and Asian women.[2]Asian and White womenpharmacists are similarly likely to work part-time, indicat-ing that the polarised employment positions of women incommunity pharmacy are linked to the hours they workrather than ethnic origin. In the hospital sector, BAMEwomen are less likely than White women to occupy man-agement positions and are almost three times as likely tobe self-employed locums. Although age could be a factor,as the mean age of BAME women is younger than Whitewomen,[2]what is not known is why BAME women aremore likely to work in the community sector and be self-employed than White women.

Research on this topic is important in the light ofcurrent debates about the future shape of pharmacy prac-tice. With an ageing population, the pharmacyprofession is evolving to meet the increased demands. Acollaborative care approach is high on the agenda, withclinical pharmacists in GB working in primary care tosupport GPs with prescribing. The role of communitypharmacists is also evolving with more undertaking train-ing as independent prescribers.

As at least half of allwomen pharmacists prefer to work part-time and notengage with career development opportunities, therecould be concern that women pharmacists, particularly Asian women, who are more likely to both locum andwork in the community sector part-time, are less likely to‘up-skill’ than their male counterparts.The aim of the study was to understand if the careerchoices of White and BAME women pharmacists areinfluenced by different factors. The objectives of the studywereTo explore if the career choices of White and BAMEwomen pharmacists were the result of individual agencyor structural constraintsTo explore if BAME women pharmacists face differentbarriers to career progression and development thanWhite women pharmacists.

Findings both support and extend the existing literaturein medicine and pharmacy which have shown arelationship between career progression and hoursworked.[10,12–14,33]Resonating with previous research findings, womenpart-time workers had broadly similar career trajectoriesand opportunities irrespective of ethnic origin.[4,12,14–16,34]There was some evidence that cultural perceptions ofmotherhood underpinned women’s working time prefer-ences. This was more prominent in the interviews withthe White, Asian and Middle Eastern women interviewed.Women without children also hinted at working part-time in the future. However, one of the Black womeninterviewed had previously worked part-time when herchildren were younger, showing that women should notalways be pigeon-holed because of their ethnic origin anda variety of other factors, such as their children’s age,social context, partner status and financial situation arealso significant in shaping the career choices of women.The women working full-time had not encounteredgender discrimination, but they did express concernabout remaining in management roles after children.While this concern was to an extent a reflection of theirown preferences, there seemed to be an acceptance thatmanagement roles were incompatible with part-timeworking. These concerns were validated by participantswho had experienced downward career mobility onreturning to work part-time. While women part-timeworkers had fewer opportunities for career progressionor training, indirect gender discrimination was nor-malised as inevitable. As White and Asian women aremore likely to work part-time than women fromBlack and other minority ethnic groups, they aretherefore more likely to encounter indirect genderdiscrimination.Cultural ideals relating to self-employment continuedto underpin the career choices of some BAME womenlater in their careers. All the locums interviewed wereBAME women who valued the flexible working patternsand high pay. This, however, came at a cost as locumsare generally unable to participate in career developmentopportunities, (such as the clinical diploma), and work-place pensions. As BAME women are significantly morelikely to locum than their White counterparts. BAMEwomen may, therefore, be disproportionately disadvan-taged long-term compared to White women in makingthis career choice.Resonating with other research,[35,36]there was limitedevidence that perceptions of ethnic discrimination mayaffect the career decisions of BAME women pharmacists. Anumber of participants implied that having a manager ofthe same ethnic origin would have a positive effect oncareer development. The lack of BAME women mentors,particularly in hospitals, in addition to cultural perceptionsof pharmacy, may deter some BAME women from enteringhospitals and climbing the career ladder in this sector. Foremployers, positive action recruitment strategies may beuseful in this context to encourage more BAME women toapply for positions in the hospital sector. Universities should also consider how they encourage BAME women toconsider a career in the hospital sector.

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