A call for female leaders in medicine
Progression
In the 19th Century, women had to masquerade as men. Individuals such as Dr James Barry, who achieved the prestigious title of Inspector General of Hospitals in the British army, was only discovered at her deathbed that her name was in fact, Miranda [1].
Since then, we have come a long way — 55% of medical students are now female and there are 10 times more women in surgical specialities than before [2,3].
However, to date, less than a quarter of hospital Trust medical directors are women [2]. Why?
Addressing the gap
The Royal College of Physicians (RCP) recognises this dire gap and has sought to motivate and inspire women in medicine to undertake key leadership roles.
A study led by Johnny Boylan and Jane Dacre has identified three key enablers to encourage women into leadership [4]:
1. Addressing practical difficulties such as childcare needs and part-time employment
2. Overcoming social and cultural pressures like maternal identity, conformation to gender norms, and balancing family with work
3. Building resilience through role modelling, mentorship, and a collective support from others
A collective effort
Organisational
There is now a call to restructure Trusts and other healthcare organisations. Workforce planning should anticipate the transient shortage of doctors on maternity leave. The fact that women have to take leave should not be a deterrent to the employment of half the world’s population. Childcare services with longer operating hours could be offered, where fees are deducted off gross income instead of net earnings. Not only will this reduce the strain on childcare provision, but also the financial burden, especially as a fresh graduate [5].
More importantly, a greater emphasis should be placed on flexible working hours. Women tend to gravitate towards specialities which have more predictable schedules. This is evinced in a higher proportion of women in primary care rather than practicing in hospitals [6].
However, more can be done to introduce similar schemes in other specialities, encouraging a greater representation of women across the diverse field of medicine [5].
The perennial question is: How do we ensure such policies are in place?
We need more women at board meetings.
We need our voices to be heard.
We need to be the trailblazers so we can help each other climb the ladder.
Individual
In addition, we should alter our own personal expectations and goals.
Just as Sheryl Sandberg encourages women to lean in, and sit at, the discussion table, we should empower ourselves to have the confidence to do so.
Even as a doctor in a junior position, Dr Kate Granger made an impact with the #hellomynameis movement. As Vijaya Nath from the Kings Fund echoes, gender stereotyping, which has been ingrained since early on, affects our inner dialogue when making active career choices. It also affects our confidence in our own capabilities and potential, especially in leadership roles [7].
We need to work on this front.
An ode
We shall end with a simple quote,
“It’s about challenging the structures that entrench inequality, but also about challenging our own behaviour and attitudes, and those we experience every day” — Mark Porter, 2017 [8].
Let’s break some glass ceilings.
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About the author
Jaclyn Tan is a fifth year medical student at UCL with a particular interest in healthcare leadership and policy. She hopes of one day being able to empower healthcare professionals by getting them a seat at the Board table, making their voices heard, and impacting real change from within the healthcare industry. During her spare time, she serves as a freelance journalist and takes painting, poetry, and jazz pretty seriously!
References
1: Hurwitz B, Richardson R. Inspector General James Barry MD: putting the woman in her place. BMJ 1989;298:299–305.
2. The King’s Fund. Women and medical leadership infographics [Internet]. Dec 2014. [Accessed Nov 2020]. Available from: https://www.kingsfund.org.uk/audio-video/women-and-medical-leadership-infographics.
3: Health and Social Care Information Centre. NHS Hospital and Community Health Services: 2013 Workforce Statistics in England. London: Department of Health, 2013
4. Boylan J, Dacre J, Gordon H. Addressing women’s under-representation in medical leadership. The Lancet 2019;393(10171):E14.
5. Deech R. Women doctors: making a difference. Report of the Chair of the National Working Group on Women in Medicine. London: Department of Health, 2009.
6: Elston MA. Women and Medicine: The Future. London: Royal College of Physicians, 2009.
7. The King’s Fund. Her story: Barriers facing women in health and care. July 2014. [Accessed Nov 2020]. Available from: https://www.kingsfund.org.uk/blog/2014/07/herstory-barriers-facing-women-health-and-care
8. Porter M. It doesn’t have to be this way — Mark Porter’s ARM speech in 10 quotes [Internet]. The BMA. [Accessed Nov 2020]. Available from: https://www.bma.org.uk/connecting-doctors/b/work/posts/a-state-of-affairs
