{"id":49279,"date":"2020-12-22T16:21:57","date_gmt":"2020-12-22T15:21:57","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=49279"},"modified":"2021-01-05T15:21:53","modified_gmt":"2021-01-05T14:21:53","slug":"clare-marx-outdated-career-ideals-stifle-medical-women-and-hurt-us-all","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/12\/22\/clare-marx-outdated-career-ideals-stifle-medical-women-and-hurt-us-all\/","title":{"rendered":"Clare Marx: Outdated career ideals stifle medical women and hurt us all"},"content":{"rendered":"<p><span style=\"font-weight: 400\">It was my pleasure to welcome five brilliant women to the GMC\u2019s council this month.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">From ethical leadership to immersive technologies, the expertise they bring with them is testament to the profound impact of women in public life. They\u2019ll fill the seats of five other trailblazing women who have left a wonderful legacy.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">The success and standing of these women is also a sign of how things have moved on. When I qualified as a doctor 43 years ago, such representation seemed like an impossible dream.<\/span><\/p>\n<p><span style=\"font-weight: 400\">I have been extremely fortunate to have had inspirational teachers, mentors, and role models throughout my career, all of them men. But I\u2019ve also seen poorly disguised undermining and sexism masquerading as \u201cjoking.\u201d I\u2019ve been in roles where people questioned if I was \u201cstrong enough\u201d or \u201chad big enough hands\u201d to be an orthopaedic surgeon. Or when I planned to \u201cleave the playing field to the boys.\u201d Even passing my surgeons exam was met with a degree of disbelief. \u201cOh my God we\u2019ll have to take you seriously now\u201d was one memorable response.<\/span><\/p>\n<p><span style=\"font-weight: 400\">I thought it would stop as I got more senior, but I think it\u2019s actually become more blatant, even as the medical landscape has become more diverse.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">At a glance, the numbers look good. Women make up a greater proportion of licensed doctors than ever before at 48%, according to this year\u2019s <\/span><a href=\"https:\/\/www.gmc-uk.org\/-\/media\/documents\/somep-2020_pdf-84684244.pdf?la=en&amp;hash=F68243A899E21859AB1D31866CC54A0119E60291\"><i><span style=\"font-weight: 400\">State of medical education and practice in the UK<\/span><\/i><\/a><span style=\"font-weight: 400\">. And in the past few years, there have been higher numbers of female students attending medical school<\/span><span style=\"font-weight: 400\">.<\/span><\/p>\n<p><span style=\"font-weight: 400\">But put the profession under a microscope, pay is as good a place to start as anywhere, and you\u2019ll find disparities glaring.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">The Independent Review into Gender Pay Gaps in Medicine in England, chaired by Dame Jane Dacre and <a href=\"https:\/\/www.bmj.com\/content\/371\/bmj.m4904\">published last week, identified a pay gap<\/a> of 24.4% for hospital doctors, 33.5% for GPs, and 21.4% for clinical academics<\/span><span style=\"font-weight: 400\">.<\/span><\/p>\n<p><span style=\"font-weight: 400\">In my specialty, representation is improving at a glacial pace, with the ratio of male to female consultant surgeons still about 8:1<\/span><span style=\"font-weight: 400\">.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The pipeline of female talent has never been healthier, so why isn\u2019t this translating into genuine parity in medicine?<\/span><\/p>\n<p><span style=\"font-weight: 400\">It\u2019s complicated, but a few issues come to mind.<\/span><\/p>\n<p><span style=\"font-weight: 400\">For one, society and workplaces are still set up around old-fashioned assumptions and rigid structures. The premise that the mother should be the first contact for the nursery when there is an issue rather than the father, for example.<\/span><\/p>\n<p><span style=\"font-weight: 400\">But this isn\u2019t what the doctors of today say they want\u2014neither men nor women. One in five doctors reduced their hours last year, work\/life balance being an important factor for both sexes<\/span><span style=\"font-weight: 400\">. Meanwhile, there are signs that doctors also want more flexible training pathways\u2014the number of doctors pausing training after Foundation Year 2 is higher than ever before<\/span><span style=\"font-weight: 400\">.<\/span><\/p>\n<p><span style=\"font-weight: 400\">In short, this is still a service model designed for a predominantly male workforce. While there is now no shortage of women in medicine, the workplaces they enter haven\u2019t adapted.<\/span><\/p>\n<p><span style=\"font-weight: 400\">And let\u2019s look at those later in their careers. A BMA survey this year illustrated the issues perfectly. 90% of respondents said symptoms of the menopause had impacted their working lives. But the majority were not receiving any support from their employer to make their symptoms more manageable, running the risk that they would leave the profession altogether<\/span><span style=\"font-weight: 400\">. At a time when there is already a shortage of senior doctors, losing this talent would be a profound waste.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Luckily, there is an antidote\u2014enabling fair, inclusive cultures that help everyone to work at the top of their game.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Today\u2019s doctors have diverse needs, and to get the best out of them training programmes, assessment methods and timings, and the workplace should accommodate those needs. That means listening, showing compassion, being flexible, and being open about balancing the needs of the individuals and the needs of the service.<\/span><\/p>\n<p><span style=\"font-weight: 400\">This is not only in the interests of the doctors themselves, but also their patients. As a <\/span><a href=\"https:\/\/www.gmc-uk.org\/-\/media\/documents\/caring-for-doctors-caring-for-patients_pdf-80706341.pdf\"><span style=\"font-weight: 400\">recent report<\/span><\/a><span style=\"font-weight: 400\"> for the GMC by Michael West and the late Dame Denise Coia showed, doctors that work in supportive environments deliver better care. Where working environments are inflexible or cliquey, patient care is compromised.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Inequality is insidious. Throughout my career as a surgeon, I\u2019ve seen it take many forms. Sometimes it\u2019s as ostentatious as a sexist slur or a hand on the knee. But most of the time, it creeps quietly into our professional lives, undermining confidence and the care we provide. That\u2019s why combatting inequality of any kind is not a distraction from delivering first class care. It\u2019s an essential part of it.\u00a0<\/span><\/p>\n<p><i><span style=\"font-weight: 400\"><strong>Clare Marx<\/strong> became the General Medical Council\u2019s first female Chair in 2019. Prior to this she was Chair of Faculty of Medical Leadership and Management (November 2017-18) and President of the Royal College of Surgeons of England (2014-17).<\/span><\/i><\/p>\n<p><em><span style=\"font-weight: 400\"><strong>Competing interests<\/strong>: none declared.<\/span><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>It was my pleasure to welcome five brilliant women to the GMC\u2019s council this month.\u00a0 From ethical leadership to immersive technologies, the expertise they bring with them is testament to [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/12\/22\/clare-marx-outdated-career-ideals-stifle-medical-women-and-hurt-us-all\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":66,"featured_media":49195,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[236],"tags":[],"class_list":["post-49279","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nhs"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - 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