It’s Time to Confront Sexism in Medicine

I was told often at school that I was “very good at maths…for a girl.”

It’s been a long time since then. I believe that gender stereotypes in science and maths are a little less rife today. We cannot afford to become complacent though, as unconscious biases still exist.

Now, in my work as a doctor, antiquated comments crop up regularly.  Patients will mistake female doctors, residents and students for nurses. This happens regardless of how a female doctor introduces herself. The idea that a woman could only possibly be a nurse is clear evidence of the sexism that pervades society.

In spite of the steadily increasing proportion of women in medicine, the culture of medicine has not caught up. It’s well-documented that women are vastly underrepresented in leadership positions, such as full professors and department heads.

Stereotyping also exists within specialty programs. Many assume that the nature of the work demands detachment from emotions and an ability to withstand long hours and grueling procedures. To be tough, resilient and to soldier on have traditionally been thought of as male traits.

Even though the number of women taking up surgery has significantly risen in recent years, surgery is still very much a male-dominated field.

Sexism in medicine is deeply ingrained.

It is difficult for most young doctors to gain visibility and recognition. The situation is even more complex if you’re a young woman. Misogynist jokes and remarks about physical appearance or potential are obstacles that many have to deal with.

One challenge I have frequently faced is assumed incompetence. As a woman, I have had to fight for people to take me seriously. I hear doubts like ‘Can she provide medical care or take critical decisions when required?’ Often, a patient asks to see ‘the real doctor’. Translation? The male doctor.

There is no easy fix. On one side, you should not let any of the gender stereotypes thrown at you affect you. But neither can you ignore the bias.

The #MeToo movement has shined a light on the many places in our society where insidious or obvious sexism have long gone unremarked.

Medicine is no exception. There have been moments when I have been interrupted by an irrelevant comment and I have had to listen to sexist jokes. I have had to work hard to be heard and recognized. I’ve had to go the extra mile to earn the trust of patients, and even to identify with the scientific community.

I am learning that the most important thing is never to lose confidence. I try to stay focused on what’s important: doing great medicine.

What the medical profession needs is a drastic culture shift.

Sexist comments and inappropriate behavior in the medical field are evidence of a much larger problem. They show the insidious misogyny in our culture.

Doctors do not exist in a bubble. We are, to a large extent, products of our society. This includes people who make sexist jokes or commit sexual harassment. It also includes people who laugh along or accept sexism as normal. A shift this great requires courage and concerted efforts.

As one of the underrepresented populations in STEM, I believe I am making a difference simply by existing. I believe that it is really important to #balanceforbetter. We must put forward diverse, inclusive visions of the kind of future we would like medicine to create.

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Women Inspire: Onika Harris

This post is the fifth in a series of interviews from women and girls at the Georgetown Public Hospital Corporation (GPHC) in Georgetown, Guyana.

I’m here in Georgetown, Guyana to conduct interviews with inspiring women and girls and to listen to their stories. Last week, I met Onika Harris (second from the left), 29, on a beautiful, sunny day when she was walking with her fellow nursing students across the GPHC compound. Full of laughter and joy, Onika and her friends could undoubtedly put a smile on anyone’s face.

What made you interested in becoming a nurse?

A: I have always wanted to be a nurse for as long as I can remember. I’m really passionate about helping people.

What is your favorite part about being a nurse?

A: I love getting an up close view of the organs that keep us alive. It’s fascinating.

Who inspires you and why?

A: Dr. House on TV! I love him because he always gets the job done, no matter how difficult the case may be.

Why is women’s health important to you?

A: Women are 50 percent responsible for our future! Our health matters.

What is the one thing you’re most proud of in your career or in life?

A: I’m proud that I have made it this far in my career without help from my parents – financially, emotionally, or physically.

What are some challenges you have faced?

A: Money is a major barrier. But I try not to stress over it. What does stress accomplish?

What advice would you give to young women and girls who want to make a difference?

A: Go after what you desire. Not what others want for you.

Women Inspire: Romalia Black

This post is the third in a series of interviews from women and girls at the Georgetown Public Hospital Corporation (GPHC) in Georgetown, Guyana.

I’m here in Georgetown, Guyana to conduct interviews with inspiring women and girls and to listen to their stories. Recently, I met Nurse Romalia Black in the GPHC emergency department. She graciously shared with me her story, her ideas, and her passions.

What made you interested in becoming a nurse?

A: When I was 7 years old, my grandfather suffered a stroke and I helped care for him alongside my family. I discovered I really enjoyed caring for him and making him feel better. A few years later, my friend fell ill with a serious infection. It was at that point that I knew I wanted to be a nurse so I could help care for people my entire life.

What is your favorite part about being a nurse?

A: I love to see people get well and being able to help and care for them.

Who inspires you and why?

A: I’m inspired by Dr. Gwen Frazer Tinnie, my teacher when I was a university student. Dr. Tinnie always went the extra mile not only for her students, but for her patients as well. Approachable and eager to answer our questions, Dr. Tinnie only wanted the best for her students – as well as her patients – staying after hours if necessary.

What is the one thing you’re most proud of in your career or in life?

“Women must stand up and say ‘Hey, I matter!’”

A: I’m extremely proud of my academic achievements and my family. When I went to university, I was pregnant and also worked a part-time job on the side. Now, I have two wonderful children and a successful career. I am proud that I did all that and have achieved where I am today.

What are some challenges you have faced in either your career or your life?

A: It is difficult to be a working mom, particularly at a hospital in a low-income setting. As a nurse, I strive to provide the highest quality patient care. However, when resources are unavailable or limited, I often must improvise and find different ways to provide the best possible patient care. When I think about what’s best for my family and what I want my children to achieve, it makes all the hard work worthwhile.

Why is women’s health important to you?

A: When women learn to respect and stand up for themselves, cases of domestic violence, abuse, and HIV/AIDS will decrease, improving women’s health and the economy simultaneously. Women must stand up and say ‘Hey, I matter!’

What advice would you give to young women and girls who want to make a difference?

A: If you love it, do it. Don’t begin on a career path just for the money. If you do, obstacles and challenges will pop up and irritate you. Nursing is hard work – it’s not easy. If you’re passionate about being a nurse and caring for others, do it. Do what you think is best for you and not what is best for somebody else.

A Midwife’s Point of View: Breastfeeding

The contractions have ended and the only sound is the cry of the newborn little baby lying on her mother’s belly. The room becomes calm and relaxed as the family exhales and begins to recover. After a few minutes the little baby starts searching for her mother’s breast, pecking her little head back and forth, smacking her lips and making her very first sucking movements with her mouth. Using her legs to push herself upwards, she slowly moves towards her mother’s chest, and with the help of her mother’s gentle hand, her mouth finally reaches the nipple.

The breasts are well prepared. The first milk, known as colostrum, starts to be produced in week 18 of the pregnancy. It doesn’t feel like the breasts contain any milk. It takes approximately three more days until the real milk flows into the breasts. But this first milk is perfectly suited for the little baby. The baby’s stomach and intestines have only known the amniotic fluid and is now slowly but surely getting used to breast milk. This first milk contains substances that help the intestines adapt to a life outside the uterus and brings vital nutrients that the baby needs to grow.

The new mother is now holding her baby in her arms. The baby lies looking up at her mother, seeing her for the first time. They look at each other for a moment. The distance between them is just as long as the newborn’s small eyes may be capable of seeing and being seen is extremely important for the little baby’s continued psychological development. After looking at her mother for a while, the baby starts to cautiously and tentatively suck on her mother’s nipple. Being close, skin to skin, enables both mother and child to relax even more, as oxytocin, the natural, well-being hormone, flows like currents in their bodies. Oxytocin causes the heart rate, blood pressure, body temperature and respiration to stabilize in their bodies and causes the production of breast milk. This hormone also causes the mother’s uterus to contract, preventing her to bleed too much.

After sucking for a while on the breast, the baby falls asleep, exhausted but satisfied with both the birth and the first meeting with her family. Colostrum contains enough energy so that the baby now can sleep for a day and the new parents can rest.

The above scenario may be recognized by some women, but not by others. The description has been used to demonstrate the awesomeness of our bodies, and particularly, a woman’s body.

A peaceful breastfeeding start increases the chances of successful breastfeeding in the future.

As a licensed nurse and midwife, I meet women who breastfeed every day. Some do it with ease. Some fight through each feeding in pain, with babies who do not want to suck or babies who don’t want to stop sucking. Some women struggle without enough breast milk, while other women have too much milk. I also meet women who have chosen to partly breastfeed, or who, for various reasons, have chosen not to breastfeed. What is common for all women I meet is the incredible love they carry and the strong desire to do the best they can for their child.

It is imperative that we, as health professionals, are aware that our knowledge and treatment can be critical to how a mother succeeds in breastfeeding.

Becoming a parent generates a wide range of emotions: love, fear, anxiety, joy, sadness, loneliness, togetherness, uncertainty, fatigue, giddiness, and more. To breastfeed or not to breastfeed is not always an easy choice and to get breastfeeding to work or to stop breastfeeding may require professional help. My wish is that new mothers and their families receive the help and support they need, and are able to make informed and empowered choices, leading to results that works best for both the mother, the child and the family. Breast milk contains the best nutrition a child can obtain during the first 6 months of its life, but what is just as important is having a mother who feels well, is present, strong and confident.

Liza HenningThis is a guest blog post by Liza Henning, licensed Nurse and licensed Midwife. Liza works at the maternity hospital and the breastfeeding clinic in Malmö, Sweden.