Gender Bias and Sexual Undercurrents: Attitudes to Women Doctors in 2020

Vol 8 #7

 Author information:

Noam Raiter BA (to be received at convocation in October 2020)

Medical student/MD Candidate 2022, Michael G. DeGroote School of Medicine, McMaster University; ✉ [email protected]

What is it about the female body that is so often objectified in the field of medicine? This question arises often, but there is still not a clear cut answer.  There has been great advancement in gender equality in medicine over the past several decades (Kellie et al., 2019). According to the latest Canadian census in 2017, 56% of Canadian medical students identified as female (AFMC, 2019) while less than 80 years ago, Queen’s medical school still had its doors closed to female candidates (Cataudella, 1999).

Although this progress in gender equality is remarkable, it is naive to believe that sexism no longer pervades numerous aspects of the medical field. Recently, an article by Hardouin et al. (2020) on the topic of the prevalence of perceived unprofessional social media content among medical trainees sparked a long-awaited discussion about this issue. Although the article has since been retracted by the publishing journal due to public backlash, this commentary is meant to explore some ideas and themes from the article that were deemed problematic.

In this study, Hardouin et al. (2020) created Facebook, Twitter, and Instagram accounts to view publicly available information on the profiles of vascular surgery residents from a list compiled from the Association of Program Directors in Vascular Surgery. The content found was rated either “clearly unprofessional” or “potentially unprofessional.”

Clearly unprofessional content included “Health Insurance Portability and Accountability Act (HIPAA) violations, intoxicated appearance, unlawful behavior, possession of drugs or drug paraphernalia, and uncensored profanity or offensive comments about colleagues/work/patients” (Hardouin et al., 2020). Potentially unprofessional content included “holding/consuming alcohol, inappropriate attire, censored profanity, controversial political or religious comments, and controversial social topics” (Hardouin et al., 2020).

Undoubtedly, physicians have the responsibility to maintain HIPAA guidelines and not engage in any illegal activity. However, is it wrong for physicians to do things that most people do everyday? Is it wrong to enjoy an alcoholic beverage in one’s free time, discuss one’s religious beliefs, or wear a bathing suit on a hot day by the pool?

When discussing what was deemed “potentially unprofessional”, the authors included the following: “Inappropriate attire included pictures in underwear, provocative Halloween costumes, and provocative posing in bikinis/swimwear” (Hardouin et al., 2020). The use of the word bikinis is an obvious reference to women’s swimwear rather than males. Thus, the study by Hardouin et al. served a glaring reminder that sexism in medicine is far from gone.

This idea is reinforced by numerous studies that report a prevailing culture of sexism in medicine. A study by Jagsi et al. (2016) reported that 70% of female physicians have experienced gender bias in the workplace either from their colleagues or from their patients. Yes, the proportion of female physicians relative to males is increasing annually.

However, if one accepts women as physicians only if they look, dress, and act a certain way, then he or she does not truly accept women as physicians. This messaging inadvertently tells female physicians that they must hide their femininity in order to gain respect from their colleagues and patients. Clearly, an equal number of female and male medical students is not synonymous with equality in medicine.

Medicine is known as one of the most high-stress professions in today’s society (Brown, 2019). Rates of physician burnout are rising yearly and now stand at up to 50% in North America (Lemire, 2018), with women being 1.6 times more likely to experience burnout than their male counterparts (McMurray et al., 2000). Burnout is a work-related syndrome of stress and emotional exhaustion, where one’s life demands are perceived as exceeding their resources.

By claiming that certain social media content is “unprofessional,” Hardoun et al. inadvertently state professionals must not engage in the acts depicted in these photographs. This messaging fundamentally depersonalizes physicians, both to themselves and to their patients, and depersonalization is known to be one of the major drivers of burnout.

Doctors are well-respected and important members of today’s society. However, this cannot negate the fact that doctors, just like everyone else, have lives outside of their careers. Research has shown that increased time off work, as well as engaging in stress-reducing activities that are unrelated to the workplace, significantly reduce burnout rates in physicians (Patel et al.,  2019). So, why does the definition of professionalism in medicine’s hidden curriculum disapprove of such activities? This outdated definition is one which only benefits old-school patriarchal medicine.

The article by Hardoun et al. was retracted after a well-justified uproar on social media. Female physicians everywhere began sharing their stories of both academic success and feminism by sharing images of them in bikinis or enjoying a drink on social media. However, a few days of social-media discussion surrounding gender equality is not enough. Let this since-retracted paper serve as a reminder that there is more to ending sexism than simply equating the numbers.

Gender bias is alive and well in the medical field. Day in and day out, female medical students are told which specialties they can and cannot choose if they want to have a family. Women in medicine are still being paid less than their male counterparts for equal work (Boesveld, 2020) and female physicians must stand by politely when some patients demand to see the “real doctor”.

In 2020, a year of many unexpected occurrences, let’s finally add breaking gender bias in medicine to that list. I am a first year medical student at Michael G. DeGroote School of Medicine, McMaster University, and I hope to soon be practicing medicine in a world with true gender parity.

Conflict of Interest Statement:

The author reports no conflicts of interest concerning the subject matter of this article.

REFERENCES

Association of Faculties of Medicine of Canada (AFMC). TableG-1. In Canadian Medical Education Statistics 2018 (40th vol, pp. 137). (2019). Ottawa, ON: AFMC. https://afmc.ca/sites/default/files/pdf/CMES/CMES2018-Complete_EN.pdf. Accessed August 2, 2020.

Boesveld, S. (2020). What’s driving the gender pay gap in medicine? Canadian Medical Association Journal, 192(1), E19-20.

Brown, C. (2019). Stress of first postgraduate year leaves mark at cellular level for medical trainees. Canadian Medical Association Journal, 191(27), E773-774.

Cataudella, J. (1999). When women came to Queen’s.  Canadian Medical Association Journal, 161(5), 575-576.

Hardouin, S., Cheng, T. W., Mitchell, E. L., Raulli, S. J., Jones, D. W., Siracuse, J. J., & Farber, A. (2020). RETRACTED: Prevalence of unprofessional social media content among young vascular surgeons. Journal of Vascular Surgery, 72(2), 667-671. doi:10.1016/j.jvs.2019.10.069

Jagsi, R., Griffith, K. A., Jones, R., Perumalswami, C. R., Ubel, P., & Stewart, A. (2016). Sexual harassment and discrimination experiences of academic medical faculty. JAMA, 315(19), 2120-2121.

Kellie, D. J., Blake, K. R., & Brooks, R. C. (2019). What drives female objectification? An investigation of appearance-based interpersonal perceptions and the objectification of women. Plos One, 14(8), e0221388.

Lemire, F. (2018). Combating physician burnout. Canadian Family Physician, 64(6), 480.

Mcmurray, J. E., Linzer, M., Konrad, T. R., Douglas, J., Shugerman, R., & Nelson, K. (2000). The work lives of women physicians. Results from the Physician Work Life Study. Journal of General Internal Medicine, 15(6), 372-380.

Patel, R. S., Sekhri, S., Bhimanadham, N. N., Imran, S., & Hossain, S. (2019). A review on strategies to manage physician burnout. Cureus, 11(6), e4805.