Challenge by example

Mei Wen is a medical student in the Class of 2019 at the University of Toronto

 

“Intersectionality” was always a term that I saw in academic discussions, but never something I consciously thought of as it pertains to my own identity as a person of colour — a Chinese-Canadian — and a woman. This changed in my third year of medical school, when I was no longer in the safe space of a classroom but in the real world as a clinical clerk, interacting with people from all walks of life.

In the hospital, I grew accustomed to patients, nurses, and sometimes even colleagues assuming I was a nurse based on my appearance: a small, young-appearing Asian woman. But it wasn’t until a 5-year-old patient took one look at me and said with conviction, “You’re not a doctor, you’re a nurse! Because you’re a girl and girls are nurses and boys are doctors!” that I was overwhelmed with the feeling that I did not “naturally” belong in the space of medicine. Of course, there is nothing wrong with being a nurse — they are amazing, competent individuals and I don't know how hospitals and clinics would run without them — but it's the automatic assumption that I am a nurse (which my male colleagues do not face) that is problematic.

I was shocked that a 5-year-old had already developed this mental schema of gender roles in medicine. Although it may be tempting to attribute this to the parents’ teaching or state it was just this particular child, it's important to take this opportunity to re-evaluate the societal views whereby — in this day and age — a 5-year-old child can be convinced that "women are nurses" is a fact. Based on this and many other similar situations, I have seriously considered choosing a specialty in medicine where female physicians are more prevalent and taken more seriously. This would be letting society's perceptions influence personal career decisions; it is the consequence of not-so-subtle remarks and micro-aggressions that shape our view on how we see ourselves as future female physicians and where we belong.

 

On intersectionality

In the same vein, I am a Chinese immigrant with a traditionally Chinese name; after having my name mispronounced or misspelled so many times by authority figures and my own institution, I have given consideration to anglicizing my name. But my name is part of my identity — why should I change it to appeal to Western standards in order to be taken seriously?

Amid my confusion, doubt, and frustration, I had a moment of insight: whether as an ethnic minority or a woman, if I am not experiencing any “-isms,” then I am not challenging the boundaries society has pre-determined for me. Instead of being discouraged by these comments, I should be encouraged to follow my own passions and be in a space where I may be the only Asian female physician in the room. All that matters is following my interests and passions, regardless of what society has said is my place. And hopefully, any future young medical student who may look like me will be able to see someone that does reflect who they are.

 

What a time to be alive 

In a time of #MeToo and #StandUp movements, it is crucial to continue challenging the systemic barriers that make it difficult for women to have a seat at the table. Training in Toronto, I am grateful for the systemic changes here, including opportunities such as the Summit for Academic Women in Medicine, which brings in female physician role models whom young trainees can look up to. I'm also starting to see many more female physicians of colour in practice and in academic settings, where they can make a significant impression on young trainees. With initiatives such as the Diversity Mentorship Program, set up through the University of Toronto, there are also formal channels to connect mentors to medical students with similar backgrounds and interests. Less formal — but no less important — is having allies and supports in the clinical space. I'll never forget when my one of my preceptors, a male emergency physician, went back into a room to correct a patient who called me a nurse as we left the room (after I had completed a full history and physical, and provided a plan).

Even with these promising examples, there is still much to improve. Despite the fact that 42% of Canadian physicians are female, when I broke down the numbers according to statistics from the Canadian Medical Association, there were a few notable gaps:

  • Regarding the age group under 35 years old, the numbers of female physicians outweigh male physicians by nearly 1.5 times (F: 4405, M: 2835). However, as age increases, the trend reverses; by age 55-64, males outnumber females (F: 7216, M: 12,710). This may reflect the admission rates in older times, but is that all there is to it?
  • With respect to statistical breakdowns by specialty, female physicians are almost equal in number compared with men within family medicine (F: 19,981, M: 23,499). However, this ratio shifts toward male predominance across most specialties — namely, emergency medicine (30% female), cardiology (22% female), anesthesiology (32% female), and surgical specialties (30% female, which is highly skewed by obstetrics and gynaecology).

And this is not even including statistics on women in leadership positions.

 

So... what now?

To all my colleagues who have ever felt like they should either change an unalterable aspect of themselves or change their aspirations in order to fit societal standards: know that you are not alone (check out this piece on HealthyDebate). I don't have a solution, but I know we can lift each other up: female comrades and male allies. As difficult as it may be, I’m making a promise to myself to strive to be in the space I want to be in, not the space I think I should be in by society’s standards.

My hope is that one day, when waiting to be seen by the doctor, it will become normal for a child to ask, “When is she coming?”

2 thoughts on “Challenge by example

  1. Adam Shehata

    An excellent article with fascinating insight into an important topic, Mei.

    My first career was as a professional pilot, but I’ve since entered medical school. When my daughter was two and a half, we had an exchange, the essence of which was that she was under the impression that boys could be pilots and girls couldn’t. I was completely surprised by this as I have several female friends and former colleagues who are now captains at major Canadian airlines. When I pointed this out to her (Aunty So-and-So; Aunty Such-and-Such are pilots that we know), you would not believe the unbridled joy on her face when yelled out, “Mommy, we can be pilots!!!”

    What’s interesting is that around that time, she corrected me for asking if she wanted to be a “fireman” (“It’s firefighter, daddy!” – and she was absolutely right – I would find it odd to refer to someone as a policeman rather than police officer, yet this anachronism remained).

    In other disciplines, it has become commonplace when referring to a lawyer or doctor or other professional to write the female pronoun rather than writing the male pronoun or “they” or “he/she”. I try to do this as my way of paving the way for exactly the kind of society your story envisions.

    Thanks for sharing your writing and your experiences.

    Reply
  2. Jenn She

    Thank you for writing this. I’m sorry to hear of some of these experiences. As an Asian-Canadian woman myself, I can empathize with a lot of these things – my parents made the very valid decision to anglicize my name when we immigrated here nearly 2 decades ago, but my legal name is always met with exasperation here. Medicine is deeply personal on all sides, and we need to have more opportunity to unpack prejudices in our basic education and acknowledge subconscious biases that everyone has. One would think that in a diverse city like Toronto, this education would be obvious to include.

    Kind regards, and good luck with CaRMS,
    -Jenn She (Queen’s Med 2020)

    Reply

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