Issue 2 • 2022
© 2022 The Royal Australasian College of Physicians

Gender equity in medicine

Gender equality means that people’s rights and access to opportunities do not differ based on their gender. Equity refers to the notion that there may need to be differential treatment that is fair and addresses the bias or disadvantage that is due to gender roles and norms.
Gender equity in medicine is a complex, but incredibly critical issue that continues to have a serious impact on the careers of physicians in the medical workforce. Although progress is being made, there is still a long way that we as a College, and as an industry, can go.
So, what can we do to achieve better gender equity in medicine and create long-lasting results? Building on past discussions and actions taken, this important topic was explored at the RACP Congress 2022 earlier this year. This article will also dive into the recommendations from the RACP Gender Equity in Medicine Report, which was launched at a member event held Tuesday, 21 June.
The RACP Congress 2022 ‘Gender Equity in Medicine’ session was chaired by Dr Jacqueline Small, who started her Presidency of the College on 13 May 2022.
Dr Small said, “In 2019, a survey of members told us that you think it is important that the College advocates for gender equity in our profession, and we are doing that. Close to 90 per cent of respondents to that survey indicated that it was a really important issue for the College.”
She then introduced Dr Jenny Proimos, Consultant at Royal Children's Hospital, who demonstrated the difference between equality and equity with a clever illustration of people on bicycles.
“As you can see, in the top row, everyone has the same bike, but they have different needs. While there is equality of access, there isn’t the ability to use that in the way that is helpful for them” explained Dr Proimos.
“In the bottom row, you can see they’ve all been given bikes that actually meet their additional needs, and therefore they’re all able to benefit from that bike ride together.”
Dr Proimos explored some of the benefits of gender equality and how it is good for our wellbeing and the economy.
“There have been several studies looking at higher female political participation, smaller gender wage gaps, and better reproductive rights. These have led to reduced mortality rates in men and women, have led to less disability in women, and lower depression and PTSD rates.”
Referenced studies: Kawachi l et al. Soc Sci Med 1999; 48:21-32 Chen YY et al. Soc Sci Med 2005; 60:49-60 McLaughlin KA et al. Soc Psychiatry Psychiatr Epidemiol 2022; 46:1161-1171 McKinsey report: Women Matter 2015.
“In India, they randomised village councils to be led by men or women. It was a pure randomised trial. Ten years later, they showed that in the villages that had been led by women, adolescent girls had received more education, had higher job aspirations, and spent less time on domestic chores than girls in male-led villages.” (Chattopdhyay R et al. Women as policy makers: evidence from a randomised policy experiment in India. Econometrica. 2004: 72(5): 1409-43).
Dr Charlotte Chambers, Director Policy and Research, Association of Salaried Medical Specialists spoke about getting past the ‘feminisation’ of medicine and why gender equity is healthy for all. She shares an interesting quote by William Osler (1849-1919) to help explain the decision of many women to work part-time during their training as physicians — ‘There are three classes of human beings: men, women, and women physicians.’
“Medicine continues to be defined by time. How much time it takes for you to train, whether it be through your gruelling hours of work, your residency, or the time you spend working outside of ‘normal’ work hours.”
“Working these long hours and doing so full-time continues to be a defining feature of showing you are committed and dedicated to your career.”
A confronting but necessary look into gender equity in RACP training was then discussed by Dr Davina Bunstsma and Dr Hashim Abdeen, Chair and Deputy Chair of the RACP Trainees’ Committee.
The lack of flexible training was brought to our attention through quotes from current trainees. One said, “I have ‘elected’ to return to full-time training much earlier than planned after my pregnancy, as I am not able to meet the rotational requirements of basic training part-time. I feel really sad about missing this time with my children, and worried about the pressure it will place on our family unit.”
Dr Bunstsma spoke about the need for better gender equity policies when it comes to flexible training, parental leave, rural rotations, and selection into training.
Dr Hashim Abdeen tied the RACP Congress 2022 theme of ‘a climate for change’ in with gender equity, saying the time to change is now.
“There are lots of policies and processes within the RACP. We’re talking about standardisation across the many different programs we have. There are some programs that are doing really well with gender equity and that’s perhaps why these specialties are attracting more women.” “We need to look at reasons why and how we can emulate and share that knowledge across the College.”
The RACP Gender Equity in Medicine Report The RACP acknowledges that we can do more as a College to improve gender equity in medicine. In February 2020, the Board approved the establishment of the Gender Equity in Medicine Working Group as a body reporting to the Fellowship. Its purpose was to undertake preliminary work to define gender equity, understand the gender equity experiences of members, and make recommendations to the Fellowship Committee and Board on the role and actions the College should undertake to support gender equity in medicine.
The RACP Gender Equity in Medicine Working Group recently released a report to the Fellowship Committee and RACP Board outlining their findings and recommendations. We encourage you to read the member-version of this report.
The following recommendations have been made for the College:
  • Gender equity in medicine as a strategic priority.
  • Improve gender representation and equity in College bodies and leadership.
  • Advocate for gender equity in medicine.
  • Support gender equity in medicine through College priorities.
  • Support gender equity in medicine activity through partnership in the Advancing Women in Healthcare Leadership Program.
  • Establish a Gender Equity in Medicine College body to oversee the implementation of the Gender Equity in Medicine Working Group’s recommendations and drive member engagement on this issue.
Read the report.
The College would like to thank Gender Equity in Medicine Working Group members for their ongoing work to help drive change: Associate Professor Catherine O’Connor, Dr Nathalie de Vries, Dr Sally Gordon, Dr Natasha Gorrie, Dr Susan Harch, Associate Professor Peter Hill, Ms Debra Letica, Dr Fabiola Martin, Dr Dylan Mordaunt, Dr Swati Mukherjee, Dr Lauren Shearer, Dr Manoshayini Sooriyakumaran, and Professor Helena Teede.
For more information, visit the RACP Gender Equity webpage.