IWD 2022: Beating a better path for the medical women that follow me by Chloe Orkin

I am the 80th President of the Medical Women’s Federation (MWF), the organisation that has been the voice of medical women in the UK for 105 years. The organisation’s history is inextricably intertwined with the history of suffrage in the UK. MWF has a proud and consistent history of effective activism, feminism, and mentorship. On International Women’s Day I reflect on my own efforts to beat a better path for the women that follow me and ask myself the question: what more I could do?

Recently I listened to the first MWF podcast in which Sophie Almond speaks about her PhD thesis on the history of MWF. The history is scarily current. The penny quickly dropped that we are still grappling with many of the same fundamental issues that caused ten women to meet in a tavern and establish the organisation 105 years ago. To name a few: equal pay (aka the gender pay-gap), women being under-represented in certain medical fields, the effects of menopause on senior women’s careers and the expectation that care work should be the unpaid work of women.

The episode also describes MWF’s first contribution to research – qualitative research about a gendered societal issue. The prevailing norm at the time was that women could not be in the workplace or at school during menses because they were thought to be too incapacitated to function. The MWF researcher decided to interview schoolgirls and allow them to narrate their own experience of being at school during their menses. Interestingly, more qualitative research is done by women even now.

Women are under-represented in academia. This means that there are fewer female researchers to ask these qualitative questions and fewer answers. Qualitative research is less likely to be published in the highest impact journals, further compounding the gender inequities in terms of academic progression and achievement. Racially minoritised, LGBT+ and disabled people also pose ‘why’ questions that seek to explain inequities. Increasing diversity of researchers expands our horizons.

I am the Academic Lead for Equality Diversity and Inclusion (EDI) for the Faculty of Medicine at QMUL. EDI work aims to ‘fail-safe’ processes so that they are hard-wired for inclusion. This is important because even well-meaning people who really want things to be equitable are still affected by implicit biases. Only by reforming our processes can we ever truly protect ourselves and each other from the effects of our biases. Some of this work involves carefully scrutinising processes involving selection, recruitment, promotion, appraisal and induction. We also need to pay attention to the content of our medical curricula and how we teach them.  Scenario-based teaching can casually and repetitively inculcate biases into our students by reinforcing gender and racial norms. Picture Prof John Smith the famous Consultant kindly explaining a disease of poverty to his patient Mrs Mabel Akyeampong, the cleaner. Sound familiar?

First and foremost, I am a clinical researcher. I focus on viral drug development and have delivered many clinical trials including leading the first long-acting therapy trial in HIV therapy. This has led me to the podium and in turn onto international conference committees. I relish these huge opportunities to reconceive how we include and appoint speakers, panellists, core committee members. It’s important to realise that the first person who comes to mind may not be the best or the only person who can do the job well. They may just be the person that other people have thought of and asked repeatedly.

I direct the SHARE Research collaborative based at QMUL which focuses on health equity in HIV, viral hepatitis, COVID-19 and sexual health. The research team is representative of the diverse community we serve in terms of ethnicity, race, gender and sexuality. An area of special interest for me is how to protect women of child-bearing age, pregnant women and breastfeeding women through and not from research. This means understanding that women are not vessels of procreation, that maternal health is essential for good foetal health as described in this Lancet HIV opinion piece and in another Lancet HIV commentary out today for IWD nearly two years on.

For me things have come full circle, my gender work for MWF now intersects directly with my academic work at QMUL. SHARE Research academics have been working with junior MWF members who are developing their own research questions much like the early medical women did. Some of their questions focus on sexism:  at conferences, for medical students, junior doctors and for academics during COVID-19. Other projects focus on the treatment of women who experience gynaecological pain, or on menopause and the medical curriculum. We aim to help them frame their research questions, analyse and publish their work. We aim to help the next generation of medical women to find their voices and to amplify them.

In my recent  MWF Podcast on leadership , ably hosted by MWF VP Dr Nuthana Bhayankaram, I shared my personal experiences of leadership and described some of the social science behind terms such as the broken rung, the glass ceiling, the glass slipper, the glass cliff and how to navigate these many leadership perils.

Speaking up honestly about what it is like today to be a woman in a leadership position is important. My younger MWF colleagues have taught me the importance of role models. That’s why, when asked,  I continue to provide LGBT+ role model profiles internally and externally for institutions such as the RCP #thisdoctorcan series touching on my own intersectionality.

Today I am co-chairing an MWF IWD event together with fellow QMUL Professor Jane Anderson, the second female Master of the Worshipful Society of Apothecaries in 400 years. We will be discussing the safety of women in cities. An important topic and another reason that IWD remains relevant to all women.  No matter what we create, invent, or lead we are still women and must clutch our keys tightly when we walk down a dark street.

Professor Chloe Orkin 

Chloe Orkin is Professor of HIV Medicine at Queen Mary University of London and Consultant Physician at Barts Health NHS Trust where she has led the HIV clinical trials unit for the past 18 years. She has delivered more than 60 clinical trials of novel anti-viral agents to treat HIV, hepatitis C and SARS-CoV-2 thereby contributing to the licensing of 22 drugs. She is the global lead author for the first-ever long-acting injectable HIV therapy. Equity and justice are at the core of her academic and advocacy work. She directs the QMUL-based  SHARE research collaborative for health equity. Chloe is Academic Lead for Equality Diversity and Inclusion  at her medical school. Chloe is the 80th President of the Medical Women’s Federation (MWF), an organisation which has represented the views of medical women in the UK on medical issues for the past 105 years. The organisation was closely aligned to suffrage has a proud history of effective advocacy on gender issues.  She has recently recorded an MWF Podcast on leadership. She is immediate past Chair of the British HIV Association and a member of the governing council for the International AIDS Society .

Declaration of interests

I have received honoraria for educational lectures, travel scholarships to conferences and advisory boards from Gilead Sciences, MSD, Gilead Sciences, Janssen Pharmaceuticals and Viiv Healthcare. I have received research grants to my institution from Gilead Sciences, MSD, Gilead Sciences , Janssen Pharmaceuticals, Astra Zeneca and Viiv Healthcare.

 

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