(Editor’s Note: This is the 1st of 3 articles written by Dr. Shahina Braganza, an Australian FemInEM. Her contribution was inspired by our recent SMACC talk which will be available via podcast by the end of the summer.)
I would like to start with some disclaimers.
Firstly, I have no claim to fame as a FeminEM – I have been privileged (so far and touch wood) to not suffer a major hardship which I’ve had to overcome, nor have I conducted any studies or presentations on this subject matter. As such I am no authority on it. Indeed I am the quintessential “ordinary” emergency physician.
Secondly, I don’t for a moment suggest that all in life is rosy, as long as we earnestly wish it to be so and consciously choose to see the glass half full. My views are not intended to minimise the issues of those who have faced genuine adversity and injustice.
Nonetheless, I would like to share a “good news” story of being a FeminEM. My hope is that this story may present a positive counterpoint in the discourse on gender bias in medicine. It is important that both sides of this debate are fairly represented in order to ensure that the pendulum does not swing too far, leaving our junior colleagues anxious about entering a workplace or speciality which they preconceive as a wholly hostile and malevolent environment.
I would also hope to recognise the people and the factors that have played a role in making my experience a fortunate one.
For many years, I have contemplated the issues of bias, discrimination and professionalism in the medical workplace. I have been an Emergency Physician for 10 years, and for the past three, was also a part-time Director of Clinical Training, overseeing the professional development and progress of all junior doctors at my hospital. From this vantage point, I have been exposed to the spectrum of experiences faced by doctors within our profession.
In recent times, the issues of bullying, harassment and discrimination have been brought into stark relief. Concurrently we are more openly discussing wellbeing, burnout and compassion fatigue. The conversation about unconscious gender bias has become prevalent across all specialties.
The data and the stories are real and important. Almost certainly, this is the reality of many of our colleagues, male and female.
I graduated with my medical degree in the late 1990s. By then, at least half of medical graduates across Australia were female. I have dug deep into my memories of whether I ever experienced gender bias as a student. The only two events I can recall are not necessarily negative ones:
When I was a second year student, my elderly Anatomy professor took me aside at the end of a dissection lab. “I note you’re spending some time with the young man who always waits for you at the end of class. You MUST get a good education and you MUST complete your medical degree. If you become a mother, the greatest gift you can give your children is to be well educated yourself”.
Of course, I had no intention of ever compromising my career prospects, and perhaps my 19 year old self may have felt insulted at his perceived need to intervene in my misguided priorities. But I greatly appreciated his concern.
As a 4th year student doing a Surgery rotation, a professor appeared from nowhere on the ward and took my (female) classmate and I to see a patient who had just been admitted. The patient was an elderly man with a very large indirect inguinal hernia with a grossly enlarged left scrotum. There was likely an intercurrent fungal skin infection because the odour was distinct. The professor directed us to examine the patient. When we reached for gloves, he advised us that this would be unnecessary and would only detract from our examination. I shudder to imagine what we would think of this now with our enhanced attitudes towards infection control.
Once dismissed, my classmate and I spent the rest of the afternoon obsessively washing our hands! Looking back, I don’t know whether the professor was being inappropriate, or whether he was just a very old-school practitioner with warped traditional views – who knows, but I have managed not to hold a grudge.
I undertook my resident years at an inner city tertiary hospital. Again, I don’t recall ever being made to feel like I was “the girl”. Sure, I’d spend a long time taking a careful history and conducting a focused examination on a patient, and then spend a long time explaining diagnosis and plan, only to be then asked “When do you think the doctor will see me, dear?” But I never took offence.
One shift in the ED, I decided I was going to try to better connect with the demographic we would often see in our department and model the communication I’d observed in some of my valued senior colleagues. The first person I picked up that shift was a tradesman in his mid-40’s: “I’ll just send off these bloods, and write you up for some pain killers – mate”. He stopped me and said, “Doctor, you are too much of a lady to be using that word. It doesn’t suit you”. I haven’t ever called anyone “mate” again.