Introduction:
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Gloria Wu, MD:
Hello, this is Dr. Gloria Wu. We’re going to talk about women in medicine, and as more women are practicing medicine today, we find that there’s still not so many women in medicine as tenured faculty or tenured professors or medical school deans or department chairs. And as more of us are growing into this role and we’re seeking to rise up in our own leadership positions, we’d like to kind of discuss what’s been going on.
So there was an article by Thompson-Burdine in JAMA Open Network 2019. The title was Defining Barriers and Facilitators to Advancement for Women in Academic Surgery. They looked at Michigan Health, part of the University of Michigan healthcare system, and they had 26 interviews and they did 45 to one hour interviews, and they tried to figure out what was happening. There were three themes that emerged that the organizational culture and institutional policies that affected opportunities for advancement for women.
So there were certain policies that made it impossible for women to advance. Maybe it was because it required long working hours, committee service, and the women had childcare responsibilities or they were of childbearing age and they couldn’t do it, and they then opted for a more clinical position, which would then make it impossible for them to rise up in the academic ladder.
Number two. There were relational interactions with the leadership, mentors, colleagues and staff. So sometimes this affected promotion and attrition, simply because the relational interactions, how you interacted with your mentors, your chief of the department, the sub chiefs. If you could not get along or you perceived you didn’t get along, you were not able to be in the same wavelength. That affected promotion and made the woman surgeon want to leave. And also, there was staff not cooperating, like nursing staff or even male and female residents.
Number three. The individual characteristics that mediate the perception of professional and personal success. So some of the themes are what were these women’s surgeons defining as personal success? And so it’s important in leadership as Rosabeth Kanter mentions in her TED Talk. She’s a Harvard Business School professor, tenured faculty. And she mentions it’s very important to know your mission statement, your personal mission statement. As Simon Sinek says in his TED Talk, what is your why? Like Martin Luther King, he had a why. He had the I Have a Dream speech. It was his belief. It was his belief that touched people’s hearts and minds, and that led them to follow him. It inspired them. It inspired a movement. So this type of mission statement, this type of why, is going to drive the women’s position. Now for these women physicians, the individual characteristics, sometimes perhaps they did not know what their mission statement was, or they were conflicted because they had childcare duties.
They were of childbearing age, and it then affected their perception of their own professional and personal success. So it’s an interesting three themes that these interviews came up with. So there were expressed reasons for attrition. Perceived lack of opportunity, hostile work environment, better opportunities elsewhere, number three. Number four, job opportunities for the life partners or spouse elsewhere outside of Michigan. And number five, health was compromised by the stress.
In general surgery all these women knew that they had very long working hours and they felt they had to tough it out because it was that type of specialty. And many of the interviews dealt with that concept that they had to kind of have a stiff upper lip and be stoic because it was the culture of surgery. One participant said, “It’s not anything big that undermines women in academics. It’s many, many, many small inequities that build up over a career.” So that’s a very interesting comment. So what can we do about it?
What can we do now that we know, read this article? This was 2019. For women in that situation, we must find communities that foster support, that foster personal growth, and give us a chance to intellectually breathe and feel good about ourselves. Number two, we have to find mentors. Mentors that will support us, that will facilitate our moving up the ladder. Number three, we must find other ways, be creative, that there are many ways to roam, and to find that joy again and find a journey within that hierarchy that would give us that joy. So we have to be creative and not think that one size fits all and that we can still rise up and find a way through this quagmire. Lastly, I found in my own career that one has to be relentlessly optimistic, be relentlessly cheerful, and persevere and never give up.
That was one of Professor Kanter’s six rules. Number one, show up. Number two, speak up. Number three, look up to your mission statement. Number four, team up. Find partners that believe in your why. Number five, never give up. Remember, Nelson Mandela was 27 years in prison. Then when he walked out, he was elected to be the first Democratic elected president in South Africa. So he was in prison for 27 years and he never gave up. So find the inner Nelson Mandela. And number six, when you succeed, lift others up. Share that success. With that, I leave you. Thank you. And tune in next time. Thank you.
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