There are a number of studies about gender differences of surgeons out there – but are there gender differences in surgeons’ spouses? Although we have never asked ourselves this question before, we stumbled across a survey which investigated just this and thought it quite interesting. After all, spousal support is without a doubt an important factor in career satisfaction or life satisfaction more generally.
Interestingly, there was no gender difference in percentage of respondents who had children or in number of children. The myth of the childless career woman thus seems to be just that – a myth. There was, however, a gender difference in whether or not spouses had a job outside of the home. While 88% of male spouses worked outside of the home, only 55% of female spouses did so. Both male and female spouses indicated that they would be happier if their spouse worked less. Maybe unsurprisingly female spouses indicated that they carried most of the responsibilities for home and childcare whereas this was not the case for male spouses – and this held true regardless of the working hours of the spouse. This is problematic, as it indicates that female surgeons have an overall higher workload than their male counterparts – and while a number of initiatives aim at improving work conditions for women at work, the differential work load outside of the workplace remains largely unaddressed.
Women in fields in which they are under-represented often name the lack of female role models as a barrier in their careers. Yet, research often finds that the successful women who are available are often rejected. They are seen as pushy, overly masculine and cold and generally not as someone most women can identify with – even when no information indicating these traits is given. But why is that?
A study by Parks-Stamm and colleagues suggests that this might be a strategy to protect our beliefs about our own competence. In other words, if we saw a successful woman as highly competent and on top of that as nice and likable, this might undermine our own confidence. After all, how are we supposed to compete with that? The authors tested this idea by presenting men and women with information about a highly successful woman. In some cases, this woman was described as warm and likable, whereas in other cases no such information was given. Unsurprisingly, both men and women in the former condition described her as less pushy and cold than those in the latter condition. What was interesting, however, was that those women who had been told that the successful target was warm and nice, rated their own competence as lower compared to those who were able to penalise the potential role model.
So what does this mean? Should successful women be presented as unlikable and cold? Certainly not. It is, however, important, that they are described in ways that make them seem attainable. Evidence for this claim comes from a second study by the authors in which they show that the negative effect of preventing women from penalising the role model disappears when they are given positive information about their own future success.
While women remain underrepresented in certain areas such as surgery, other occupations struggle to recruit men. There are a number of potential explanations for this phenomenon out there, including the idea that we show greater interest in occupations associated with our gender role (e.g. because we see a lot of women in childcare, we associate childcare with being female), and the idea that we seek out jobs that are in line with our values (e.g. because women have more altruistic values, they are more interested in childcare). It is of course hard to disentangle these two explanations – after all, while it might be the case that women rate altruistic values as higher, this could just as well be the result of seeing women in “altruistic” occupations.
However, Weisgram and colleagues investigated this question in a clever study which used fictional occupations rather than real-life jobs with which everyone has already formed aforementioned associations. They presented children, adolescents and adults with fictional descriptions of new jobs that were described as fulfilling a randomly assigned value and being mainly done by men or women.
They found that, indeed, the sex of the typical worker in the new occupation affected the degree to which participants associated certain values with these occupations. For example, if a job was presented as being mainly done by women, participants believed that these were jobs associated with a better work-life-balance. Interestingly, this was only true for adolescents and adults but not for children. The authors also found that both the sex of the workers and the values influenced participants’ interest in the new job.
With regards to women in surgery this is particularly interesting, as it suggests that it is not enough to point out the “feminine” values in the occupation (e.g. helping others), but that it is most of all necessary to change the image of the male surgeon.
While there has been great progress for women in medicine, there are still obstacles and barriers they face and which need to be addressed. In an interesting short article, Hamel and colleagues reflect on these issues for women in academic medicine in the US.
They also talk about potential interventions to close the gender gap and a need to emulate those that have already proven successful such as making promotion criteria more explicit and assessing the appropriateness for promotion for both men and women once a year.
There are different approaches when it comes to achieving gender equality and quotas are a hotly debated issue. But what do women directly affected by hard and soft policy strategies think? To answer this question, Casey, Skibnes and Pringle interviewed women in senior management both in Norway and New Zealand – both of which are countries that rank high in gender equality. However, while New Zealand’s strategy to improve gender equality on company boards is a soft one, meaning that they encourage companies to appoint more women to their boards without any legal consequences, Norway introduced a quota that companies are obliged by law to fulfil.
Interestingly, they found that gender equality was perceived as quite similar by female senior managers both in New Zealand and in Norway. However, while women from Norway were generally in favour of the quota, women from New Zealand had strong objections towards it. The authors conclude that it is hard to say which strategy is better – while the quota has definitely succeeded in drastically changing the gender landscape of management in a short period of time in Norway, it may also result in women being pushed into positions they might not feel comfortable taking and negative evaluations of these women. Soft measures, on the other hand, work much slower or not at all, which results (among other things) in the need for women in senior management to adhere to masculine norms.
We would like to add another thought. First, while quotas certainly increase the quantity of women in management, it might not necessarily mean that their positions are equal in quality to those of their male counterparts. Our research suggests that these women might run the risk of finding themselves on a glass cliff. On the other hand, however, the think-manager-think-male stereotype is only going to change if women are equally represented in leadership positions – which might then very well make quotas unnecessary.
Female doctors, especially those in their early careers, might be worried about being judged as less competent than their male counterparts by colleagues and patients alike. However, research by Shah and Ogden suggests that young female doctors should be more confident in how they are perceived, at least by patients.
In their study they presented patients with one of eight pictures of a doctor who was either young or old, male or female and Asian or White and asked them about their perceptions of and reactions to those doctors, for example how comfortable they would feel with the doctor physically examining them or how good they thought the doctor would be at explaining the cause of their symptoms to them. While Asian and White doctors were perceived quite similarly, young and female doctors were overall evaluated more positively. For example, patients believed that younger doctors were more likely to have a positive personal manner and better technical skills. They also stated that they would have more faith into the younger doctors’ diagnosis. Similarly, female doctors were – maybe not surprisingly – rated as more likely to explore the emotional aspects of health and having a better personal manner. However, contrary to stereotypes, they were also rated as having better technical skills and patients had more faith in their diagnoses.
So can we hope that we are slowly moving away from the stereotype of the old, white, male doctor? Patients certainly seem to do so!
Female role models are often thought of as a solution for the under-representation of women in certain fields such as surgery and there is indeed quite some research that backs up the fact that women make more effective role models for other women and girls. However, other research shows that this is not the whole story.
A study by Sapna Cheryan and colleagues investigated the effect of stereotypical (“nerdy”) and atypical (“normal”) computer science students on women’s interest in the field. They found that gender did not matter, but that those interacting with an atypical member showed more interest in computer science and believed that they could succeed in the field more strongly. The reason for this seemed to be that women saw the atypical computer science students as more similar to themselves.
Now, the stereotypical traits for a surgeon are certainly different than those for a computer scientist. Nevertheless, both stereotypes have more in common with traits typically associated with men (e.g. competence for computer scientists and assertiveness for a surgeon). So in a way, these findings are quite promising as they suggest that both men and women can inspire girls and women to become surgeons as long as they are seen as atypical and, more importantly, similar to oneself. This illustrates an important point about role models: We need a diverse range of role models in surgey – after all, nobody is going to be seen as similar to oneself by everyone. And if we want surgery to be a diverse field, we need to make sure that we communicate that it already is.
Male dominated organisations are often thought of as an “old boys’ club” with the members favouring one another and rolling their eyes at gender equality initiatives. However, that is certainly not always the case. The Harvard business school, known for being a rather sexist environment, has recently gone out of the way to bring about gender equality. Reactions were mixed, but a New York Times article nicely illustrates how things can indeed be tackled and changed, despite a reluctant majority.
Although women remain under-represented in surgery even today, there are some extraordinary cases of women in surgery dating almost a century back. This article, titled “Australia’s female military surgeons of World War I” tells the story of three women who worked as surgeons at times in which women in medicine were sailing against the wind much more than today. These stories are informative and inspiring and definitely worth a read!
As women continue to carry a larger part of the responsibilities regarding housekeeping and childcare, it is not surprising that they generally find it harder to achieve satisfactory levels of work-life-balance in occupations that are generally associated with long working hours such as medicine. A recent survey study looked at how the perception of hospital doctors’ work-life-balance was related to burnout and intentions to quit their job and how whether this depended on gender.
The author found that work-life-balance was the most important predictor of burnout and that support from superiors and co-workers as well as working in a family friendly environment significantly lowered burnout. Interestingly, support from co-workers was the most important factor for female doctors, whereas support from one’s superiors and working in a family friendly work environment was more important for male doctors. Similarly, work-life-balance and support for co-workers were related to female but not male doctors’ intentions to quit, while working on a rota working pattern was predictive of male but not female doctors’ intentions to quit. Overall, women also reported higher levels of burnout.
This is interesting, as it shows that reducing burnout and retaining skilled doctors, might be achieved quite differently for men and women. It also shows that the fact that women are still responsible for the majority of domestic tasks is reflected in their higher need for a work-life-balance and that this issue needs to be addressed, both at and outside of the workplace.