Women in Medicine: Past, Present and Future - Dr. Nuthana Bhayankaram (Medical Women's Federation)
Summary
This on-demand teaching session provides an informative look into the history of women in medicine and how they were historically treated differently than men. Dr. Nothing, Pediatric Registrar and Vice President of the Medical Women's Federation, will discuss how women were oppressed in the past, how Elizabeth Blackwell and Elizabeth Garrett Anderson broke barriers to become the first female doctors, and how society has changed since then. Attendees will be able to take away helpful insight, understand societal changes, and learn more about female pioneers in the medical industry.
Learning objectives
Learning Objectives:
- Understand the history and development of the status of women in medicine and the societal inequity that has existed throughout the years.
- Discuss how long it has taken for Woman to become physicians and receive equal rights in comparison to their male counterparts.
- Recognize the accomplishments of members of the medical profession such as Elizabeth Blackwell, who overcame a multitude of difficulties to be accepted into medical school.
- Evaluate the current state of Medical Women's Federation and its purpose in the medical community.
- Comprehend the potential impact of discrimination and gender inequity in the medical field and discuss methods of improvement.
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everyone. Thank you so much for asking me to talk about. Well, Medco Inference. I'm really sorry that can't be with you in person or join. You've actually I'm I'm on call this weekend, but I am hoping that you can see me and see the slides. Okay, on this recording. So I am Dr Nothing a bionic or, um, I'm a pediatric registrar. And I'm also the vice president of the Medical Women's Federation, which is the largest body off women doctors in the UK and the voice of medical women or medical issues. And you might be able to tell I've had quite a bad cold and cough this week. So apologies if I am suddenly stop coughing during the talk. So I was asked to speak about subject off women in medicine on a thought would be really helpful if we speak about women in society in general, from the lens of looking the past. Because then we can understand why things are the way they are at the moment, and then what we can do about them to improve things in the future. So if I was in the room with you now and if I asked everybody who identifies as a woman to stand up. I would predict that about 60% of the room would be standing. So 60% of medical students and doctors in the UK are women. Um when we look at kind of different grades of doctors, those that are in the highest academic posts and leadership posts are still more likely to be men. But overall, 60% of doctors are women if we go back 100 years on. But that's the same question. In 1922 only 5% of doctors in the UK would be women. And if we go back another 100 years to 18 22 there will be zero doctors in the UK who were women. So it's only in the last 157 years that we've had women doctors. Now, if we think about the Royal College of Physicians, that's over 500 years old. So there's It's been quite recent that we've actually had women doctors in the UK and I want us to think a little bit about history and look back just going to move this so that you can see images and and think about about women in history and society in general. So this first picture that I've got here is off something called the Hammer. I'll be code on do this this'll particular code that it's all like Return on. You could still go and see now in the Louvre. But this is from Babylonian times in about 17 76 BC The king at the time was called Hammer Ah, be And they came up with this code. So this is where the hole and I for night comes from. If if a man goes in and damage is the eye of another man, then that man is that a lot of damage The first persons I um So this is how they had rules in society. And it's very interesting because when we look through the code on what we find is that men and women which treated completely differently. So the life off a female commoner was were 30 silver shackles. So that's life of a woman. Um whereas the eye of a male commoner was worth 60 silver shackles. So a woman's life was worth half of the amount that the the a man's I was worth. So it shows how in the society is they thought very differently about men and women. And then the next picture have is a group of women from the Roman Empire. So we're going back about 2000 years here. So in Roman times, um, women were allowed to talk about women's issues or they were not allowed to talk about Children. That was that they weren't allowed to talk about anything else. Eso the way that things will run in society. How how different. Different things We practiced that they just weren't allowed to have a seat on it. Either you keep quiet or if you're gonna talk only allowed to talk about things to do with women and Children. So they were allowed to speak up about things, but only if it was specifically about women and Children. So these sorts of things have have made it a very unequal society for women for years. And yet and then come to a picture off. My good friend Jane Austen. Um who, of course, is very famous for writing lots of novels about the life off women in the 17 hundreds and the 18 hundreds. But in those times we see that women were. They were allowed to have have money. So lots of the way that she describes people is that Miss Mary Crawford has 20,000 lbs. Um and so people want to marry her for her 20,000 lbs. But when we say that they had that money didn't really belong to them, it was in their fathers bank account. And then the woman would get married and I'm get transferred to the Husbands bank account. So they were allowed to have their own bank accounts that weren't allowed to go and have a job. It was very much you. You go to school and then you get better on education. You've become accomplished by learning how to play the piano and learning how to dance and learning how to draw on. Then the aim of your life is to get my read on day, try to marry somebody who is, which is possible, because then you can have more comfortable life. So then we fast forward, of course, to the early 19 hundreds, where I really there was becoming more of a change on. Women were wanting to be treated more as equals in society on I think the 1st 1st World War in particular really helped with that, because women were then doing all the jobs that the men would have been doing before the wall, and it showed that they were just as capable as men of doing those jobs, and therefore they were capable off voting and having their say on more things than things that get labeled as women's issues. And so that's how things have bean in in society over time. And I think it's helpful to look back on that and think about how things were 5000 years ago, when 100 years ago, because it takes a lot of time for things to change on. Humans have been around for thousands of years, but it's only within the last 200 years that women have bean allowed to. Well, in the last 100 years that women have been allowed to vote and, uh, same go to university and go to medical school on be doctors. So of course, we're not at a time where things are fairly equal at the moment. So, uh, let me just move this so that you can see my time like so this is a history off women in medicine. I'm focusing on the UK. So in 18 47 was woman called Elizabeth Blackwell, who was born in England and grew up in England. And then the family all moved to the US on day. She decided while she was in the US that she wanted to study medicine. And so she applied to various medical schools. Um, at that time, of course, women weren't allowed to go to medical school on, so most of them said no. But there was one medical school in New York the, you know, put it away. The male students. Do you think we should let her come on? They thought it was a joke. So they they said, Yeah, sure. Come see what happens. So she got a place to go and study medicine. Um, and I think from reading through about her I think it must have been very difficult, cause there was a lot of sexism in society at that time, and she used to have to sit separately to all of the other mail students. And when they were doing dissections, you know, she she wasn't allowed to be included. I think she had she faced a lot of sexism, no, only from her peers, but also from all of her teachers. And I think they also It was ridiculous that there was a woman that was there, but she persevered, and she ended up graduating top of her class on. She became the first woman to be a doctor both in the US and in the UK because after practicing medicine in the US for a few years, she then moved back to the UK on was practicing medicine here, and in 18 59 the GMC Register was formed on Do they assumed that everybody who applied to be on the register would be a man? Because in the UK, you had to be among to go to medical school. So why would they expect that to be any women? I'm so the GMC kind of worked all the doctors and said, You know, we're thinking forming this register. You're eligible to apply if you've seen a doctor within the last three years on. So they were incredibly surprised to receive a letter from a woman who said, Oh, I am eligible because I have a medical degree and I've been back, since that's in here within the last three years because they hadn't put it as a close. But, um, that you have to be a man to join the register. They couldn't exclude her. So when the GMC Register was formed, there were 16,000 and 81 doctor's on Dwan. Of them was a woman, Elizabeth Blackwell. Of course, as soon as they formed the DMC Register, they then voted to change the rules. So then you had to be a man to join the register. So that meant that it closed the door to other women who want to become doctors in the UK. So, around this time, when the DMC register was being formed, Elizabeth Black girl was giving talks organized by society called the Society for Promoting the Employment of Women. And one of the people that came to these talks was a woman called Elizabeth Garrett Anderson. She have bean reading about her because I recently got us to write an article about her for for March being Women's History Month and Elizabeth Gary Anderson Waas brought up in the UK She was one of 12 Children, and her father was a merchant who came into some money, and I think you must have been a feminist because he decided that actually, his daughters should receive the same education as it's since, which was quite unusual about time. Usually the sons would get a better education on the daughters. Hey, made sure that they all got a very good education. And she decided that she wanted to go instead of months, Um, on looking through the archives off the Medical Woman's Federation. Um, it's really interesting because I found quite a few articles about Elizabeth Car and er Sanon. One of them. It said that when she decided that she wanted to be a doctor, her mother spent two days crying in her room. I guess because from a societal point of you at that time, um, it was expected that a young woman would go on, go get educated and then get married and live Life is a lady. Instead, she wants to go around working really hard in the hospital so you can kind of understand why, why? I'm, um, spent two days crying, Um, and it also shows how how determined Elizabeth car and er sunburn have bean to to go on Daddy medicine, if the whole of society. And if your mom is a real telling you that you know, I don't think I don't think she can bother with. This is very easy to say. Okay, fine. No, I'll just live a life of leisure. But she didn't do that. She went to the worshipful society off apothecaries who again let the GMC They hadn't specified that you had to be a man to go and do a licensing exam because they assumed that everybody who applied would be a month. But she applied, and she got her license things exam on the 28th of September 18 65 on Dove course. As soon as she got that, they then voted at the worshipful Society of Apothecaries to change the rules. So you had to be a man to go and get your licensing exam. So again, this meant that it closed the doors to other women who were trying to follow in her footsteps. So she got a licensing exam on then that doesn't exactly make things easy for her to get a job as a doctor, and nobody wanted wanted to employ her. But clearly, there were lots of patients that wanted a woman. Doctor, if you think about it at the time, um, any woman for any apps and gynie issue was seeing a male doctor. I'm quite a few women were saying, Well, actually, and around the address, see a woman about this, Um so she set up her own hospital, the Elizabeth Carrot Understand Hospital, which still exists today on Houston Road in in London. Um, it's it's not used as a hospital anymore. I think it is used more. His office is, but it's good that the building is still standing. So she was working in in this hospital, and it was a hospital looking after women's health and child health. And then in 18 76 finally, the gyms, he said. Okay, men and women allowed to do the licensing exam. And then, in 1917, there were quite a few medical women that were coming through. And, of course, we were in the midst off the first World War. Onda women were well, medical women were doing quite a lot, so they were taking over their husbands practices. Um, quite a few of the medical men were, of course, going and being doctors in the Army. Women weren't allowed to officially be doctors in the Army, but they were still going and doing their bit. And so they had formed these pockets, called the Associations of of Medical Women in different areas of the country. But in 1917, they decided that actually, it would be good to help a national organization. Making sure that we're doing are bits to look after everybody at home during the war. So on the first of February 1917, group of thumb founded Medical Woman's Federation. At that time, they had about 190 members, and I think it's important to think about what things were like in society at that time, too. Understand what kind of things they were doing, what issues they were up against. So in 1917, as as I said, you know, we're in the midst of the first world well, and women weren't allowed to vote at that time. It was only in 1918 that women over 30 with the property were allowed to vote. So suffrage waas really closely linked to the initial beginnings off the Medical Woman's Federation. And that's why even today all of our branding, as you can see here, is still purple because it's it's intramuscular, the early roots of the organization on the suffragettes. So when they were formed in 1917 of the main things that they were tackling on that time was equal pay for men and women, birth control, nutrition for the whole population, assaults that were happening on, you know, people and menopause. It's really interesting looking at that, because if you fast forward 105 years to 2022 on Bill, go, go going to talk about this. But later on, we're still fighting a lot of thesafeside things. Today. We haven't We haven't resolved these issues. So in 2017, it was the Centenary year of Medical Women's Federation. On by 2019, the jams the register had reached 300,000. Sorry, who? The perils of having a cold and cough and giving a talk at the same time. Eso the GMC registered by this time was 300,000. I'm almost half of the register with men and women, but now if you look at the data, there's there's more women doctors, then's the male doctors. So in 2022. As I was saying, We're still facing quite a lot, just moved. So obviously we're still facing quite a lot of the same issues that they were facing in 1917, which is a little bit sad, really, either in 105 years with no completely got rid of these issues. So don't worry about reading. One of these is another. Quite small. But first thing is the top one is something that I've taken from the British Medical Associations Review on Sexism in Medicine, which, actually one of my colleagues in the Medical Woman's Federation Doctor Chelsea, do it. Who is a MENSA mention mention registrar. She she was the one that kind of started off this work that then the B m e took over asshole national service. So they did a survey to try and find out about everyday sexism in medicine. How bad is that? How much does exist? Um, there's quite a bit about sexism from patients. So, you know, assuming that a male doctor was gonna be better at doing a colonoscopy than a female doctor or assuming that the man was a doctor on did the woman was a nurse. Um, but what I found really sad was looking through and seeing the differences in treatment from cleans. Quite a few testimonials from from women Consultants. But this one particularly struck me. So a woman consultant said when reviewing a patient on another team's ward, the mail consultant from the other team approach the mail. Shor i I After we'd entered the walked the mail consultant didn't look at me or even turn his head in my direction When talking to us, you spoke directly to the S H O, even though he knew that I was the consultant. Continue to ignore me even when message Oh pointed to me and said that I was consulted. So this isn't just patients assuming that your woman see redness and his amount, So he's in charge. This is doctors assuming that of other doctors, or even when they know that the woman is the consultant. They're still just looking at, um, elicit So which it seems a bit strange for 2022. Um, and unfortunately, there is still agenda pay gap in in medicine. So in England, I'm sorry. I do actually have the data for Scotland in the in the report. It highlighted England's I've just taken that here. Women Hospital Looked is an 18.9% less than men on women GPS then, on average, 15.3% less than men and with clinical academics, women and 11.9% less than men. And this is almost higher than the average in society if you look at other sectors. So the gender pig exists across all sectors, not just in medicine, but it's about 11% in other sectors, whereas here were saying that hospital doctors it's 18.9% which is significantly higher. So clearly there's something that needs to be done about that. Um, and of course, I'm sure you'll have come across in the last few months. They have Bean. Quite a few reports in in the news about a horrible experience is that women trainees have had sorry okay, story that women trainings have had, particularly in surgery, and it's incredibly incredibly brave of these women to be speaking up about their experiences. But when you read three some of the experiences that they've had that women who went out consultants, but well, there were a trainee. They had consultants being completely inappropriate and harassing them on D. Um you know, when they said no, I don't consent to this. They were told. Well, I'm gonna make things very difficult for you because I'm your clinical director. Um, I am going to write to people and say that you're about trainee, um, and then when you read through it, what's really difficult is that nobody around them has has known how to support them because they're worried about their own careers. So it shows that there's still a lot of things that that we need to change. We need to change the culture from being over. That's just what happens to you to know we don't tolerate that here. We need to make sure that people are getting paid the same for the same work that they do. Um, Andi, you know, I guess it's more of a societal still thing that still, if you ask people to close your eyes and imagine a doctor, most of them will imagine a male doctor, even though there are quite a lot of women doctors around, and it still happens every day on the world. So the other week, when I was doing a wardrobe. Um, I had a bright yellow lanyard, said ST three plus doctor On it. I introduced myself as doctor Anathema Onda. Um, I'm still the parent was saying, Oh, so is the doctor going to come and see me today so clearly, my bright yellow lanyard didn't quite identified that I was a doctor. So there's still lots of issues that we're facing that we need to tackle so that we get a more call society on. You know, a lot of the times things get labeled as women's issues that you know will like maternity leave and flexible working and sexism in on things that get labeled as women's issues. But they're not women's issues, the societal issues. Everybody benefits for a more equal society and definitely, you know, being a feminist of being in the Medical Woman's Federation it's know about or we want to work against men. It's about working with men and with allies. It's about everybody working together to make things better and equal for everybody, because ultimately we want services that treat our male and female patients equally Onda. The only way that will get that is if we actually treat doctors equally as well. So in terms off the Medical Women's Federation on what we do at the moment, we're tackling the gender pay gap on the gender pension gap. Unfortunately, in all sectors, including Medicine Cove, it has significantly impacted women more than men s. So when when we were in, although lockdowns women were women doctors compared with male doctors, even if both husband and wife were doctors, women doctors were more likely to be trying to juggle doing their work on be managing everything at home and looking after the Children when they were home schooling and all of those things as well. So that has impacted their careers, particularly with academics, and that's significantly impacted women women's careers. The round gaps in if you look at senior leadership was, I said before, and when you look at a conference because and conference panels there are gaps in the number off women and those were ethnic minorities that get us to come and be on the conference panels. Unfortunately, we still have conferences that have models, all male panels. Um, there's several organizations that trying to do work. Teo, get away from that. Um and you know, we still, we're still don't understand menopause. There's still lots about it, but we don't understand. There's not much research about it. We don't get talk much about a medical school. I graduated six years ago, and we weren't really talk anything but menopause at medical school. I'm speaking to medical students now. They don't really get much teaching about it, so there's still lots of disparities in the way that were training doctors. So then we've got to change lots of things to make sure that things are really cual I'm on the future depends, of course, on what all of us do now on. You know, you are a lot of medical students and the new doctors. So you know, we are the future off the NHS and off medicine. So it's important that we tackle everyday sexism because otherwise it's it's not gonna go away, and we really need to support women who have had these horrible experiences of being harassed and assaulted. We've got to have a culture where it's safe for for them to come forward, and it's safe for their colleagues to support them without people worrying that there then going to end up losing their job when we went to cultivate a culture where it's we don't accept that here, that's not done it rather than Oh, well, that's just how it's I'm We need to get rid of the gender pay gap because it doesn't serve anyone on tackling gender stereotypes and wider society. So generally the way that we have things, you know, maternity leave is 12 months. Paternity leave is two weeks. So of course, we're expecting that a woman is gonna be doing all the child cat. And obviously some of it has to be that way in the sense that a woman is able to breastfeed and you know, a father isn't. But we could still have better parent to leave policies. And two of my colleagues at the Medical Woman's Federation are running a campaign on this at the moment that it that benefits father's a swell as much others. And it benefits work places because then you don't just have women out the workplace for 12 months and then be out of sight and out of mind. And we're also doing research on gender inequity. So our president of the moment is Professor Chloe. Okay. In who is very keen to get junior members doing research. So we've got lots of research projects. I'm looking at different aspects of gender inequity, including sexism. Face by medical students um, differences in pain experienced by women and men and held us manage differently. Onda menopause education at medical schools are just a few examples, and it's really important that we work with allies across collaborate so where developing links with other organizations who are also trying to improve things and make things more equal. And so that was everything that I that I wanted to say. So I guess my main take home are. But, um, we've come a long way since since Babylonian times where a woman's life was worth half of that As a man's. I we've still got a way to go to make sure that things are more equal on depends on all of us now, regardless off your gender, I'm gender equality and, you know, supporting men and women in medicine is is everybody's issue. It's not a woman's issue on. We've all got duty to do our bit to make things more equal so that in another 100 years, when people look back, They'll be thinking, Oh, okay. Yeah, they they did something. They got rid of agenda pay gap. They made things better and they paved the way so that things do get better in the future. And if you are interested in joining the medical means Federation, we would absolutely love to have you. I'm really sorry. We're only allowed because of our Constitution. You do actually have to be a woman to join. But we do have male on a remembers for for men who are who are particularly good allies. So if you're interested, please do look a joining the McCormack's Federation followers on social Media. We have various conferences and competitions on D. In February 2022 to celebrate 105 years off the medical industry duration, I launched a podcast called Medical Women Podcast, which is free to listen to. Anyone can listen to him. It's, you know, a move. Gas is to help support and empower medical women in their Korea's. But we covered lots of different things, from leadership to money to help to negotiate how Teo speak up and feel confident speaking up and using your voice. And this week it's Mother's day. So this week's episode is about motherhood. But but it's about being among toe ourselves rather than being 12 Children, because lots of our last lots of our members do have have Children and our mothers. Lots of members are mothers, and I wanted it to be relevant. Everybody s oh, definitely have a listen to the podcast followers on social media. Thank you very much for listening and for inviting me to come and speak of the conference that I said, I'm really sorry that I couldn't be with you live virtually or in person. And I hope you enjoy the rest off the conference. Just get get in touch if you have any questions and would like Teo be in touch with me, Thank you very much.