(Editor’s Note: This is the 2nd 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)

A pivotal moment in my career development occurred one day as I was arriving on shift.  A very senior ED physician (Prof Tony Brown) was conducting a rapid initial assessment of the patient. When I entered the cubicle, he said to the patient: “Ah, here is our star resident. She’ll look after you”. Now, I was hard working, conscientious and diligent, but I was no star resident. However, that day, I figured that if Prof Brown thought I was a star, I was going to do my damnedest to not disappoint him!

When I started as an Emergency registrar, females made up 50% of the cohort. At the time (2001-2005), we were quite a homogenous bunch: late 20’s, mostly unmarried, no dependents. We were collegiate and cohesive. Again, I cannot recall experiencing bias either within the ED or with my inpatient colleagues. I do recall greeting a grumpy orthopaedic registrar with “You seem tired and you probably haven’t stopped for dinner. Can I make you a cup of tea?” The effect at defusing him was palpable.

In my 2nd year of training, I moved to a major regional hospital. Here, I met a Director who has been (and continues to be) the key single factor in my sheltered experience as a FeminEM. He is the main reason that I have only started to think about gender bias in EM 10 years into my specialist career – not because I have experienced it but because I have read, heard and talked about it.

I know that it is real and that it exists. But I have somehow been protected from it.

It took me about 10 months to work up the courage to talk to my Director. He is formidable and therefore intimidating, until one knows him. He asked me how I was settling in and I said I loved the team spirit there. He replied with: “If I had a choice between the clinically best Emergency registrar in the country and a good team player, I would choose the team player any day”. No male attributes; no female attributes; just a team player. In the 15 years I have worked with and for him, I realise that he has been what is described in the literature as my sponsor.

I have never been made to feel like “the girl” in my ED. For the record, I am 160cm (5’3”), slight to average build, and of non-Caucasian decent. Admittedly, I have mostly grown up in Australia and have what’s been described as a “neutral accent”.

When I was pregnant with my first child (2007), I recall an aggressive patient being brought in by police. I looked up over the central desk and my male colleague immediately stood up and said, “ This one is mine”. No explanation, no assertions, no justifications – and it has never happened when I wasn’t pregnant. This was a colleague acting, almost unconsciously, out of a sense of care and responsibility. Would some have taken offense to this? Is it okay to feel more fragile and vulnerable when you are pregnant?

When I returned from maternity leave, there were some new nurses in our ED. I was taking over the shift at 1pm and introduced myself to a Polish patient with chest pain. The nurse must have missed my introduction as she conducted the ECG. As I held my hand out to receive it, she swept right past me and to the older male colleague from whom I had received handover. He looked at the ECG, at her, and then gave me a perplexed glance. He then advised her that I was the consultant and able to assess the ECG. She returned to me and with some annoyance said, “I thought you were the interpreter”. Again, perhaps I could have taken offenae but at the time I was distractingly amused that she’d been so specific in her presumption: an interpreter? (I chose to believe that it was my elegant and stylish dress sense that led her to believe I was European).

Thanks to societal bias, my own daughters have betrayed the cause at times. When my oldest was about two, and I’d been back at work for 18 months, we were chatting:

Me: Where does Daddy work?
Her: At the hospital
Me: Where does Grandad work?
Her: At the hospital
Me: And where does Mummy work?
Her: At home

And just last month, aged 9 and 7, they both asked me “Mummy, how can you be a doctor? Boys are doctors; girls are nurses”. Be assured that they were re-educated very quickly.