Women entrants to medicine, and to general practice in particular, are now outnumbering men, yet there are few female doctors in the profession's top positions. However, there are some exceptions.
Dr Barbara Hakin, Chief Executive, NHS East Midlands
A seat on the NHS Management Board is as senior as it gets in the NHS and members are mostly career NHS managers. One exception is Dr Barbara Hakin, a GP with more than 25 year's experience as a practising doctor.
Dr Hakin is chief executive of NHS East Midlands, an SHA covering one-tenth of the English NHS.
She is also chief negotiator for NHS Employers on the GP contract (on the opposite side of the table to Dr Beth McCarron-Nash) and runs the NHS Top Leaders programme on the National Leadership Council. In addition, she has recently finished acting as interim chief executive for Yorkshire and the Humber SHA.
'I never seem to have just one job,' she says. 'But to be honest, it never fails to amaze me that I have such a senior position.'
Her involvement in NHS management began a little over a decade ago. Before that, she was a GP principal in Bradford for about 20 years, working mostly part-time as she brought up her two children.
She says: 'I thoroughly enjoyed all the time I was a practising GP. I liked the relationship you have with patients, the fact you are dealing with people not illnesses, and I liked the variety and freedoms of being a GP.'
As her children grew up, she did more clinical sessions and made her first foray into management as fundholding lead for her practice. From there, she ran a local fundholding consortium and then became chair of Bradford South and West Primary Care Group.
But the creation of PCTs in 2000 marks perhaps the biggest turning point in Dr Hakin's career.
'What became apparent was that, if I really wanted to continue to run the organisation, I'd have to become its chief executive. It couldn't be done as a part-time clinician,' she says.
After a lot of soul-searching, she decided to apply for the job and became the first chief executive of Bradford South and West PCT in October 2000.
Dr Hakin went on to make it one of the most successful PCTs in the country, perhaps best known for originating the idea of GPs with a special interest. She says this remains her proudest achievement, proving that more care could be delivered in primary care and providing a new career for GPs across England.
She was soon spotted by the DoH and recruited as director of primary care and national PCT development lead at the NHS Modernisation Agency. She also chaired a group responsible for the DoH's response to the Shipman Inquiry.
She looked after four merged PCTs in Bradford following another NHS reorganisation and was appointed chief executive of NHS East Midlands in May 2006.
Dr Hakin has not experienced discrimination as a woman, and she argues that many women bring particular skills on the 'softer, emotional intelligence of life' - skills she believes work well for her as both a doctor and a manager.
She is very proud to have been named a Dame in this year's Queen's Birthday Honours List in recognition of her services to healthcare and says next year will mark 40 years of work in the NHS. She says she plans to work for 'just a few more years' with no new career aims in that time.
'Serendipity has played such an enormous part in my career so far so I think I would just like that to continue,' she adds.
Dr Barbara Hakin
Dr Beth McCarron-Nash, GPC negotiator
The highest echelon of medical politics is an unusual place to find a young woman but Dr Beth McCarron-Nash looks quite at home there.
She was elected last year as one of the UK negotiating team for the GPC, representing the UK's 40,000 plus GPs in contract talks with the DoH.
Dr McCarron-Nash, then aged 35, was the youngest and only the second female negotiator in the GPC's 91-year history.
'I am honoured to represent my colleagues because I feel so passionately about general practice,' she says.
Dr McCarron-Nash says she 'fell into general practice', because her husband's job as an RAF pilot meant she needed a career in medicine that allowed frequent changes of location.
She adds: 'I joined the GP rotation in Bath and when I did my GP placement I loved it and knew I had found my niche.'
She became involved in the BMA through the GPC's trainee subcommittee and sessional GPs subcommittee, seeing medical politics as a way to 'make a difference'. When there was talk of the profession fighting back against constant attack from government and the media, Dr McCarron-Nash stepped into the limelight.
'I felt strongly that the BMA and GPC should stand up for GPs and I stood for the communications working group and ended up being the lead GP for the Support Your Surgery campaign.'
The campaign, protesting against commercialisation of the NHS and the government's plans for polyclinics, gained more than 1.2 million patient signatures in less than three weeks.
Valuing general practice
Dr McCarron-Nash says: 'I value traditional general practice and the local services we provide for our patients, and I think it made a difference as we stood up and said this is not right for us or our patients.'
She juggles being a GPC negotiator with her work as a salaried GP in Devon and being mum to five-year-old Joe. She spends two days a week in London on GPC work, does four clinical sessions and has one day a week to do the school run and catch up on emails. However, work often continues in the evenings and at weekends.
'My husband now works part-time as a commercial pilot and I am very lucky to have my mother to help look after Joe. There is no way I could do this without that kind of back up,' she says.
Although still only 36, in addition to her current role, Dr McCarron-Nash has experience of being a GP partner, a locum, a flexible career scheme GP and working for a PCT.
'I decided to stand as a negotiator as I have experience in several different roles and contract types and wanted to bring something different to the team,' she says. 'In some ways I represent future general practice, which is why I value the role of partnerships so highly.'
She says the GPC needs to reflect modern general practice and encourages GPs to stand who are 'enthusiastic, committed and passionate'.
'I don't think you have to be a woman to understand female GP issues but GPC should be as representative as possible. I think you should be there on merit rather than just your gender.'
For her, the last year has been about 'promoting quality general practice' and getting the 'best deal' for GPs. She clearly relishes the challenges. 'If an opportunity comes up, stand up and be counted if you feel you have the right skills or experience.'
She says being female is not what makes her different. 'I am one member of the team, but I want to ensure unity within the profession, using my interest in communications to promote high-quality general practice and ensure independent contractor status remains a choice for GPs as I believe it is best for us and our patients.'
Dr Beth McCarron-Nash