Gender diversity in medicine: the long and winding road

Gender diversity in medicine: the long and winding road

Gender diversity in medicine: the long and winding road

When I graduated from medical school in 1994, most of my fellow graduates were female and back then it was said that it would not take long before women would take strategic positions in medicine, given our majority among medical graduates. More than 20 years later, we are still waiting for female doctors to become visible as leaders in our field: in my own institution less than 1 out of 9 professors is female. How can this be?

For a long time, the lack of medical career advancement has been attributed to the women themselves: they would rather stay at home and take care of the kids, and at the most only want to work part-time, not wanting to invest sufficiently in their career. These arguments were offered to me many times by chairs of clinical departments during debates on the topic in my own institution: these women simply do not want a high position in medicine. But were the arguments of these department chairs based on observation, or on their perception of the problem?

In my view the question we need to ask is NOT: “Why do these women not want a career in medicine?” No! The question we need to ask is: “Why do we fail as a community to recognise talented female medical professionals, and how can we make this change?”. It is my profound belief that the underlying cause of the lack of medical career advancement among females is rooted in implicit bias: our collective inability to recognise that women are as talented as men in the medical profession, or business, or science. Luckily, my belief is now supported by a growing body of evidence, for example through Project Implicit (implicit.harvard.edu) where you can test your own implicit attitude regarding a range of topics, such as Gender & Career, and Gender & Science. Most people – including myself – have an implicit attitude toward associating family with females, and toward associating career with males; and an implicit attitude toward associating liberal arts with females, and science with males. In short: we simply have difficulties associating women with a successful career!

Now that it is becoming evident that the main problem is our collective disability to recognise talented women in the medical field, we can start working toward solutions. While in the past decade great initiatives have emerged to empower talented women through MD programmes, networks and mentoring & coaching, the next step forward is to create collective awareness of gender bias in medicine and shared responsibility to improve gender diversity in the medical field. We need to be aware of our implicit bias to be able to start recognising female medical talent: we need to let the sun in so as to be able to see the bright lights. MD programmes aimed at female talent are only effective in organisations that have created awareness of implicit bias and have implemented effective strategies to nurture a culture that is aimed at inclusiveness. For the scientific community Ross-Macusin et al  (Science, 2014) recently published a range of proven effective approaches to improve diversity, such as active learning techniques and an organisational culture of shared responsibility for diversity, and predetermined measurable outcomes to ascertain that the effects of interventions can be proven. These concepts can be easily translated to the medical field.

How can you  make things happen? Change starts from within: with your own awareness of the real problem, and the awareness by your organisation of our collective near-sightedness for female medical talent. As gender diversity in high corporate positions is strongly correlated with the success of an organisation in terms of profit and return on investment, one can only root for organisational measures to supplement MD programmes for talented females in medicine.

Sign up here for the Masterclass "Gender equality in medicine" on 11 June 2015.