I have been very fortunate to grow up in a world surrounded by incredible women. Whether it has been family members, friends, through my education, or my working world, I have never been short of women role-models to provide tangible guidance, inspiration and hope for my own future. As a child, these women helped cultivate a belief for me that the world was my oyster; they helped me to feel strong, independent and determined, leading me to believe I could be whatever I wanted to be when I grew up and that being a woman was advantageous. My feelings were personified in Helen Reddy’s lyrics “I am woman, hear me roar”- the song which was the official anthem of 1975, the year the United Nations declared ‘International Woman’s Year’ and the convening of the first world conference of the status of women, held in Mexico City.The objectives of the conference as set by the General Assembly were:
- Full gender equality and elimination of gender discrimination;
- The integration and full participation of women in development;
- An increased contribution by women towards strengthening world peace.
We all know how women have struggled for equal rights for many centuries. My youthful, rightful sense of entitlement to a life full of opportunities, on an equal playing field to men, is thanks to centuries of hard work and successful battles fought by many amazing women activists. I am very aware that I have been extremely fortunate to have had this real-life support, cushioning me throughout my development and that this is by no means a universal experience for women of my generation and generations to come.
With the rise of the digital age, we have greater exposure and access to local, national and international exemplary women to be our role models, and platforms that allow us to continue the legacy of past women activists, such as social movement campaigns. Hopefully, women out there who do not have direct access to a network of strong women, can now self-cultivate an individualised support network through these social medial channels. But there is much work left to be done for the three objectives to be fully met. The World Economic Forum Global Gender Gap Report 2020 stated it could take as long as a further 257 years to close the global gender gap.
International Women’s Day 2022 theme is #BreakTheBias. I believe one of the greatest challenges we face as women is gender bias. Sometimes it can be relatively benign, but other times it can be malignant with damning impacts. Despite my youthful optimism that my gender would only benefit my life choices, gender bias is something that I have experienced throughout my adult life and NHS career. As a first year medical student sat in one of my first ever university lectures, surrounded by approximately 400 other eager students (coincidentally a greater proprotion of female to male students in the room), I was stunned when a female lecturer took to centre stage and declared that 90% of us would one day be a General Practioner (GP). I remember thinking, ‘how can someone who doesn’t know me, pigeon-hole my career choice and narrow my options? Is that comment directed to all the female students in the room?’. I was once told by a cardiology consultant that I would make a good cardiologist. When I asked why, he replied that it was because I was female and they needed more female cardiologists to join the club, nothing to do with my cardiology knowledge, experience or clinical skills. I have lost count of the number of times that I have been referred to as a ‘nurse’ by patients, despite using my standard introduction line of ‘Hello, I am Emma and I am the doctor looking after you today’. More often than not, the ‘nurse’ name calling happens oppurtunistcally when walking past the bed for another reason such as picking up a drug chart, when a patient needs assistant like using the commode – I am not aware of this ever happening to my male colleagues.
It is important to note that I hold both GP and nursing careers in very high esteem. Having grown up with a mother who works as a GP, I was in awe of this career path, and my nursing colleagues really are vital pillars to the NHS; I could not do my job without working synergistcailly with them. The problem lies in the assumptions that are made – both conscious and unconscious bias. Often, bias is not meant to be malicious and there are other factors at play, for example, with almost all NHS staff wearing scrubs during the pandemic, it made it very difficult for both staff and patients to ascertain who is who in the clinical environment. Harro’s 1982 model of the cycle of socialisation helps to understand the social, cultural and institutional factors that influence how we see and behave in the world. When we are born, we are born without bias, assumptions or questions but we are immediately socialised by those around us as to what their expectations, norms and values are. This is then followed by conscious and unconscious shaping of our views and beliefs by insititutions and cultures we are exposed to such as school, religious places and work. All of which is enforced through reward or punishment which ulimately leads to oppression and at the core of all of this, fear, misunderstanding, insecurity and confusion.
My experiences of gender bias have not been damaging, but have taught me how to push back on gender bias and inequality in the workplace. As a Junior Doctor on a leadership scheme, I am learning about the different leadership styles, what attributes make a good leader in the NHS and deciphering what my own core values are and consquently the type of person I want to be, both at work and at home. The NHS Leadership Academy have developed a Healthcare Leadership Model, which is composed of nine dimensions of leadership behaviour, with one of those nine being ‘Leading with Care’. Leading with care is needed for us to breakdown some of the institutional and cultural socialistions recognised in Harro’s model that contribute to gender bias in the NHS. I hope one day to be a leader who can recognise my own unconscious biases in the workplace, continue to be educated and re-evaulate situations to avoid bias and empower my fellow women colleagues so that all women, and all men, feel that they can roar Reddy’s lyrics –
“If I have to, I can do anything
I am strong – strong,
I am invincible – invincible,
I am woman”
Dr Emma Hadley
Dr Emma Hadley is a Geriatric and General Medical Registrar, working across Kent, Surrey and Sussex Deanery. Having undertaken leadership roles within local NHS trusts and participation in local quality improvement projects, Emma applied to the Faculty of Medical Leadership and Management (FMLM) National Medical Directors Clinical Fellow Scheme to continue to develop her leadership and management skills as well as to gain a deeper understanding and appreciation of change management within the NHS at a national level. Emma has a particular interest in the wellbeing and morale of the workforce, which has been at the centre of many of her previous QI projects and Emma feels incredibly privileged to have been placed within the Health Inequalities Team at NHS England. Emma hopes that she can bring both her medical and clinical leadership skills to the team, her holistic approach to addressing tasks and her passion for contributing to positive change, now with a new health inequalities lens. Emma hopes to be an ambassador for the Health Inequalities Team, networking within NHSEI and liaising with the FMLM fellows across other organisations to align the health inequalities work being done nationally.
Declaration of interests
I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: none.