Let’s Talk About Women in Medicine

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A while back, when my post about South African Public Hospitals was popular, someone recommended I write about women in healthcare. I chose not to because at the time I just didn’t feel really strongly about it. I suppose I kind of wanted to believe that there was no sexism in South African medicine, the same way I tried convincing people (when I was twelve, mind you) that there was no more racism in South Africa.

I mean, guys. There are more females than males in most classes at my medical school. Why would there be issues?? Anyway, the #YesAllWomen hashtag from a while ago had me thinking some, and then I tweeted this, and then I realised, “OMG, I have something to say.”

This is real, by the way. My friends and I have grown so tired of being asked how old we are, where we live, and whether we have boyfriends by patients. I have never seen a male colleague being so blatantly hit on by a (non-psychotic) patient. (Not saying it doesn’t happen, but…) And the only time a doctor has taken our concerns seriously was when the perpetrators were psychiatric patients. Because, you know, that means they’re being sexually inappropriate. But when the offending patient is not a psych patient, we are told that it’s “normal”.

I learned in third year that because I am a female, most of my patients will refer to me as “sister” or “nurse”. And I also saw how male nurses, no matter how proudly they displayed their epaulets, were referred to as “doctor”. Incidentally, I’m not insulted by being called nurse. Nurses are awesome and there’s a great post about that here.

But the first time I realised something is not quite right was in one of my first SI-rotations last year. We were a group of girls rounding in trauma post-call with a senior registrar (who had been known to say dickish things before). I can’t remember what the situation was, because I was zoning out (post-call, as I said), when I heard him saying,

“You have to ask yourself why you’re doing medicine. Because you’d better not be taking up a spot in your class just to leave later and become a pretty little housewife and raise kids.”

I haven’t done gender studies. I can’t really tell you why this pissed me off big time. But it did.

Because it’s none of your damn business why I’m studying medicine. And it’s none of your damn business if I want to pass my (pretty good) genes onto kids. And I’m not having the debate about career vs. family with you, because I’m not in the mood.

I get that with a doctor shortage, people don’t take kindly to people leaving the profession, but nobody bats an eye when a male doctor decides to do an MBA and go into business, or consult for a medical aid. Or leave clinical practice to lecture part-time and play golf the rest of the time! It comes down to the same thing, doesn’t it? Not being an active clinician. Isn’t that what everyone’s so upset about?

So, who are you to assume that because I am a woman, I plan to leave once I have my degree? And if I do decide to leave, who are you to assume that it has something to do with my genitals?

Anecdotally, Maria Phalime points out in her book, Postmortem, that it tends to be mostly females who leave the medical profession. Let’s accept that there are no official stats in this regard, but that it appears to be a trend. Instead of judging the women who leave the profession, what we should be asking ourselves (men AND WOMEN), is, “What are we doing to make the workplace safe for female colleagues?”

What are we doing to protect female doctors and nurses from sexual harassment by patients and colleagues? Because where I work, a blind eye is turned unless there is actual threatened rape. What are we doing to even the playing field, rather than perpetuating the idea that females have to PROVE their worth. Do we place the same pressure on male doctors?

Once in med school, I lodged a complaint against a consultant that was vicitimising me. I went to our course convener in tears. He commented that he had noticed that it was always the female consultants the female students complained about. And he asked, “Why are you women so mean to each other? Shouldn’t you be supporting each other?”

Shouldn’t we, indeed.

I am tired of these things. And I am tired of being asked the easy questions in ward rounds. And I am tired of seeing male students get better ward marks than me, despite them disappearing from hospital for long periods of time. And I am tired of males being “gunners”, but females being “in your face”.

So yes. There is sexism in medicine here. As there undoubtedly is in most of the workplace. At least in South Africa, your gender cannot influence your salary. But that is not enough.

As always, intelligent debate is welcome on this post. Rude and bigoted comments, however, are not. Also, my views are pretty much encapsulated by Chimamanda Ngozi Adichie’s Ted-Talk, “We Should All Be Feminists”. I highly recommend it!

22 thoughts on “Let’s Talk About Women in Medicine

  1. Great post and provides plenty of food for thought. I have to say that I don’t beat the feminist drum even though I am in a male-dominant specialty. In my region, I am one of 7 female plastic surgeon amongst 62. I actually have had bad experiences with female colleagues stirring up the ‘feminist’ cries and flying their banners to try to resolve disputes which would have been easily mediated via professional standards. I am not particularly harsh on my female juniors because I expect the same things from them as I do from my male juniors, yet I get more complaints from the female ones. To the point now that I have to be more ‘considerate’ in my comments to female students. I have seen male colleagues pursued by female patients not irregularly, they just don’t talk about it as much. I have seen the stats which showed: for every male surgeon trained, three female surgeons need to be trained to take up the same load in the workforce. I have been called a bitch because I demanded the same things as my male colleagues, but I have seen them being labelled as dickheads and bullies just because they said what they thought without apology. Sexism runs both ways. The way I see it, is that you are a victim only if you chose to act like one. If I suspect someone is being sexist, I fall back on being strictly professional, as any doctor would do. Running away crying foul and acting the victim does nothing to empower women. I tell this to my students who come to me with their sob stories. I tell them that they have done nothing to deserve it but they need to stand up for themselves if they really believe they have been wronged. It may be harsh, but getting someone else to fight your battles is different to fighting your own with someone’s support. It is only by your own actions can your perpetrator learn that they have no hold over you. And I am definitely not saying it is easy. When my male colleagues are being protective, I don’t think it is sexist, I think they are aware of my true vulnerabilities as a female and are acting out of goodwill to a colleague in need. Yes, sexism exists, but even though I am as indignant and pissed off by sexist comments as any feminist, they don’t touch my self worth and my will to always try and do the right thing. Respect is earned, whether we are female or male. That’s just my experiences and opinion. There you go, you have just given me verbal diarrhoea on screen🙂

    • I appreciate your opinion, and I agree to some extent. Although I identify as a feminist, I definitely don’t go protesting around the workplace, and I fully support the notion of resolving disputes by relying on basic principles of professionalism.

      Like you, I am not offended by male colleagues or superiors being protective. Equality by no means means that we should be blind to differences and vulnerabilities.

      But BECAUSE of that, I think it goes hand-in-hand that we recognise the vulnerabilities in terms of a female’s experience of harassment or victimisation in the workplace, and take complaints very seriously. We cannot recognise inherent vulnerabilities, but expect that a female student will respond the same in all situations as her male colleagues will – but we can suggest the female students learn from the coping strategies of their male counterparts, and vice versa.

      I am in support of dealing with complaints personally first and not crying victim, but I think that many women have been told that they must deal with it on their own and that seeking help reflects weakness, which in my opinion makes the problem worse. Sometimes, one does not tell a superior of an incident out of seeking pity, but out of seeking advice or help. For example, when I told one doctor that a male patient was making me incredibly uncomfortable despite my firm refusal and my pointing out that his behaviour was unacceptable, I was told that it is the price of being a female in medicine. I was not seeking sympathy and I was not asking the doctor to “discipline” the patient – all I wanted was for a) a security guard to stand with me while I examine the patient b) a nurse to stand with me or c) the doctor to see the patient himself, or assign a male student. I don’t think that it was an unreasonable request given that I had already stood up for myself but continued to feel uncomfortable, and I think anybody else would have felt the same discomfort in my position. But I do think it is wise to to remind them that they are not at fault and that their approach to the situation may affect their dignity more than the situation itself.

      Also, I think that if a male doctor/nurse/etc feels negatively about a patient coming on to them, it should be treated in the same serious light. I definitely agree that sexism goes both ways.

      Thanks for sharing your experiences🙂

  2. YES!! I want to do a response to this!! I’m reading Lean In by Sheryl Sandberg at the minute, and while I never considered myself to be a feminist when I was young (negative connotations with the word and all that jazz) I now see I am very much a feminist, if not someone who gets on a soapbox every now and then and bellows for what is ok, what is not ok, and why in the male-dominated industry I work in (95-98% male) I can and will be heard just as much as any other employee regardless of their gender. At times it can suck, because I’m always the one with the agenda, the issue, something to say on the matter, I’m the girl who speaks up, speaks out and my job means that I’m the bringer of change (that the MD wants), so I’m the poster-child for that too. I’ve had my eyes opened in the past 3 or so years and luckily everything I’ve seen has spurred me on rather than making me want to hide in the corner, or accept things as they are because “that’s just how it is”. I have SO MUCH to say on this, can’t wait to sink my teeth into it! R x

    • Oh, please do write a blog about it, I would LOVE to read more. I have been thinking about reading Lean In, but I’m just not sure about it. Do you recommend it? Keep well and I look forward to reading your post!

      • I definitely will be doing a response post when I review Lean In – so many video links to share for it too. While Lean In does touch on some more conversational topics, it focuses more on taking the statistics and facts and shedding light on their effect in the business environment, how women are treated differently to men, how women in fact encourage this with their learned behaviors, how our natural psychologies can hold us back in the workplace. So, while it does have a lot of really great things to say, and I’m loving it, if you were looking for a text solely on feminism etc. it may not be the best. But I would recommend it anyway to get the viewpoint of women in business. There are two other females in my company, and I’m passing it to them when I’m finished, then my male Manager wants to read it, and I’m really looking forward to that – there are a lot of sexist undertones where I work and I can’t wait for them to maybe take something from this book. I think I’m a little in love with Sheryl Sandberg.

        R x

  3. This is a really great post and you said it so clearly. I AGREE. Sexism sucks, it absolutely does, but more than that I think it’s entirely illogical. Even today?! I thought we’d be past this by now…
    I’m not studying medicine or anything obviously, but I assume this is similar in Australia as well. I just hate all the little random throw-away phrases like, “You hit like a girl,” or ‘don’t be a girl about it’. That’s horrible and wrong. Makes me sad every time.😐

    • Thank you! I honestly also thought we’d be past this by now. And sometimes I think we are but then sometimes these subtleties just hit me like a bus. Have you watched that advert (I think it was by Always) about “what does ‘like a girl’ mean to you”? It’s really awesome and empowering, check it out if you can.

  4. Ah sexism. They’re still prevalent even at these present times. I am not a medical student but I can totatlly relate with you dilemma. I am from the Philippines and the country has been a patriarchal society since time immemorial. Fortunately, Filipinas are already rising up to make a difference. Although sexism has seen some sort of a decline during the years, it still happens even in our own house. I’m not badmouthing my father but it’s clear that he really belonged to the generation of old. There are numerous times that he would tell me that I should be good at cooking and doing household chores because I am a girl. You can imagine the row that ensued.

    Lovely discussion post!

    • My dad and I sometimes have arguments about sexism too, even though we have a very good relationship. I always laugh at the cooking argument because a) most of the big-name chefs in the world are male and b) cooking is important to survive. When you’re starving, your body isn’t going to ask whether you are male or female. There’s a really funny meme about that somewhere but I couldn’t find it right now…

  5. Is it really a stereotype? A chair is a most likely to remain a chair and an object that look like a desk is most likely to be a desk! Am I a raciest; if I walked into ikea and saw a lovely looking desk and it turned out to be a crazily designed bed?
    I know the topic at hand is much complicated. But again, what isn’t!

  6. So I’ll go against the grain just to balance out the comments section. Is feminism really the same as egalitarianism? Sometimes it seems like we’re just expected to ignore all statistics and biological differences. No doubt sexism exists, and I agree that we should do all we can to eradicate it. But we shouldn’t be expected to just ignore facts to spare feelings either. (e.g US open tennis grand slam winners are rewarded equally, regardless of gender or amount of sets played/viewers drawn).

    Regarding the boy’s comment – I’ve heard the same sentiment expressed multiple times. Now, if this was a myth or some hypothetical probability, that’s one thing, but I’ve spoken to several women who have this as their “plan”. If it happens, it’s a legitimate concern. Sure, men change professions too, but that’s often unforeseen; no one plans to spend 6 years studying and then study something else. But some people do plan to get the degree and never practice (stay at home). I can’t judge the tone, but sounds like this guy was being a jack-ass, and if things are said in a derogatory way (even quoting racial stats for a malicious argument), it does come across as sexism.

    Female students being hit on – that’s true. If our society were truly equal, female patients would also be hitting on male doctors. But there is also an obvious difference between the genders too which one can’t ignore in this debate, beyond mere social conditioning.

    Don’t get me wrong, I think the incidents you mentioned are atrocious and I’ll fight the good fight against sexism right alongside you. But, seeing as we are all equal, I don’t see the need to ignore uncomfortable facts and stats just to spare feelings. Good post.

    • I had a long response typed out and it disappeared. Meh.
      The short of it was that I agree that differences should be considered, but as per Adichie’s talk that I posted, I do believe that feminism IS egalitarianism. There are many bastardised versions of feminism out there that are certainly not MY feminism.

      There are girls who plan on staying home after studying, but in my experience they are few and far between, and it is not fair to generalise the phenomenon, as the doctor in my example did. Many women doctors I know who are no longer working are in the position for equally unexpected and unplanned reasons. And I do know several male students who are studying medicine and have no passion for clinical practice, and plan on doing something other than treating patients after they complete their studies, which should then be seen in the same negative light.

      I agree with facing stats, but never to discriminate. Thanks for your support!

  7. I love when people make the argument against sexism in medicine by saying that there are more women in med school than men. I’m pretty sure that means little.

    I’ve never had people really say any sexist comments to me, but I know that they’re said, for sure. And I do often get the assumption that I’m a nurse. I highly doubt that the male med students face that!

    Great post – thanks for sharing your thoughts.

    • Thanks for reading! I agree, the ratio of sexes in med school is pretty useless. I always give the example of the minority of white people in South Africa who managed to oppress the majority. Ratios mean nothing.

  8. Pingback: Stacking the Shelves & Wrappin’ It Up August 2014 |

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