Unconscious bias and the gender riddle

A father and son are in a car crash and are rushed to the hospital. The father dies. The boy is taken to the operating room and the surgeon says, “I can’t operate on this boy, because he’s my son.”

HOW is this possible?

Apparently, most of people can’t solve this riddle because they’re unable to imagine the surgeon is a woman. The surgeon is the boy’s mother. This is an example of the unconscious bias that can exist in the minds of people when it comes to women in medicine.

As a father of three daughters, my dream is for them to be able to grow up in a world where they can have the opportunity to fulfil their full potential and be whomever, and whatever, they want to be. We are lucky we live in a Western democratic society, where the rights of women in general have progressed much further, so they have a better chance than the majority of girls growing up in other societies. Australia and New Zealand lead the way in this regard, with New Zealand the first country in the world to give women the right to vote on a national level in 1893, and Australia not far behind in 1902.

However, the truth of the matter is that humanity as a whole still as a long way to go in recognising women as having equal rights and status. There are still countries in the world where women cannot vote, go to school or even drive. We should note that in Australia, it was as recently as 1966 that the marriage bar which restricted the employment of married women was removed. There are currently women in the world who have subordinate legal status, leading to a lack of access to education and other opportunities that we may take for granted here.

Nevertheless, Australia still has a way to go when it comes to gender equity in career opportunities. According to recent news reports, Australia will not be hitting its target of having 30% of women on company boards by 2018. And apparently, there are fewer women in top management roles in Australian companies than there are men named John, Peter or David. This is despite evidence that having women in leadership roles leads to better performance. Let’s be honest though, the issue is to do with our current culture and society. Today, we still celebrate beauty pageants where women are rated on how they look in a swimsuit; where the media still focuses on what a female political leader is wearing rather than on her substance.

But the focus of my article today is specifically about women in medicine. Dr Constance Stone was the first woman to be registered to practice medicine in Australia in 1890, and Dr Dagmar Berne, the first Australian medical student to be enrolled in 1886, registered to practice in 1895. It took Australia over 100 years to reach gender parity in 2000, with now just over 50% of medical students being female.

Despite this, there are still less women in certain medical specialties, and there is a definite under-representation of women in medical leadership roles in hospitals, specialty medical colleges, and other health organisations. A study I was involved in – “Reasons and remedies for under-representation of women in medical leadership roles: a qualitative study from Australia”– identified a range of potential barriers for women across three broad domains: perceptions of capability, capacity and credibility.

With the barrier of the perception of capability, organisations need to ensure that their female doctors are being given opportunities for leadership training. At Monash Health, we recognised the lack of female representation at our highest medical leadership roles, and we have decided to address this by implementing our Monash Doctors Women in Medicine program, which was launched by the Hon Jill Hennessy, Victorian Minister of Health, in 2015. Since then we have had four cohorts of female doctors, totalling an alumni group of 70, who have undergone leadership training and development. I had the privilege of meeting them last week, one of the reasons why I decided to pen this article. As Marie Curie, the twice Nobel Prize winner, once said: “Life is not easy for any of us. But what of that? We must have perseverance and above all confidence in ourselves. We must believe that we are gifted for something and that this thing must be attained.”

The second barrier is the perception of capacity. I recall the decision my wife made to defer having children until she finished her specialty medical college training, because she was very aware that part-time training was difficult and meant a delay in embarking on her career of choice. When she became a mother, she was fortunate to be able to take sufficient time off on maternity leave.

There are two points to make here. First, there is still work to be done by both employing health services and the training medical specialty colleges, on creating better maternity leave frameworks to support female doctors. Second, we cannot underestimate the impact of maternity leave on a female doctor’s career progression.

Many female doctors make the conscious decision to be the main carer for their children if they choose to have any, and this again affects their capacity to spend more time in their clinical practice, which influences their opportunities to progress into medical leadership roles, as well as their ability to attend leadership development programs. But it should not be a complete barrier. Carol Greider, the molecular biologist who won the 2009 Nobel Prize for Medicine pointed out: “In the newspapers, there’s a picture of me and my kids right there. How many men have won the Nobel [Prize] in the last few years, and they have kids the same age as mine, and their kids aren’t in the picture? That’s a big difference, right? And that makes a statement.”

The last barrier is one of credibility. I started off this article with a riddle demonstrating the potential for unconscious bias that may exist in all of us. Female doctors today, are still called “doctors” less than their male counterparts. We need more women in leadership roles in medicine so that they can be role models for others, provide better representation of our medical community and allow us to have a more diverse leadership group. I really believe that although we have come a long way, we still have a long way to go. An old Chinese proverb says: “Women hold up half the sky.”

Let’s work together to make this a world where all of us, no matter our gender, race or faith, can be truly equal in both rights, opportunities and roles.

Professor Erwin Loh is chief medical officer at Monash Health, and clinical professor at Monash University.

 

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