Advancing women in medicine: how can we move from rhetoric to action?

‘In no nation are women equal to their men.’ The words of Aparna Mehrotra of UN Women stirred many at our recent summit aimed at advancing women in medicine. Like many in our mostly female audience, my thoughts ran to the number of injustices perpetrated against women globally, including violence, denial of access to education and the freedom to choose.

But gender inequality can take more subtle forms. Women in medicine, for instance, are still facing professional and personal barriers to taking up senior roles – despite women accounting for 77 per cent of employees in the NHS. Only 24 per cent of trust medical directors are women, and in some surgical specialties only one in ten are women.

It is worth applauding the fact that a number of royal medical colleges have appointed female presidents, the British Medical Association has a female chair, and Chief Medical Officer Dame Sally Davies holds office at the same time as the Department of Health has its first female permanent secretary. But at the summit, we were all aware that these landmark posts were not representative of the wider landscape for women in medicine.

Views from the advancing women in medicine summit

Why does the gender imbalance in medicine persist? Gender stereotyping and discrimination, organisational cultures and women’s personal expectations all play a part in perpetuating the imbalance. Unconscious and conscious biases, like ‘all-male interview panels’ and ‘old boys’ networks’ for example, were mentioned several times throughout the summit. Dr Krishna Kasaraneni, Chair of the Equality and Inclusion Committee at the British Medical Association, reminded us that this is not a problem limited to medicine or health care – women only make up 22 per cent of the House of Commons.

But why does the number of women in senior roles matter? It matters because having women at the top of organisations has been shown to improve organisational performance and change cultures. ‘Oestrogen dilutes testosterone in the boardroom,’ Sir Bruce Keogh, Medical Director at NHS England, said in one of the most tweeted comments from the day.

In his contribution, Jeremy Hunt, Secretary of State for Health, pledged to see more women appointed to leadership roles in health, acknowledging their considerable contribution. Finding, supporting, nurturing and promoting talent from within a workforce increasingly made up of women is key to changing cultures.

Commitments to advance women in medicine from attendees at the summit

If inspirational female role models are part of the answer, Dr Kate Granger OBE is a great example of a doctor who is leading cultural change. Kate, who is terminally ill with cancer, has recently achieved the professional status she has long aspired to: Consultant in Medicine for Older People, currently working at Mid Yorkshire Hospitals NHS Trust. Her experience as an inpatient prompted her to establish the now globally recognised #hellomynameis campaign which has changed the way many health professionals view their behaviours and attitudes towards providing patient care. ‘I thought I would do something…’ she modestly told the summit.

Studies have shown that shining a light on the barriers to women advancing in medicine will also make a contribution towards enabling us to tackle other inequalities, including the absence of black and ethnic minority leaders in health and medicine when compared to the numbers who make up the working population.

A career in medicine is ‘not for the faint-hearted – you have to be able to make hard choices’, Clare Marx, the first female president of the Royal College of Surgeons, told me in a post-summit interview. She called for a more open discussion of those choices – which for women so often stand in the way of career advancement. Clare also described the importance to her career of support and sponsorship from male colleagues. Tackling gender inequality is everybody’s issue – we cannot advance this agenda without the support of our male counterparts.

Vijaya's interview with Clare Marx

At the summit we heard from women and men who have taken action, taken on organisations and started to make the progress we need to advance women in medicine, but there is still much more to do. It is through the commitment and determination of all those who attended or followed this summit that we will move from rhetoric to action.