Scenario 1: A male surgical resident speaks over a female emergency medicine resident as she performs her trauma survey, confusing the care team about the patient’s injury burden and plan. Afterward, the emergency medicine resident voices her concerns to her male attending about having her role publicly undermined. “I think this is particularly a problem for female residents,” she says. He responds, “It’s not a female resident problem. They do this to everyone.”
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ACEP Now: Vol 39 – No 07 – July 2020Scenario 2: At the physicians’ workstation, a nurse asks the male attending about the plan for a patient being cared for by a female resident physician sitting in proximity. The attending answers the nurse’s question without involving the resident. The resident then respectfully tells the attending that she’d appreciate being looped into conversations about her patients. “Female residents often aren’t recognized as the decision makers about our own patients’ care,” she says. He responds, “It’s not a female resident problem. This happens to male residents, too.”
Scenario 3: During a residency conference, a resident brings up several barriers to placing central lines in the emergency department for critically ill patients. She recounts the numerous times she was told the procedure could be performed in the ICU and to send patients upstairs. A male resident says, “I’ve never had that experience.” She responds to her male co-resident, “I think this is a female resident problem,” reflecting her personal perception and her female co-residents’ perceptions that ED staff show more support for male residents to perform procedures. A male attending responds, “It’s not a female resident problem.” He says the decision depends on whether there are beds ready.
Common Experiences for Female Physicians
As female resident physicians, we have the privilege of working with masterful clinician-educators on a daily basis. We are humbled by their knowledge and clinical skills. However, we are troubled when we raise concerns about gender inequalities to attending physicians and receive the response, “It’s not a female resident problem.”
We recognize not every health care challenge or unprofessional interaction stems solely from gender inequalities.1 Maybe the surgery resident was under extraordinary stress from sleep deprivation. The nurse who bypassed the resident might have forgotten her name, choosing to defer to the attending, whom she knew well. Though the patient headed to the ICU needed a central line, the ED volume was high, limiting the ability to perform time-intensive procedures.
However, when we witness unprofessional and unsupportive interactions happening repeatedly and disproportionately more often to us than to our male colleagues, we feel compelled to bring it to the attention of our superiors. We do so in hopes of improving patient care and developing a better training environment for ourselves and others.
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3 Responses to “‘It’s Not a Female Resident Problem’”
August 2, 2020
AAHow about “It’s not a racial minority / LGBTQ / *other resident problem”? Same solutions?
August 2, 2020
shari engstromExcellent summary of a real problem. I have been practicing Emergency Medicine for 30 years and this issue has been persistently pervasive and still affects patient care in my ED.
August 3, 2020
Samara Kester, DOIt’s not just a female resident problem, it’s a female attending problem, as well. I’ve been in practice as an ED physician for 30 years. In residency, I’ve been overspoken by male residents, I’ve been body-checked by another surgery resident when attempting to place a chest tube, I and the other female residents were told that we were too assertive. There are many, many more examples. I have learned to call out these actions now, face-to-face when there’s been an issue with my gender. It comes with being down the road a bit and not worrying about repercussions. But how just it that, to have to learn to handle it? Or to have to still after all these years even being subjected to it? In reality, it’s not a female problem. It’s a cultural problem of long-standing. Progress it slow in coming. Be strong. I stand with you.