I have been wanting to write on this topic for a while now but was unsure of how my peers would react. But then I read somewhere that women should write about anything that makes them feel small and miscredited. So here I am writing about the misogyny and gender bias in medical schools and hospital administrations.
Misogyny exists everywhere, to begin with, but in a country like Pakistan, the effects of gender disparity are more worrisome, as reflected in the World Economy Forum's Genetic Gap Report 2023 where the country is placed at 142nd out of 146 on the gender parity index. Misogyny is one of the biggest problems faced by women in any institution and is a concerning issue, especially in medicine. Keeping in mind how our society has limited women to two acceptable professions (teaching and medicine), with each career already having its own share of challenges.
In medicine, gender discrimination begins the moment you walk in through the doors of a medical college, despite women outnumbering men there with 80% enrollment. It ranges from subtle biases to outright discrimination. It begins in the lecture/dissection halls and labs, where male students are given better participation opportunities; in clerical offices where they get favours and attendance marked on the side; and in leadership roles where male representatives are called 'class representatives' but their female counterparts are just 'girl representatives' who, despite taking up a greater workload, end up unrecognised while the former becomes the primary contact source with administration, thus taking up female input off the table for college policies which impact all students equally albeit gender.
It is hidden in the sarcasm of male professors who remark how girls are taking up seats when there is a chance they might not be able to practise in future. It is reflected when certain 'super specialists' announce proudly how their fields are male-centric, and even when research work is primarily undertaken by women, upon publication, the male members demand to be primary authors.
Any time women complain and express their grievances, males begin victim-blaming and 'mansplaining', thus perpetuating the cycle of prejudice, which is nearly impossible to overcome
Many male classmates refuse to recognise female peers or give them their rightful space, especially when they know these girls might have greater potential than them. Unwanted remarks and advances create hostile learning environments, and when girls take up managerial roles in activities or college events, many batchmates make it their goal to create hindrances. The most amusing thing about this is their deflections when they are confronted about their misogyny or use of benevolent sexism to their advantage, which they categorise as mutual respect, knowing full well how far it is from that. Anytime women complain and bring out these grievances, males begin victim blaming and 'mansplaining', thus perpetuating a cycle of prejudice that is hard to overcome for many.
Keeping in mind women's role in patriarchy, it also comes as no surprise when female teachers are subjected to differential behaviour based on gender. It is most obvious in matters of conflict, where women are encouraged to be the 'bigger person' while professors side with male students. Internalised misogyny lies in moral policing remarks passed against women under the guise of 'sincere' advice on how to dress or behave. Senior female professors often misuse religion to state that girls are supposed to practise medicine restrictively while their male counterparts have a world of opportunities before them.
What begins in medical school continues to become more and more evident as women progress in their careers. During house jobs and internships, women are given assignments which hospitals refer to as 'female dominant specialities' such as paediatrics and gynaecology, without any consideration to the inherent interests of these doctors, whereas male interns get placed in orthopaedics, surgery and neurology, to name a few. Gender bias is also prominent in residency interviews and placements, where women are often asked about their marriage and family plans, while men are let off the hook — or asked about plans for specialisation.
Internalised misogyny lies in the remarks of moral policing given to women, disguised as 'sincere' advice on how to dress or behave
Female doctors do not deny the fact that one of the main reasons for the shortage of doctors in the country is that 50% of female medical graduates either fail to join the workforce or discontinue their jobs early in their careers, resulting in a national healthcare crisis. It is, in fact, the delivery system's deterioration in the country, and what we need to understand are the multi-layered social, cultural and familial factors that prevent women from working after graduation. Discrimination that begins in medical school progresses to workplace gender bias, with lower wages, improper job placements which are compounded by early marriages, familial interference, child bearing/raising and pressures of homemaking, among other serious obstacles faced by women pursuing medicine.
It is high time we eliminate gender disparity from medicine in our country. Deans of medical schools and hospital administrators must realise that women are the backbone of our healthcare system, and their integration into the workforce is crucial. There should be policies for upholding their rights both in medical school and in hospitals, including protection against harassment, equal learning opportunities and placements similar to those afforded to male counterparts, as well as overcoming the huge gender pay gap. It is also time to set up female professional associations, which can effectively demand women's representation in healthcare policymaking so that female student doctors and physicians can adequately voice their concerns and problems.
Most importantly, there is a need for a wave of change where it all begins: the hallways of our medical schools, which may be prestigious and hundreds of years old but are in dire need of a break from the past to fully embrace evolving pathways. We need to make our campuses free of bias and foster an inclusive learning environment so that female students can focus on their education and career rather than spending time and energy holding out against misogyny and gender discrimination.