Background: Today, women constitute about half of medical students. However, women are still underrepresented in prestigious specialties such as surgery. Some suggest that this could be explained by women being more oriented towards work-life balance. Aim: The overall aim of this dissertation was to explore aspects of gender in work-life priorities, career plans, clinical experiences and negotiations of professional ideals among medical students and newly graduated doctors, all in a Swedish setting. Method: We based the analysis on data from two different sources: an extensive questionnaire exploring gender and career plans among medical students (paper I-III) and interviews with newly graduated doctors (study IV). In paper I, four classes of first- and final-year medical (N=507, response rate 85%) answered an open-ended question about their future life, 60% were women. We conducted a mixed methods design where we analyzed the answers qualitatively to create categories that could be analyzed quantitatively in the second stage. In paper II, five classes of final-year medical students  were included (N = 372, response rate 89%), and 58% were women. We studied their specialty preference and how they rated the impact that the motivational factors had for their choice. In order to evaluate the independent impact of each motivational factor for specialty preference, we used logistic regression. In paper III, final-year medical students answered two open-ended questions: “Can you recall an event that made you interested of working with a certain specialty?” and “Can you recall an event that made you uninterested of working with a certain specialty?”. The response rate was 62% (N = 250),  and 58% were women. The analysis was similar to paper I, but here we focused on the qualitative results. In paper IV, thematic interviews were conducted in 2014 and 2015. We made a purposeful sampling of 15 junior doctors, including nine women and six men from eight different hospitals. Data collection and analysis was inspired by constructivist grounded theory methodology. Results: When looking at the work-life priorities of medical students and junior doctors it is clear that both men and women want more to life than work in their ideal future. The junior doctors renounced fully devoted and loyal ideal and presented a self-narrative where family and leisure was important to cope and stay empathic throughout their professional lives. The specialty preferences and the highly rated motives for choosing them were relatively gender neutral. However, the gender neutrality came to an end when the final-year medical students described clinical experiences that affected their specialty preference. Women were more often deterred by workplace cultures, whereas men were more often deterred by knowledge area, suggesting that it is a male privilege to choose a specialty according to interest. Among the newly graduated doctors, another male privilege seemed to be that men were able to pass more swiftly as real doctors, whereas the women experienced more dissonance between their self-understanding and being perceived as more junior and self-doubting. Conclusions: The career plans and work-life priorities of doctors-to-be were relatively gender neutral. Both female and male doctors, intended to balance work not only with a family but also with leisure. This challenges the health care system to establish more adaptive and flexible work conditions. Gender segregation in specialty choice is not the result of gender-dichotomized specialty preferences starting in medical school. This calls for a re-evaluation of the understanding where gender is seen as a mere background characteristic, priming women and men for different specialties.

This thesis contributes to the historiography of women in medicine by exploring, in-depth, one small specialty, public health, which, from 1974, offered women doctors working within it equality of opportunity with men for career development. At that time, most women doctors working in the English health service were relegated to junior or support roles, their particular needs for family-friendly working environments being largely ignored. This research examines the reasons behind the development of these equal opportunities and the subsequent rapid trajectory of women doctors in public health, comparing it with the much slower progress made by female colleagues in hospital medicine and general practice. In considering the factors helping or hindering women’s advance in medicine from 1974, it proposes that these changes occurred in public health because the specialty was not tied to the pyramidal model of medicine, developed in the 1930s by senior male doctors for male doctors, which dominated other specialties and which stifled progress. An innovative feature of this research, following women’s entry to consultant and training posts in proportions equal to men in public health, is to highlight their subsequent move into major strategic roles within the health service management structure from the late 1980s. Interviews with senior public health men and women doctors help shed light on how this move was achieved and how women in strategic positions were able to combine high profile careers with domestic responsibilities. Also includes five transcipts of interviews : The five interviewees, whose career stories are presented here - Professor Sian Griffiths, Professor Sheila Adam, Professor Mala Rao, Dr Sue Atkinson and Professor Fiona Sim - were selected, with the help of the Faculty of Public Health, for their considerable achievement in strategic leadership roles in public health practice, whether in leading complex organisation, chairing national policy committees, leading international work, promoting education and development.

Depuis de nombreux siècles, médecin et patient sont unis sous le prisme de la confiance, principe qui a connu des vicissitudes face à la judiciarisation de la relation de soins et la mutation de l’exercice médical. L’essor du tourisme ainsi que la création du premier hôpital transfrontalier participent à ce phénomène, et montrent que désormais le patient n’hésite plus à franchir les frontières pour recevoir des soins de qualité. C’est dans un contexte d’étroite collaboration entre la France et l’Espagne que s’inscrit l’étude des relations contractuelles et extracontractuelles dans le secteur médical. Elle met en avant un enchevêtrement de jeu d’acteurs entre établissements publics et privés de santé, professionnels de soins, compagnies d’assurance de prestations de services sanitaire et patient. Il est donc difficile d’identifier la nature des relations qui les unit et le régime d’indemnisation applicable. L’impact des droits des patients et la recherche de la qualité des soins dans les deux pays frontaliers démystifient l’aspect contractuel de la relation et amènent à une nouvelle lecture en faveur d’une qualification unitaire. L’approche institutionnelle doit être privilégiée, caractérisée par l’intromission constante des législateurs français et espagnols, sur l’exécution des soins mais également sur l’indemnisation des dommages médicaux, mais à quel degré ? / Since the early ages, doctors and patients are bonded together under the lens of trust, principle that has suffered tribulations faced with the increasing litigiousness in the caring relationship and the professional medical practice changes.The rise of tourism as well as the creation of the first transborder hospital play an important role in this phenomenon, and show that from now on the patient does not hesitate to cross the borders in order to benefit from high quality medical care. The study of contractual and extra-contractual relationships in the medical field falls within a context of close collaboration between France and Spain. It reveals an entanglement in the interactions between public and private health care facilities, healthcare professionals, health care services insurance providers and the patient.Thus, it is difficult to identify the nature of the relationships federating them, as well as the practicable compensation system. The patients’ rights impact and the search for high quality medical care in both transborder countries explain the contractual aspect of the relationship and bring in a new point of view in favour of unitary qualification. The institutional approach must be given priority through the constant insertion of French and Spanish legislators, regarding the accomplishment of medical care as well as the medical damages compensation, but to which degree?

Magister Public Health - MPH / Objectives: To document the distribution of medical doctors between the National Health System (NHS), NGOs and the Private Sector over the period 2000-2010; (2) To explore the perceptions of medical doctors (MDs) and human resources managers (HRMs) regarding factors that influence MD internal brain drain in Maputo city, Mozambique, more specifically, the movement of doctors from the Mozambican NHS to NGOs and the private sector within Mozambique.

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The master thesis deals with the historical development of humanitarian aid against the backdrop of transformations of the world order. Firstly, the thesis scrutinizes the differences between the classical humanitarianism of the Red Cross and the so-called new humanitarianism, which emerged during the Nigerian civil war (1967-1970). Secondly, the thesis demonstrates that although the new humanitarianism tends to be presented in an opposition to and as a more historically advanced form of the classic humanitarianism, when examined in a more detailed manner, the two humanitarian approaches face similar dilemmas in relation to political power. The overcoming of the "end of history" era, which gave rise and prominence to the new humanitarianism, opened discussion about the alternatives to the future of the world order. This shift allows us to formulate the main argument of the thesis - the evolution of the humanitarianism should not be seen as teleological and linear but as a continuous process in which both the classic and the new humanitarianism need to balance between strict legalism which can lead to moral failure and exaggerated moralism which can have consequences contradicting the basic principles of humanitarian action. Keywords: classical humanitarianism, new humanitarianism, human rights,...

Doctors' Right to Withhold Medical Care Abstract Very little attention is being paid to the rights doctors have to refuse to provide medical care, notwithstanding how important this area of interest is. It is not the aim of this thesis to provide a superficial description of fundamental grounds for withholding treatment. Its primary purpose is to present an analysis of the issues that are of most concern. To this end, the key concepts closely examined are conscientious objection and religious beliefs, as these constitute the subject of frequent interpretative, judicial and ethical disputes. A chapter in this thesis is also dedicated to refusal to provide healthcare based on a risk to the life or body of the health professional. All of the other reasons for not providing medical care or for ending it are briefly discussed within the context of the so-called contractual obligation of healthcare providers. Conscientious objection and religious beliefs are most often viewed from the perspective of public law. Nevertheless, in this thesis the two concepts are presented mainly in the light of private and civil law. A short philosophical and ethical analysis of the two concepts is followed by an extensive legal analysis. The theoretical part of the thesis concentrates on related statutory regulation and the...

Denna undersökning behandlar den småländska predikosjukan, vilken uppkom och spreds bland den småländska allmogen år 1841-1843. Av de uppskattningsvis flera hundra fall som behandlades av läkarkåren bestod den övervägande majoriteten av kvinnor. Undersökningen är medicinhistorisk och syftar till att undersöka hur den religiösa epidemin beskrevs, förstods och 2 tolkades som en sjukdom under 1840-talet. Således utgörs undersökningens källmaterial av läkarkårens utsagor, genom bl.a. provinsialläkarrapporter och skrifter. Undersökningen har utförts med ett socialkonstruktivistiskt perspektiv i enlighet med medicinhistorikern Roy Porters teorier, och består av en kontextnära och tematiskt orienterad närläsning. Inom den tidigare forskningen har predikosjukan främst undersökts som en av 1800-talets väckelserörelser, där allmogens agerande förstås som en upprorshandling mot en ”överhet” bestående av myndigheter, prästerskap och läkarkår såväl som det borgerliga skiktet. Benämningen av fenomenet som en sjukdom, förstås i tidigare forskning endast som ett bildligt uttryck och som en del av en medveten strategi för att slå ned väckelserörelsen. Undersökningen visar att läkarkåren förstod predikosjukan just som en sjukdom och behandlade den därefter. Sjukdomsdefinition och behandlingsmetoder gjordes i enlighet med rådande medicinvetenskapliga grundantaganden. Diskursen om den småländska predikosjukan aktualiserade en rad olika för tidsperioden rådande föreställningar om kropp, själ, sjuklighet, kön och religion. Inom den medicinska förståelsen av predikosjukan inbegrep dessa föreställningar ständigt i varandra, och innebar en komplicerad sjukdomsbild vilken i hög utsträckning var både kulturellt och tidsligt betingad. / This study centers around ‘the preaching disease’ (predikosjuka), an illness which arose and spread among the peasantry in the Swedish province Småland between 1841-1843. Out of the estimated hundreds of cases treated by the medical profession, the vast majority consisted of women. The disease was quickly described as epidemic, and had strong religious connotations. The purpose of the study is to examine how this religious epidemic was described, understood and interpreted as a disease in the 1840’s. Thus, the source material consists of the accounts of the medical professionals, mainly through provincial medical reports and medical publications. The study has been carried out with a social constructivist perspective in accordance with the theories of medical historian Roy Porter, and consists of a contextual and thematically oriented close reading. In previous research, ‘predikosjukan’ has mainly been examined as one of the 19th century Christian revival movements. Here, the activities of the peasantry are understood as a rebellious act against a vaguely defined ‘power’ consisting of authorities, clergy and doctors as well as the bourgeois class. Previous research has understood the phenomenon as only a sickness by the name, as a figurative expression and as part of a conscious strategy to suppress the revival movement. This study shows that the doctors who was confronted with ‘predikosjuka’ during the 1840’s understood the phenomenon as a disease, and chose to treat it accordingly. The doctors’ definitions and medical methods were made in accordance with prevailing and fundamental medical notions of the time. The discourse about ‘predikosjuka’ encapsulated a number of different notions about body, soul, morbidity, gender and religion, all deeply entrenched in the 1840’s. Within the medical understanding of the disease, these notions constantly intertwined, which made for a complicated clinical picture, which to a large extent was both culturally and temporally conditioned.

The introduction of welfare markets in publicly financed healthcare system has together with digital innovation of healthcare delivery led to a rapid growth of direct-to-consumer telemedicine services. In Sweden, the rise of such digital doctors has sparked a debate and there are indications that these developments might affect the overreaching goals of Swedish healthcare delivery on equal terms and according to need. This thesis examines the emergence of the new digital healthcare market and the political debate surrounding these developments, in order to answer the overreaching question of what these developments mean for equity in health in the Swedish healthcare system. This is done by describing developments on the digital healthcare market in Sweden and by conducting an idea analysis of the political parties’ views on these developments. Findings indicate that healthcare providers have great influence on the digital healthcare market in Sweden at the expense of public actors. Results from the idea analysis shows that political parties mainly discuss health equity in relation to the digital healthcare market in line with social or liberal egalitarian ideas of health equity.

A raíz de la pandemia del Covid-19, si uno desea acudir a una cita médica, debe tomar las medidas necesarias para evitar ser contagiado, ya que en los centro médicos se presentan negligencias de las autoridades por no hacer efectivo el protocolo de bioseguridad, por lo que, los pacientes van a sus citas médicas de manera presencial con la gran angustia de ser infectados y llevar el virus a sus hogares. Es así como nace MediGo con el objetivo de brindar un servicio de asistencia médica mediante un aplicativo móvil que permitirá al paciente realizar sus consultas desde la comodidad de su hogar con una flexibilidad de horarios para reservar citas médicas, así como la facilidad de integrarse a una comunidad de personas con sus mismos intereses. Para validar el modelo de negocio propuesto, se realizaron diferentes experimentos que abarcó el diseño de prototipos de la app tanto para usuarios y personal médico, entrevistas a expertos, programadores, entre otros. Asimismo, se utilizó el método Concierge para validar los ingresos del proyecto a través de las redes sociales. Por otro lado, se elaboraron los planes de marketing, finanzas y recursos humanos, lo que nos permitió proyectar el negocio y determinar su rentabilidad a lo largo del tiempo. Finalmente, todo lo mencionado anteriormente nos indica que MediGo es un negocio viable, muy atractivo e innovador en el rubro de medicina, que da respuesta a una necesidad real y actual. / In the wake of the Covid-19 pandemic, if you want to go to a medical appointment, you must take the necessary measures to avoid getting, since in medical centers there can be negligence by the authorities for not enforcing the biosafety protocols, therefore, patients go to their medical appointments in person with great concern of getting infected and taking the virus home. This is how MediGo was born with the aim of providing a medical assistance service through a mobile application that allows the patient to make their consultations from the comfort of their home with flexible schedules to book medical appointments, as well as the ease of joining a community of people with the same interests. To validate the proposed business model, different experiments were carried out that included the design of application prototypes for both users and medical personnel, interviews with experts, programmers, among others. Likewise, the Concierge method was used to validate the income of the project through social networks. On the other hand, the marketing, finance and human resources plans were made, which allowed us to project the business and determine its profitability over time. Finally, everything mentioned above indicates that MediGo is a viable, very attractive and innovative business in the field of medicine, which responds to a real and current need. / Trabajo de investigación