On the 2nd of June I had the pleasure of attending the inaugural Woman In Surgery Scottish Meeting at the Royal College of Surgeons in Edinburgh. The programme was packed full of enthusiastic and informative speakers – and one of them, Mr Mark Hughes, an ST8 in neurosurgery who I have the privilege to work with at the Western General Hospital in Edinburgh, also happened to be male!
He spoke about broadening the discussion for gender parity in medicine to involve men, as gender disparities and the norms that drive them are as potentially harmful for men as they are for women. Afterwards I asked him a little bit more about being male in medicine, and his thoughts on how we can make things better for everybody by changing social gender-based expectations for men and for women…
The focus of gender in medicine tends to be skewed towards exploring the experiences of female doctors. In what ways do you feel being a male doctor has been an advantage and disadvantage?
‘I don’t think I have perceived much of an advantage, though I am beginning to appreciate areas where perhaps I’ve had fewer frustrations by virtue of being a man. I have never had patients assuming that I’m the nurse, for instance, whereas this is quite common for female doctors and must be frustrating. In applying to become a surgeon, and during training, I was not on the wrong end of any preconceived – and incorrect – gender stereotypes. Again, I don’t think I actually felt the advantage, at the time, because I probably lacked the insight to put myself in the shoes of a women following a similar path. These advantages ought not exist, as they reflect entrenched gender stereotypes. Similarly, I haven’t ever felt disadvantaged by virtue of being male.’
It is critically important for the discussions around gender equity in the workplace, and in society, to involve men as well as women. Where did your interest in the subject come from and have you found it challenging to stand up and call yourself a feminist in public, especially as a neurosurgeon?
‘I completely agree. I think that the conversation about inequality should be move towards highlighting how both sexes miss out due to unhelpful gender stereotypes. In the male dominated world of surgery, highlighting how men are missing out is much more likely to stimulate engagement from the incumbent men! The word feminist alienates some people and arguably has some unhelpful associations. I’m entirely comfortable highlighting gender inequality and if that attracts the label of feminist, that’s just fine. My feeling is that surgery misses out on talent by alienating women. Men and women are diverse and bring different skills and outlooks to the table. A male dominated surgical workforce undoubtedly becomes slightly skewed – arguably this is unhelpful and may not result in the best care of our patients.’
What strategies would you employ to change the norm in surgery and make it a more humanised profession for those in it (and thereby – hopefully – improve gender parity)?
‘My one key intervention would be to adopt a Swedish model of maternity/paternity leave. There, 90 days of leave (out of 480 days paid leave total!) is reserved for either parent: you use it or lose it. This ensures that men take a more significant period of time away. This means that employers ought not to resent one particular sex for taking extended leave. It would also mean that men would be more engaged in issues such as returning to work after parental leave and make the whole caring role less gender-polarised. A major reason for the lack of women in surgery is societal stereotypes, rather than surgeons themselves. These aren’t the fault of the medical profession and it will take several generations for them to be discarded. That said, as a massive employer, the NHS has the power to help accelerate some of these changes in attitudes (e.g. by instigating the suggestion above).’
I think the point Mark makes about emphasising how everyone loses out if we don’t make a commitment to diversity is a really important one, and the concept of compulsory shared parental leave as a driver for change of social norms is provocative but has much to recommend it. Women in Intensive Care Medicine is committed to identifying and removing barriers to a career in ICM for women – but in doing so, we hope to change the norm and improve working lives for everyone in ICM.
Rosie is the Chair of the WICM group. She is a consultant in critical care and anaesthesia at the Western General Hospital in Edinburgh.
Mark is an honorary Specialist Trainee in Neurosurgery at University of Edinburgh.