Our daily innocent interactions with patients and their families can be harsh reminders of how we are perceived from outside the medical institution. At some point during medical training, most female-presenting medical students will be mistaken for a nurse. I want to clarify that this is no insult as nurses are essential parts of the patient care team. The nursing field has its own myriad of issues with gender discrimination in the workplace. Beyond this innocent mistake, many medical students will receive unwanted remarks on their appearance, sexual advances, and occasionally, even be asked for a foot massage. My friends and I like to laugh about these moments, but I often think about the impact of these experiences on the way we perceive ourselves and our place in medicine. The harsh reality of these moments is that, to many, we may not look like we belong in our profession.
Despite the fact that women currently make up more than 55% of medical students and 37% of practicing physicians, medicine has been male dominated for much of its history.1 We are all guilty of making the same assumptions based on our implicit biases. The word “doctor” is often immediately gendered to be male, just as “nurse” is female. I, myself, am guilty of the unconscious bias of assuming any surgeon in a story is male. If those with an acute awareness of this issue cannot break our internalized biases, will we ever be truly “equal” to our male counterparts?
This implicit bias extends into our interactions with clinical preceptors and mentors. Almost all women pursuing a surgical specialty have been asked the dreaded question: “Don’t you want a family?” As a female pursuing a surgical specialty, this question is constantly ringing in my ears. The unfortunate reality is that women continue to bear the brunt of child rearing and have a so-called biological clock that places greater limitations on family planning than men experience. The question of family often leaves a pit in my stomach, especially when coming from a male preceptor who has succeeded both in his career and personal life. Despite limitations in on-site child care and sufficient paid parental leave, countless women have succeeded both personally and professionally with the right support systems in place. If he can do it, then why can’t I? Do we really have to sacrifice one to succeed in the other?
Another unfortunate reality for many women in medical training is the blatant physical and verbal harassment some of us will experience by our superiors. The 2021 AAMC graduate questionnaire found that approximately 26% of female-identifying medical students have been subjected to sexist remarks, compared with 5% of male-identifying students.2 I, myself, have spent far too much time decoding the words and actions of some male preceptors, trying to determine if they were that bad. I have been turned away by school faculty who did not feel that my experience was severe enough to warrant institutional action, being told to “let them know if it gets worse.” This is not to discount the experiences of male and non-female identifying students who may have faced gender based discrimination and harassment, but to share my reality.
In sharing my frustrations with my peers, I have found that I am certainly not alone. For some, these experiences add fuel to the fire and inspire them to push beyond what is expected of them. For others, these experiences stop them in their tracks and leave an uncomfortable pit in their stomach as they begin to rethink their career ambitions. I hope that in continuing to speak out about these experiences, we can shift the narrative so that female-identifying trainees no longer have to feel uncomfortable or unwanted in their profession.
References
- AAMC. 2022 Physician Specialty Data Report. Executive Summary. Accessed January 2023
- AAMC. 2021 Medical School Graduation Questionnaire. All Schools Summary Report. Accessed Dec. 28, 2021.
Dalia Koujah is a third year medical student at the University of Arizona College of Medicine-Phoenix. She graduated from UCSD, majoring in Neuroscience and minoring in Human Developmental Sciences when she wasn’t at the beach. Dalia enjoys painting, trail running, and reading in her free time. Please feel free to reach out at dkoujah@arizona.edu.