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Operating Room Talk?

The Last Word: Double Indignity

By Allyson Herbst

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When I was a third-year medical student in New York two years ago, there was a resident physician who took obvious pleasure in making me squirm.

I had just started hospital rotations and over lunch we were discussing possible areas of specialization, including internal medicine and obstetrics/gynecology. "Do you like vagina?" he asked me.

Later that week, while we checked in on patients, he told me, "You're not wearing make-up today. Maybe you should rethink that choice."

A few months after that, I was in the operating room with an all-male surgical oncology team. Their skill during long hours of surgery was impressive, but their "bro talk" was disgusting and ostracizing. Over the exposed hepatoduodenal ligament of one anesthetized patient, the attending surgeon's eyes widened and locked with mine. He cried out to the assisting resident surgeon, "Splay it open like a Russian whore!" and waited for my reaction. I somehow found the wherewithal to return his gaze and reply, "I assume the whore in question is a man, no?" I didn't ask him for a letter of recommendation.

Sadly, these were not isolated experiences. The medical profession offers plenty of regular indignities and structural biases against women. While sexist banter during surgery may seem mostly harmless, the extent and frequency of it, and the aggression toward women it communicates, is a real problem. There are also insidious, subtle signals that female physicians contend with daily. My young female colleagues and I are constantly mistaken for nurses. We are referred to as "girls" by patients and medical colleagues alike, while our male counterparts are "young men" or just "men."

The most disheartening sexist assumptions are the ones I make, though—I find myself asking patients, "Who is your primary care doctor, and do you have his phone number?" Even as a physician myself, I have internalized the idea that the profession still belongs to men.

Yes, there are more women in medicine than ever before. But studies estimate that between 30% and 70% of female medical school faculty experience gender-based discrimination. A culture like that has serious detrimental effects on women. Those who experience gender discrimination report lower career satisfaction. Female physicians have a higher rate of major depression than women with doctorates in other fields. Overall, men commit suicide four times more often than women; female physicians, though, kill themselves at a rate equal to male physicians.

I eventually chose to specialize in internal medicine. As I interviewed for residency across the country, I was discouraged by how few female department chairs of medicine I encountered: In 12 interviews, I met only one. Just 12% of internal medicine department chairs nationally are women, according to the Association of American Medical Colleges. Of the 294 surgical department chairs across U.S. medical schools, only 1% are women, and only 22% of full-time professors. Even in more female-friendly fields, like obstetrics, the disparity is clear: 83% of residents entering ob/gyn are women, but only 22% of department chairs are.

Female physicians do not advance or get promoted like men do. In the 1990s, women began graduating from medical school at rates roughly equal to men, and this was supposed to lead to equal representation in academic leadership. That hasn't happened. Women now make up 46% of medical school applicants, students, and residency trainees, but only 38% of medical school faculty, 21% of full professors, and 16% of deans. This is progress, but it's too slow.

And, if you are a female doctor who does manage to advance your career, you can expect to be paid less. A study of some of the most prominent public medical schools published this summer found that female doctors working there are paid 10% less a year — an average of $20,000 — than their male counterparts. How can we treat our patients fairly when we don't equally respect each other?

Allyson HerbstAllyson Herbst is an Emory resident in internal medicine. This essay first appeared in PostEverything at

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