The Long Road to Equality

Elizabeth Garrett Anderson (centre) with Emmeline Pankhurst

Elizabeth Garrett Anderson (centre) with Emmeline Pankhurst

(Originally appeared in the Medical Independent, 21st June 2018)

In December 2017, to mark its 100th anniversary, the Medical Women’s Federation of the UK (MWF) ran an “Advent Calendar” on Twitter. Each day they celebrated a different female doctor from the past one hundred years, marking her work and achievements. 

 

I had never heard of the MWF, and indeed had never contemplated the need for any kind of women-only organisation, let alone in medicine. Throughout my undergraduate and postgraduate training, and my subsequent twelve years as a GP, I had never once felt disadvantaged as a result of my gender. With the average intake to medical school currently 70% female, and the prevailing narrative about the “feminisation of medicine”, I felt that our profession was not a roaring example of female suppression or prejudice. 

 

However, a few weeks before I came across MWF, I had been speaking with some friends of mine who are consultants. They both, individually, told me stories about how their position in their respective hospitals was often undermined and denigrated. They described how they felt their voices weren’t heard in meetings. Suggestions that they would make about policy changes or improvements would go unnoticed; unnoticed, that is, until a male doctor in the room turned around five minutes later and repeated their suggestion, when it was suddenly heard and applauded. 

 

I started to read a little bit more about gender inequity and inequality. There has been a big focus this year on the gender pay gap, with large UK companies having to reveal their pay disparities. This has led to significant disquiet in the BBC, for example, with revelations that female correspondents doing equivalent work to male colleagues were getting paid much less But I knew this could not happen in medicine. We all start as interns on the same rate and we all follow the same pay-scale as we advance throughout our careers. Right?

 

It turns out my understanding of the gender pay gap was flawed. It relates to the overall income of an individual. It can be adjusted for variables such as part-time work, time off for parental or maternity leave, experience, occupation and education. It seems logical that if you work less hours then you get paid less money. However, what I hadn’t thought through, is that you are much more likely to take breaks for childcare, or decline the opportunity for further education, or fail to apply for a promotion, if you are a woman. Again, that makes sense, doesn’t it? Someone has to mind the little babies, and transport the budding Wimbledon champions to their matches, and feed the household nutritious, home-cooked meals. And, in 2018, that person is most likely to be the adult female in the household.

 

Pay disparity is just one issue which affects women disproportionately. Verbal and physical abuse are significantly more likely to occur to a female doctor than a male one, as detailed in the IMO’s Position Paper on Women in Medicine. The RCSI has also looked at the barriers to career progression for women in surgery in Ireland, and has highlighted that trainees with children have specific needs that need to be addressed in order to maximise their opportunities to achieve their professional goals. (Note - these needs are not specific to women with children - they can equally be true of fathers, or of doctors who care for elderly parents or other close relatives with increased care needs). 

 

The mass emigration of young doctors from Ireland is of deep concern to us all. Anything that can be done to improve the quality and value of a career in Ireland needs to be addressed urgently. Acknowledging that female doctors have different challenges to male doctors is an important step in this process. It is not about excluding males, or dismissing their needs. In fact, it is about realising that doctors of both genders are living in different times now, where a man or a woman may be equally likely to want to be the primary caregiver in a household with children, or achieve the highest pinnacle of their chosen speciality. Not everyone wants to work full time, but if choosing to reduce clinical hours has a significant longterm impact on overall income in a household, then that decision can be a difficult one to make. The idea of “portfolio” careers is sometimes scoffed at, and yet diversification of skills and experience has been shown to decrease burnout and increase job satisfaction. 

 

I set up the Women In Medicine in Ireland Network (WIMIN - yes, I know it’s corny) through the support and encouragement of many colleagues and friends, and by the glorious wonder that is social media. We will be hosting our inaugural national meeting this September 22nd in the Marker Hotel in Dublin.

 

I would strongly urge any female doctor or medical student to join us by visiting www.wimin.ie.

Sarah Fitzgibbon