Despite the growing number of women in medical academia, there is still a long way to go before gender equity is achieved. Karen Burns gives advice to those women who are trying to make their way

Although the number of women that have been entering into medicine has increased over the past five decades, [1-3] progress in gender parity lags behind with fewer women in prestigious positions, [4-6]  leadership roles, [7] or promoted to the highest academic ranks. [8,9] Recent studies have shed light on the perceived drivers and implications, personal and professional, of gender inequity in medicine [10-13] and the need for strategies to address these inequities. [13-15]

At present, practising women physicians and women entering academic medicine have few resources to help them navigate academic medicine. Although experience is a great teacher, it is an inefficient and challenging way for women academics to understand the intangible realities of academic work culture. Through personal reflection, I compiled a list of 10 things that I wish I had known earlier in my academic career and insights on how I would respond to them today. 

Firstly, understand that being a woman is an impediment to career development in academic medicine today. Invest your time and energy in moving beyond this reality. Accept that work culture will change slowly but may not change during your career. Work to ensure that circumstances will be different in the future. 

Secondly, realise that you may have to work harder as a woman for the same (or less) recognition. Recognise that even though you may be acknowledged as an expert nationally and internationally, your expertise may not be recognised locally. Know that your expertise will eventually be known through your scholarly contributions and reputation as a scientist. 

Thirdly, find time to write. Manage your own calendar. Protect your time. Find magnanimous ways to say “no” to opportunities and commitments that will distract from your personal goals and career aspirations. Find a quiet place, away from interruptions and distractions, to “get lost” in your writing. Be productive.  

Fourth, treasure colleagues who are wise, compassionate, and guided by integrity. Espouse these qualities in your work and search for them in your collaborators, mentors, and leaders. 

Fifth, know that not all accomplished women in academic medicine are good role models. Appreciate that not all women are willing to share their experiences and wisdom. Do not ask them for something that they are not willing or able to give to you. Be inspired by remarkable women! Be generous with your junior colleagues, especially junior women colleagues.

Sixth, recognise that some individuals have unfair advantages or privileges (the “haves”) and others do not (the “have nots”). Concede that opportunities come easier for some individuals. Identify privilege and look beyond it. Motivate yourself to succeed despite these inequities.

Seventh, anticipate that some individuals may doubt your knowledge, expertise, and ability simply because you are woman. Acknowledge that you may not be considered to be “equal” to comparable men colleagues. Individuals may assume that you are not a physician simply because you are a woman. Educate others that doctors looks like you. Be proud of who you are and what you have endured to be in your current position. Share your personal stories!

Eighth, accept that conflict is an inevitable part of academic life. Reflect before you respond. Contemplate your options. Focus your attention on identifying key facts and issues. Propose solutions. 

Ninth, acknowledge that it is much easier for individuals in leadership positions to lend verbal support to matters of equity, diversity, and inclusion than to take action to address imbalances. Recognise that some individuals benefit from maintaining the “status quo.” Advocate for change. Be guided by your moral compass.

Ten, expect change to occur slowly. Appreciate that change is inherently uncomfortable. Know that most individuals resist change. Work to facilitate change. 

Visible and invisible features of organisational culture affect women and men differently and contribute, in part, to differences in their academic experiences. [16] Although progress has been made, there is still a great deal of work to be done to address existing inequities and the adverse consequences that have arisen from them. While we advocate for change and await strategies to improve the experiences and outcomes of women in academic medicine, we can share our experiences, reflections, and coping strategies.

Karen E A Burns is an associate professor and clinician scientist at the Department of Medicine, Division of Critical Care, St. Michael’s Hospital and the Li Ka Shing Knowledge Institute. She holds a medical degree from the University of Western Ontario, London, Ontario; completed residencies in internal medicine, respirology, and critical care medicine (Royal College of Physicians of Canada); and holds a masters degree in clinical epidemiology from McMaster University, Hamilton, Canada. 

Competing interests: None declared.

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