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A conversation with women in anaesthesia

Historically, women have always been underrepresented in medicine. Even though women make up 50% of the physicians in training and 78% of the medical workforce they still only account for a third of physicians within the workforce. Despite, anesthesiology seeing a steady increase in the number of residents who are women, there is still a significantly faster increase in terms of women graduating medical school than those becoming anaesthesia residents.

Gender disparity is not only about the number of women entering medical school but also in regards to career progression, academic advancement, women in leadership roles and pay.

Recognising this potential gender gap within anesthesiology, WFSA established the Ad-Hoc Gender Committee, in 2018 to increase women with WFSA leadership positions and facilitate participation in gender panels and forums.

For International Women’s Day 2020, WFSA interviewed notable women leaders and future leaders within anaesthesia including: Dr. Jannicke Mellin-Olsen (Norway), President of WFSA; Dr. Carolina Haylock-Loor (Honduras), WFSA Council member and Chairperson of WFSA’s Ad-Hoc Gender Committee; Professor Patricia Yazbeck (Lebanon), WFSA Council member and President of PAFSA; Dr. Karima Khalid (Tanzania), SAFE Tanzania Course Director; Dr. Gita Nath (India), VAST Hyderabad Course Director and Dr. Marjory Ayma Palacios (Peru), WFSA Pain Management Fellowship alumni.

What challenges do women face when becoming anaesthesiologists?

Carolina: Women in anaesthesia in some countries do face bias in their work but not because of anaesthesia but their surrounding responsibilities that make her a woman e.g. maternity, pregnancy and raising children. A lot of women face depression and burnout as a result. In some countries, they are very aware of what is going on and try to support women in their career. It’s a trending topic and you can speak up easier than before but women will need to keep struggling.

Karima:Numerically, there are no issues because there are a lot of women in anaesthesia and the medical profession overall in Tanzania. However, we face challenges making our voices heard. Women are normally the first to push things forwards for change etc. but they are put in the background. Men usually outshine us. Sometimes in a clinic even if you have tried your best someone will talk to the male nurse and not to the female doctor. It’s hard to progress in leadership/senior roles. I have observed how WFSA treats women and men equally and I appreciate that. You are expected to put 100% into your work, family and community, its draining and burnouts happen frequently. Sometimes you just need to narrow down what you want to do to realign your priorities and emotions.

Marjory:One of the biggest challenges has been breaking the stereotype that women are only able to look after their home, family and children and that we have lower job performance and more absenteeism. In addition, women have to break down gender gaps such as job hostility and the myth that they are less willing to face risks. I have managed to become an anesthesiologist because these cultural gaps and stereotypes have been breaking down in time and showing commitment to every step I take.

Gita: When I started off in the profession there were a lot of men and not that many women. Women are now about 50% of the workforce however most choose obstetrics/paediatric/pre-clinical to balance their home/work life.

Jannicke: I have been very lucky, in Norway, the gender balance is very good but you must acknowledge the difficulties, sometimes I had cases where people would address a junior doctor because he was a man and ignore me. Also, Norway is a country on top of gender equality but there are many unexpressed expectations. Men and women are on the same level but there are different expectations for things you can and can’t do.

Patricia:Personally I have not faced many challenges. Lebanon is a more open society but due to the persistent gender inequality it is not easy for all women to be represented in the workforce. Some hospitals won’t employ women anaesthesiologists and only hire male anaesthesiologists because they won’t take time out. We should continue to fight against gender discrimination and issues like Lebanese women physicians not having access to long maternity leaves should be addressed.

Why is it important to increase the number of women in anaesthesia?

Carolina:It is important to increase the number of women in medicine but also to ensure equity, in leadership, wages, and training, acting in a respectful and dignified way towards women. Women need a comfortable working environment, with access to maternity leave, areas for breast feeding, time off to raise children etc. Provisions must be made to support their potential or they’ll quit because they have no support. Research has shown women will drop out if the pressure in their residency programme/working is incompatible with pregnancy or child rearing.

Marjory:I believe women bring an important balance to professional life, we are resourceful and always look for alternatives ways. Our mission should be to change the perception of stereotypes and show that we are committed, capable of leading and cultivating resilience with the right support.

Gita:A lot of patients who come in for C-sections and other procedures and request a female anaesthesiologists, some women only want women around them due to cultural/religious reasons. I personally find women easier to connect with, for example when women are taking the VAST course I find them easier to network with. I feel women are more committed to their work, they aren’t trying to become heroes and are good for patients, and it’s not about how much risk they are willing to take. Women do basic everyday things safely. There is a difference in mindset between men and women.

Patricia:In a study of literature, patients who were treated by women had a different standard of care, they provide preventive care and they have good communication skills. Women can give a lot, they have patient centred communication.

Jannicke:It is important to note that in some countries women are the majority with around 80% entering medical school. There is an increasing balance.

Why do you feel WFSA's Ad-Hoc Gender Committee is important?

Carolina:It is very relevant and important to create awareness of inequality. We first observed it within WFSA leadership, there were 20% women and the rest were men. The Ad-Hoc Gender Committee had a summit in London last year, there was a lot of diversity and professionalism. Minority groups were represented and how to increase diversity, we are presently conducting a gender survey. In summary, our objectives are to try to create equal opportunities for every anaesthesiologist. We must bring equal opportunity regardless of gender/race/religion and give respect to human dignity.

What advice would you give women who would like to pursue anaesthesiology?

Carolina:I would encourage every woman to go after her dreams and fulfil her goals. Don’t give up, it’s a male world and we know it but we are slowly gaining step by step Try to have allies your friends, your husbands and family, this can make a huge difference to get into the field. Do your best. Chase your goals but also remember to pay good forwards.

Karima:You should always try to push ideas forward, take a seat at the table and make sure you are seen and heard. Don’t let anyone silence you. Do what you need to do and make a change in the world.

Jannicke:If you want to become an anaesthesiologist you should go for it and trust yourself, you can do it.

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