In the lead up to the International Day of Women and Girls in Science on 11th of February, the Lancet has released their first bumper issue dedicated exclusively to the global topic of gender (in)equality in science, medicine and global health. Over 300 submissions were shortlisted, resulting in a diverse collection of original research, opinion pieces and reviews. These articles come from a range of countries including Australia, the United States, Yemen, China, South Africa and Nepal just to name a few. Topics covered include implicit bias, organisational best practices to gender equality, why women leave surgery, gender gaps in research and some thoughts on the missing trans women of science, medicine and global health. Apologies for the paywall - the Lancet will most likely be available through your hospital's online library.
Why is it important to have dedicated research on gender issues in medicine? Whenever I am asked this question, I think back to an end of year departmental event that I attended as a registrar some years ago. A senior clinician sat down next to me and asked me whether I thought gender equality had been achieved in medicine. He thought so because he looked around the room and saw many women doctors and thought the job was done. What he failed to see, and what I wish I had pointed out, was that most of that female workforce was at the registrar and resident level. That the head of unit was male, the directors of physician training were male, the senior registrar was male, the physician staff were overwhelmingly male. That the awards and research grants were being awarded to men. If I had pointed this out, I may have been met with a robust and eye-opening discussion, but may also have been met with equally unpleasant arguments around meritocracy. The actual fact is that I did not notice this myself until many years later, not just through personal experience and my involvement with WIN, but by becoming well read and well versed in the literature around this issue.
Research is a powerful tool you can use to institute real change, help educate the sceptics and help reorient arguments which become derailed by defensiveness. No one likes to be told they have implicit biases or that their hiring practices are discriminatory, as Coe et al point out in their excellent article, titled “Organisational best practices towards gender equality in science and medicine.” Research helps to ground gender issues to reality and to put into focus which measures we can take to dismantle institutional structures which perpetuate discrimination.
Overall, this edition of the Lancet has something for everyone. As the editorial states, “feminism is for everybody.” The highlight for us at WIN was Coe’s excellent review mentioned above. Its goal was to “discuss effective strategies to shift organisational culture and climate toward gender equality.” This change and the efforts to make change must not land squarely on the shoulders of women. It is the organisations themselves and their leaders that must also look inward and help take charge. For example, the Lancet publishing an edition completely dedicated to gender equality helps to create dialogue, validate women’s experiences and hopefully institute meaningful change. And with that, the Lancet have put their money where their mouth is and have set some targets for female representation, as ANZICS have,