Writer Marina Politis tells us why gender equality should be a priority for the next generation of doctors.
Feminism. “What has that got to do with medicine?” some may say with rolled eyes. The dinosaurs, squirming in their antiquated offices, are quick to label this as the antithesis of professionalism in an effort to maintain their comfortable status quo. Being a medical student, however, ought to be inherently feminist – as future doctors we should have an obligation to ensure that we serve all of the population equally, regardless of gender, and to promote gender equity amongst our peers, colleagues and patients.
“Being a medical student, however, ought to be inherently feminist – as future doctors we should have an obligation to ensure that we serve all of the population equally…”
The Edinburgh Seven, who began studying medicine at the University of Edinburgh in 1869, were the first group of matriculated undergraduate female students at any British university. Whilst they never graduated, their campaign put the demands of women for a university education on the national political agenda. This ultimately resulted in the UK Medical Act 1876, which sought to ensure that women could study medicine at university in 1876. Only in 2019, were they awarded a posthumous honorary degree of MBChB.
Today, more than 150 years later, women are on track to form a majority in medicine. Indeed, in 2019, women made up 48% of all licenced doctors, and in 2017, 59% of those accepted to medical school were women. If this trend continues, women will make up the majority of the workforce in the next decade. Despite this, women continue to face a number of inequities in medicine.
This year, a British Medical Association report on sexism in medicine found that 91% of women respondents had experienced sexism at work within the past two years. Almost a third of women experienced unwanted physical conduct in the workplace and 56% received unwanted verbal conduct relating to their gender. These statistics go on and on, telling us the same disheartening story. We must, however, translate these feelings of disillusionment, anger and frustration into tangible action and change.
“We must, however, translate these feelings of disillusionment, anger and frustration into tangible action and change.”
Worse still, women are also underrepresented in leadership and management roles. Only 36% of consultants in the UK are women and in 2017, women comprised only 40% of chief executives, 28% of finance directors, and 16% of chairs. As for the gender pay gap, women hospital doctors earn 18.9% less than men, women GPs 15.3% less than men and clinical academics 11.9% less than men. The total non-adjusted gender pay gap is 24.4% for hospital doctors, 33.5% for GPs and 21.4% for clinical academics.
Meanwhile, the male norm in medicine results in unequal care for women as our research is centred predominantly on males cells, male animals, male patients, and our medical education still prioritises male bodies and male voices. This results in gender health gaps, such as the heart attack gender gap, which is needlessly costing women’s lives, with women’s symptoms still written off as atypical. But how can something which impacts half the population be atypical? A woman is 50% more likely than a man to receive the wrong initial diagnosis for a heart attack, and less likely to receive a number of potentially life saving treatments or to be prescribed medications to help prevent a second heart attack.
“Our research is centred predominantly on males cells, male animals, male patients… Our medical education still prioritises male bodies and male voices.”
Furthermore, conditions such as endometriosis, polycystic ovarian syndrome and the menopause – which predominantly affect women – are neglected. Endometriosis affects 1.5 million (1 in 10) women in the UK of reproductive age, yet takes an average of 8.5 years to diagnose. Would this be the case if the condition predominantly affected men?
Medicine and STEM subjects pretend to be objective in an attempt to devoid themselves of responsibility to drive change, arguing that a basis on the scientific method means there is no room for bias, but this is wrong. Both overt, explicit, and unconscious, implicit bias permeates through all of medical education, medical research and medical practice. We must be medical feminists to stand for female empowerment and gender equality, and to neglect gendered issues goes against principles of medicine, such as to “do no harm”. There are no innocent bystanders when it comes to tackling medical bias. Importantly, our feminism must be intersectional, and we must stand especially for women of colour, women with disabilities, and trans women who still face unacceptable disproportionate discrimination in healthcare.