Saturday, February 27, 2016


Since I read Cheryl Sandberg's book Lean In last summer, I have been hyper-aware of the ways in which men and women in medicine behave differently.  I've noticed how men speak up more during lectures and stay at the microphone even after they've been told that the question period is over.  I've seen how male residents give orders to nurses while female residents make requests.  I've witnessed the self doubt of smart and talented female medical students contrasted with the cockiness of some not as smart and talented male medical students*.  It saddens and frustrates me to see, time and time again, women reflexively and unconsciously making themselves smaller because they've internalized the message that they are somehow lesser.  (And men making themselves bigger because they believe that they're greater.)

This morning I went to an educational session in which these gendered behaviour patterns were on full display.  The session was led by one male physician and one female physician, both of whom are well-respected in their fields and have similarly impressive CVs.  Although they were supposed to be equal co-chairs, the man completely dominated the session.  He read not only his introductory slides, but also hers.  He answered all of the questions without even acknowledging that his co-chair might have an opinion that she wanted to add.  The few times that she managed to start answering the question before him, he interrupted her to finish the answer.  And then, partway through the session, he deviated from the planned presentation and, without asking permission from his co-chair, started showing his own set of slides on his area of research.

I was livid!  I couldn't believe how blatantly disrespectful he was to his colleague.  And the worst thing for me was, I suspect I was the only person in the room who noticed.  We're so accustomed to this pattern of male dominance and female submission that we don't even bat an eye at it.  Even though the voice of another smart and talented woman was completely silenced in the process.

I'm still livid.

*In case it needs to be stated, I don't think that female medical students are inherently smarter and/or more talented than male students.  I've simply observed that women in medicine tend to underestimate their abilities, while many men do the opposite.


  1. I've already noticed that I am being encouraged to contribute less than the men. If I participate in discussions the way men do, I'm told I contribute too much, even when I keep track and I'm objectively contributing less than the men. If I have an opinion, no matter how cautiously or politely expressed they are, I'm 'bossy' or 'difficult.' I've already received a negative evaluation because I disagreed with someone politely, whereas males in the same group were praised for having differing opinions. It is so frustrating.

    For the last few years, I've worked in a setting where all of my immediate superiors and their superiors were women. Strong, successful, professional women. I was encouraged to speak my mind (respectfully) and to actively participate in decisionmaking even as a very junior team member. I feel so very out of place in medicine where there is a very clear expectation that I should be quiet and let men speak. I've noticed it in lectures and group settings and it just makes me want to scream.

    But I can't say anything. Or I get negative evaluations which can kill my career before it even starts. I knew medicine could tend towards old boys club but I'd have thought med school would be a little more progressive. It's not.

  2. For what its worth I hold the female doctors around me in high regard, the male ones - often not so much. The male co-chair in your example was certainly wrong in his behaviour.

    From a male perspective, its just as wrong to expect men to be hyper competitive all the time as it is to expect women to be passive. Its absurd that men are expected to "compete all the time, even in a collaborative environment where it is harmful, but if we don't we will be unconsciously penalised by our peers.

    Emasculation, as a word and concept, should be removed from our society. The answer isn't to turn women into cocky idiots too - men must be freed from the need to one up their neighbours, in doing so women will be liberated as well. I regularly call people out for mocking men for their perceived inferiority, I sometimes get odd looks for it, but I wish more people would. I have seen even feminist women participating in this system of rewarding cocky men and discounting the rest, perhaps it is not widely appreciated how important it is in maintaining the division between the sexes but it is important, just as important as how we treat women.

  3. As a medical student I have noticed that on days that I dress more femininely I garner less respect or attention from male classmates and both female and male physicians. On days when I dress more masculine (pants, and collard shirt) I am given almost equal respect (emphasis on the almost). Its ridiculous.

  4. In emerg, I really struggle with being a woman, in particular with being a small woman with a big personality (because, let's be honest, I am not shy or quiet) and a loud voice. On the one hand, I'm expected to learn to lead resuscitations with authority. On the other hand, if I do it just as the boys do (which is what comes naturally to me), I am variously called 'cocky' or told that 'you came off as a bit of a bitch in there'. If I hold back, someone (usually a male attending or resident) takes over. Similarly, I'm either told that I'm 'too social' if I'm friendly with the nurses (which, again, comes naturally) or that I don't make enough of an effort with the nurses if I focus on patient flow. I'm constantly searching for these happy mediums even though I'm pretty sure they don't exist for a female resident with my personality. I don't think the male emerg residents face the same challenges and critiques.