The covid-19 pandemic has made all working people reassess their priorities and purpose, and for many these have now changed. This is particularly true for people in caring roles, and for many it is also about their own mental health and wellbeing.

I am an NHS doctor and researcher working in an Asian country with a less robust health system than the UK. In January 2020, during the evolving covid-19 outbreak, my three-year-old daughter became extremely acutely unwell and was admitted to intensive care. I rarely pray, but I prayed many times and would have given up every shred of status, skill and reputation for her to pull through. She did, and I continue to work in the same capacity as before her illness. However, I now question my purpose more, particularly when it conflicts with my life priorities.

Recent work highlighted that as the global community tackles covid-19, “the productivity and scientific output of female academics are disproportionately affected, leading to loss of women’s scientific expertise from the public realm.” Specifically, it observed a significantly lower proportion of women as first author on research published in major medical journals.

Systemic discrimination against women in academia has been long observed in many traditionally male-dominated, hierarchal institutions. The covid-19 academic agenda and rush to publish has brought this issue more attention. The academic publishing system originated in a colonial, male-dominated era and needs to be revised. Specifically, women from ethnic minorities who trained in non-Western countries are under-represented in UK research.

Perhaps it is time to reassess the hierarchal, competitive systems of academia, driven by institutional prestige, first authorship and impact factor journal publication. Is this how we want career trajectory to be determined? Are those who don’t publish in high-impact journals, or are not first author, less academically valuable? 

A recent perspective highlighted the importance of luck and opportunity in achieving academic success and how ‘the way in which success in academia is measured does not work’. Research grant success often relates to publication in high impact factor journals but does this always reflect how relevant and meaningful the work is for translation to health improvement or public benefit?

Discrimination in the workforce undermines women, ethnic minorities, LGBTQ+ communities and those with disabilities, and prevents equitable representation. These groups may be subject to less opportunity from the outset.  For this to change, we need structural, systemic change and an intersectional lens to understand the inequalities faced. Importantly we need to reduce toxic masculinity, improve opportunities and education globally for marginalised and deprived groups, girls and women, and extend talent and promote leadership among marginalised groups.

But we also need cultural and social change to celebrate people who prioritise or believe their purpose is to care for children, and people in supportive roles who don’t necessarily seek the limelight but are equally valuable to society. 

Change requires reassessing who and what roles are deemed valuable in society. What are the messages regarding the value and worth of being a home carer during the pandemic, whether female or male? Professional women are reportedly taking on more care-related responsibilities than men. Gendered domestic labour, pay inequality and care responsibilities very likely contribute to this. But whoever takes on a caring role should not feel less valued for doing so.

In academic environments we may need to re-think how success and impact is measured and consider how to enable valuable contribution from the breadth and diversity of talent. In academic environments we need men and women’s priorities and goals to be more equally shared and celebrated. This would help to provide the right conditions for fair representation.

Keerti Gedela, is a consultant physician at Chelsea & Westminster NHS Foundation trust, chief investigator UTAMA project, UK-Indonesia Joint Partnership Infectious Diseases and Honorary Senior Clinical Lecturer, Imperial College London. @DrKeertiGedela

Competing interests: None declared.