The lack of female representation in healthcare continues to persist, but change is coming
Imagine surfing a 68 foot wave. The height of four double decker buses. Maya Gabeira entered the record books with this feat in 2018—the first Guinness World Record for the biggest wave surfed by a woman. Gabeira also holds the world’s first “World Surf League Womens XXL Biggest Wave Award”. Why was 2018 the first time a women received this accolade? Because “surfing has the reputation of being one of the most sexist sport’s on the planet” Sabrina Brennan, Califorian politician told The Sunday Times. For so long the masochism of surfing and the patriarchal structure it created has stopped women surfers competing. “It’s too dangerous”, “women just aren’t built for big wave surfing”, “it’s life and death out there.” Misogyny wrapped in the veneer of protection.
The Committee for Equality in Women’s surfing (CEWS), created by Brennan and some female surfers fed up with the status quo, helped to get women competing in big wave surfing, and earn equal pay. Gabeira still isn’t sure of any difference however—“people aren’t allowed to speak badly about women anymore. But do you [remove] that feeling out of society? No you just censor people. Sexism just takes different forms. It is generally men, after all, who have the power to hire you, give you an award, or include you in a contest.”
This quote is not just applicable to the surfing world. This story is being told and re-told across many industries where men have been the dominating gender for generations. I recently attended a conference where out of the 66 audience facing opportunities (keynote speakers, panelists, and chairs) only nine were women. Four were BAME. It doesn’t matter what speciality or type of conference this was, it’s happening across too many of them. The manel (a term coined for the all male panel) is far too often seen at conferences. It has spawned numerous #manelwatch twitter pages and much outrage. It’s depressing. And embarrassing. For the last 17 years, more women have entered medical school than men so why does this speaker imbalance still exist?
I asked one of the conference organisers who replied; yes we are aware of the imbalance, but it’s a reflection of the makeup of our leadership/senior clinicians, and it’s difficult.
He’s not wrong.
Women make up less than one quarter of hospital trust medical directors, 13% of clinical professors at universities, 27% of head of institutes in higher education, and 36% of hospital consultants.
When it comes to conference presentations, the results are no better. One paper looking at intensive care medicine congresses, from three continents, found female faculty members to be 6%, 15%, 25% and 35% respectively across the four main congress meetings. In Canada, when the proportion of Grand Rounds across five major Canadian academic centres were assessed—they looked at the standard of “at least one” female speaker.
“At least one!” The result from 1296 rounds between 2011 to 2015 was 42%.
Why does representation matter? The blindingly obvious answer is: because when half the population is female, but is not being seen in the same proportion in positions of authority, we will continue to be perceived as inferior and “less than.” We are wasting “half our genetic pool of intelligence, creativity and experience.” “Until we are truly equal, we are all diminished.”
But do not despair dear reader. A change, it is a comin’.
If we are to look at the trend over time, there is an increase in the proportion of women speakers at conferences. While still an underrepresentation, it is increasing.
Perhaps the biggest change of all is that the discussion is taking place. So much so, that like CEWS, myself and four colleagues set up an initiative to address this very problem. “Women Speakers in Healthcare” aims to make finding women speakers easy.
We have created a database of women speakers, from all professional backgrounds within healthcare, to help eliminate the reported “difficulty” of finding women speakers. To support those who are less confident at putting themselves forward, we ask for nominees when you sign up. Male allies, you too can sign up, show your support, nominate speakers, and spread the word. Much like Brennan, we aim to help lift each other up and change the status quo.
Ultimately, we want our organisation to be completely redundant one day. A day when all conferences have diverse representation across all domains including gender, ethnicity, and sexuality. When the leaders of our healthcare systems, education systems, and political systems represent the diverse and disparate backgrounds, population and workforce they serve.
This day will come. It’s not here yet. But perhaps it will be. Tomorrow.
If you would like to sign up please head to www.wsih.co.uk or follow us at @womenspeakershc on twitter.
Greta McLachlan, is a general surgical trainee currently working as the editorial registrar of The BMJ.
Rose Penfold, is a Clinical fellow to the national medical director working at NHS England.
Katie Knight, is a paediatric emergency medicine registrar, National Medical Director’s Clinical Fellow at Health Education England, and Founder/Lead Editor, paediatricFOAM.com Twitter: @_katieknight_
Nada Al- Hadithy, is a Plastic Surgery Registrar and National Medical Director’s Clinical Leadership Fellow working at the Department of Health (DHSC).
Lucia Magee, is a GP Trainee & National Medical Directors Clinical Fellow at NHS England.
Competing Interests: All five authors are founding members of Women Speakers in Healthcare.