Picture this: you’re a new physician, wearing all of the trappings of a physician, the stethoscope, the white coat. You walk into an examination room, where a patient is sitting on an exam table, hands folded. You introduce yourself and make some small talk.
You are then asked, minutes later, when the doctor is coming.
It’s actually fairly common for a female medical school student to be assumed to be training for a role other than physician. Whether intentional or not, this type of formative experience can greatly impact one’s self-worth and confidence as a new medical professional. And it’s common for someone to assume that a doctor — even regardless of that doctor’s name — is male. These are examples of perception bias, and it’s something that can affect not just the personal rapport you have with a patient — it can actually affect whether they’ll trust your opinion as a medical professional.
And that scenario above? It’s happened to me.
The State of Women in Medicine
This type of stereotyping, whether unconscious or not, still affects female medical school students, residents, and physicians. That isn’t to say that there hasn’t been progress in the area of females in healthcare, at least in terms of the numbers. When I started medical school, my class was comprised of about 30 percent women — still the minority, but no longer a rarity. Today’s medical school classes are even more balanced, with women making up 47 percent of U.S. medical students.
The prevalence of active female physicians is still catching up — only a third in the U.S. are women.
I was pregnant and had a child during my residency training. While 34 weeks pregnant, I was undergoing a shift in the emergency room — I had seven hours left — and my body was telling me that I needed to rest. But I wasn’t about to let anyone think I couldn’t finish that shift.
Many women have faced this challenge of trying to accomplish two very difficult and demanding things at once: complete their medical training and start a family. The culture of medicine demands hard work and self-sacrifice, both of which can be in direct opposition to natural maternal instincts (though it might be more accurate to say that both of these challenges — being a doctor and being a mother — call for a significant amount of hard work and self-sacrifice, and that the challenge is for the individual to supply enough of both). The best advice I can give women in this situation is to look around for female role models who can provide guidance from experience.
But this can be tough too. The search for female physician role models who have excelled and advanced while balancing family life opens the window to the current situation of female physicians in leadership.
Currently, women make up a little over one-third of full-time faculty members at U.S. medical schools.
Fulfilling Leadership Roles
When I was a resident and a new mother, I was able to find a role model who could advise me on everything — from where to pump milk to how to prepare for discussions with senior physicians. But a female medical student who looks around and sees fewer female faculty members may start to wonder if they even belong at all. I was especially attuned to this when I became a faculty member and now as a leader of medical students at American University of the Caribbean School of Medicine. Today, I can anticipate the challenges our students will face and help other women find workable solutions.
Speaking of leaders, the top leadership posts in medical schools remain predominately held by males, with only 16 percent of U.S. medical schools led by a woman dean. The leader shapes the culture, and when women lead organizations, you’ll see that organizational culture change. The good news is that many male leaders have shaped the cultures of their institutions into ones where women are welcomed and supported, and can advance in their careers.
Progress to be Made
There are many ways to gain a sense of whether a medical school is friendly to women. Look at the leadership: the deans and associate/assistant deans, and the faculty members and department chairpersons. Few or no women may indicate a problem in the recruitment and selection process for faculty and leaders, or an unconscious bias against women. Or, there may be few women because the environment has not been supportive. Aspiring medical students who are taking this into consideration when selecting a school should look at websites and other materials about a medical school: do you see women featured?
Medical students should realize that there is still progress to be made and find professional ways to raise issues important to women. I would advise women to seek leadership roles in medical school or residency — after all, all physicians need leadership skills — and start trying on leadership roles. I also encourage women to work with men on issues of gender equity. I have found many strong advocates for women in medicine among my male colleagues.
Gender inequities are not the only inequities, but in my experience, environments that are inclusive of women are often the ones that have success enhancing inclusion along multiple lines of diversity. And this is a very important point for our medical schools, particularly as we prepare students to care for a patient population that is increasingly diverse. We can teach those skills, but we have to model and instill the right attitudes as well.