Locker (Operating) Room Talk: Gender Equity and the Medical Student’s Perspective
FMWC held their inaugural Gender, Equity and Diversity Student Essay Contest earlier this year and are happy to report that they have a winner! Ms. Darby Little, Class of 2021, University of Toronto submitted the winning essay among a stellar selection.
Locker (Operating) Room Talk: Gender Equity and the Medical Student’s Perspective
Being a medical student shadowing in an operating room is always a challenge. If there is a wrong place to stand, you’re probably standing there. If you can be helpful with a task, it takes you ten times longer than anyone else. However, a few months ago, I was shadowing and found the operating room challenging for a different reason. I was the only woman in the room, observing two male residents and a male fellow. I was expecting to be asked questions about anatomy, so I studied the surgical site preparing myself to answer. Unfortunately, those questions never came. Instead, the young doctors began to talk about the staff surgeons in their specialty. Specifically, they were discussing who was the best-looking female surgeon.
In retrospect, I think what is most concerning about this experience was that I was neither surprised nor offended. This experience fit neatly into the stereotype of surgeons that I had already internalized. I stood there quietly, still wondering if they might ask me questions related to the procedure being performed, even though I had already begun ruling out this specialty, and surgery in general, as a possible career path for me.
It was months later that I realized that this was just another example of how entrenched gender inequity is in medicine and medical culture. I witnessed "locker room talk" within the confines of a supposedly progressive academic setting and doled out by people who are serving as mentors and role models to future doctors. I found myself in a situation that blatantly indicated that women are not respected in medicine, and especially not in surgery. The residents and fellow I was observing reduced their female staff surgeons to providing value solely through their appearances and not their training, experience, and abilities. This experience reminded me of how often I am assumed to be a nurse, the times I was introduced to an older male patient with a wink, and how often I am encouraged to pursue “female-friendly” specialties like pediatrics instead of surgery. The frequent gender-based microaggressions had worn me down to the point that I was normalizing, and maybe even expecting, the “locker room talk” I witnessed.
In Canada, women have made up the majority of entering medical school classes since 1995, and in 2016, 58% of first-year medical students in the country were female.(1) Despite this, the gender inequity that exists in medicine begins in medical school. Female medical students are often encouraged to choose “female-friendly” specialties, such as family medicine and pediatrics, and dissuaded from choosing surgical specialties due to their perceived incompatibility with gendered beliefs of what women seek in career paths, such as family-friendly schedules. These attitudes persist later in residency training and as physicians. Women in medicine do not receive the same recognition as their male colleagues in terms of leadership and salary.(2,3) These patterns might be reflecting the gendered pathways female medical students are encouraged to pursue, which tend to be lower paid and underappreciated, as are essentially all professions and careers dominated by women.(4)
Perhaps most concerning is a recent study from the United States which found that 50% of female medical students experience sexual harassment during their medical school training.(5) Though we don’t currently have any published or available data on sexual harassment of medical students in Canada to compare this finding with, it is alarming that at least half of female medical students will be harassed during her medical training. This has serious consequences not only for female students’ mental health and workplace safety, but also her training and career choices.
When women were fighting to just attend medical school, they required unbelievable resilience as they faced outright rejection and sexism from medical schools. Today, the resiliency of women in medicine is about battling the countless microaggressions that make you feel like you do not belong. It is imperative that the existence of gender-based discrimination and sexual harassment, through an intersectional lens, is acknowledged during medical school and that gender equity and allyship training is required for all students. Male medical students often feel uncomfortable talking about gender equity and may not know how to recognize or respond to harassment of their female colleagues. It is essential to train male medical students in allyship to ensure that the future generation of male physicians can act as advocates for their female colleagues and set new standards for what is acceptable “operating room talk.”
Darby Little, Class of 2021
University of Toronto
References
1.Canadian Medical Education Statistics. (2017). Retrieved from https://afmc.ca/publications/canadian-medical-education-statistics-cmes
2.Jena, A. B., Olenski, A. R., & Blumenthal, D. M. (2016). Sex Differences in Physician Salary in US Public Medical Schools. JAMA Internal Medicine, 176(9), 1294. doi:10.1001/jamainternmed.2016.3284
3.Jena, A. B., Khullar, D., Ho, O., Olenski, A. R., & Blumenthal, D. M. (2016). Sex Differences in Academic Rank in US Medical Schools in 2014. Obstetrical & Gynecological Survey, 71(2), 61-62. doi:10.1097/01.ogx.0000480221.58767.1a
4.Levanon, A., England, P., & Allison, P. (2009). Occupational Feminization and Pay: Assessing Causal Dynamics Using 1950-2000 U.S. Census Data. Social Forces, 88(2), 865-891. doi:10.1353/sof.0.0264
5.National Academies of Sciences, Engineering, and Medicine. (2018). Sexual harassment of women: Climate, culture, and consequences in academic sciences, engineering, and medicine. Washington, DC: The National Academies Press.