A “necessary evil”? Keeping women out of medical schools won’t fix what ails the Japanese medical profession

by Chelsea Szendi Schieder

GRAPH/Source: Ministry of Health, Labour and Welfare


News sources revealed in August 2018 that Tokyo Medical University has been systematically tampering with its entrance exam scores to reduce the number of female students at the institution. This scandal led to a government investigation into medical faculties, and initial reports suggest that such gender discrimination is widespread in medical faculty admissions. This issue relates to several stubborn problems facing Japanese society today: It reflects how a more general context of gender discrimination threatens to impede new solutions to the crises facing medicine in Japan as a workplace and as a place of care, and how recent efforts to counter discriminatory practices and encourage “diversity” lack accountability. This article shows how the gender gap in the medical field points to deeper problems in the profession, how recent research suggests that gender diversity may improve medical outcomes in terms of patient care, and how this entrance-exam scandal highlights the inadequacy and lack of accountability behind recent efforts to promote “diversity.”

Keywords: Tokyo Medical University, medical profession, women, workplace, gender discrimination, diversity

On August 2, 2018 an article in the Yomiuri shimbun broke the news that Tokyo Medical University has been systematically tampering with the scores of entrance exams to benefit male applicants. The news emerged in the course of an investigation into the university administration’s bribe of a high-ranking official at the Ministry of Education, Sano Futoshi.1* Officials at the university apparently boosted the entrance exam score of Sano’s son in exchange for his help in securing a grant to improve the university’s public image. Along with this case of cronyism, it came to light that the university routinely padded the scores of all male applicants except those who had been applying for four or more years. Apparently believing that women would not do as well in the medical profession, Tokyo Medical University systematically reduced their chances of admission for at least a decade. It seems that rising rates of successful female applicants prompted university officials to impose a system of automatically increasing male applicants’ scores to reduce the ratio of female students at their institution. The revelations prompted a government investigation of 81 schools, which revealed in December 2018 that at least nine other medical faculties engaged in similar practices.2

And yet, in 2013, the university began receiving a national grant to “support women.” Over three years, Tokyo Medical University was awarded over 80 million yen (about 720,000 USD) through this grant. Two university executives at the center of the admissions scandal – former chairman Usui Masahiko and former university president Suzuki Mamoru – played key roles in the Office to Promote Diversity, founded at the university in 2016. In Usui’s opening remarks at an event to celebrate the first anniversary of the Office in 2017, he called on the university staff to promote “diversity.”3 At the time, the school presented an increase in female admissions from 26.9% to 32.4% as evidence of its efforts, even as it was actively taking steps to deny admission to women with qualifying scores.4 That meant that the university was not only taking money from the government to promote female admissions but also taking money from individual female applicants whom it artificially failed (sitting a university entrance exam in Japan costs 40,000 to 60,000 yen, about 360 to 540 USD). A group of 24 women denied admission to Tokyo Medical University since 2006 have joined with a team of defense lawyers to build a legal case against the school, which includes a demand for compensation for these fees, and potentially for additional damages.5

The male officials and others that implemented systematic discrimination at Tokyo Medical University have framed their actions as a “necessary evil.” The key reason cited as a defense for Tokyo Medical University’s decision to depress female admissions was their concern that too many female doctors would result in too few doctors at their affiliated hospitals when women left their work for marriage or childbirth. In his testimony to the legal team currently investigating Tokyo Medical University’s discriminatory admissions process, Usui said that the university systematically depressed female applicants’ scores because “as women get older, their activities as doctors decrease.”6 This rhetoric echoed the sensationalistic “Coeds Ruin the Nation Theory” enunciated in the pages of the Japanese tabloids in the early 1960s. Then, Waseda University professor of literature Teruoka Yasutaka declared his desire to set quotas to limit the number of women admitted to humanities departments because women would waste their educations and ruin society.7 Now, male administrators at a number of medical universities secretly impose quotas fearing that too many women in the profession will ruin medicine.8

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