One essential part of an older patient’s management is the Mini-Mental State Examination. There are various questions to consider, but most include the practitioner asking, “who am I?” to assess the patient’s awareness of their surroundings. A question to which at least two women doctors I know consider as having been answered correctly if the patient’s response is “the nurse.”
I have never been mistaken for a nurse – instead, as a work experience student aged (and looking) 16, I was asked if I was the new junior doctor by a senior consultant. The same could not be said of women I know.
Unlike my older sister, I have never been questioned about my plan for balancing “career and family” nor had it suggested that it is an either/or choice between the two. I’ve only ever had to justify my decision to pursue a medical degree in the process to get in, and there is a surprise when I express that I might want to be a part-time doctor in the future.
Women’s experience in medicine came up when the Edinburgh Medical School Council’s annual debate was on the topic “Is medicine a patriarchy?” The discussion included a contrarian Dermatology professor who claimed that the gender split (with 57% of consultants and 75% of higher speciality trainees) in his field being female dominated, instead suggested a “matriarchy”.
A convenient theory for opposing the debate’s premise that ignored two key facts. One, both professors of Dermatology at Edinburgh are men. The gender balance in the field – even as far up as consultant posts – does not necessarily indicate the equal progression in the academic field which comes alongside it.
Additionally, this statement ignores the structural factors which could push women into the field. Dermatology is sometimes seen as a speciality with an ‘easier life with few on-call sessions overnight and a predictable pattern of mostly outpatient care with few emergencies. The ability for “work/life balance” – sometimes seemingly a code word for the ability to raise your kids – is cited.
The patriarchy, far too often, dominates medicine. We should acknowledge the advantages faced by men entering the medical field. Without that acknowledgement, the disparities women face as doctors will continue.
This is the call for a conversation – both in society about what we expect from women who are doctors and medics of all genders. There may be more women dermatologists, but we should go beyond the surface level and talk about why, rather than write off the sexism in medicine and the struggle women face having to justify their title of ‘doctor’ every step of the way.