I grew up in a culture where boys are favored over girls. Most of the time, it’s something subtle like saying, “let’s hope it’s a son!” when a friend is expecting a child. With the one-child policy and a system where the availability of education is not as readily accessible to everyone, it’s easy to prefer a man to carry on the family name and the family honor.
It’s not that women are disrespected. Respect is different from expectations. In traditional Asian culture, the strength of the woman comes from her ability to keep a harmonious family environment—we all have had enough holiday family experiences to know that it’s not an easy feat. For thousands of years, it’s been a respected as well as an expected role.
But what if we believe our strengths can also be utilized elsewhere? By now, I’ve lived the majority of my life in the United States, but I still get the occasional “don’t be too strong or you’ll scare away all the boys” from concerned relatives. At some point, I decided that it was a compliment and that they can’t judge me too much for wanting to be a doctor.
Sheryl Sandberg, the current COO for Facebook and the author of “Lean In,” is a major leader for women’s empowerment in the United States. Her TEDTalk had three points of advice for women who want to succeed in the workforce:
1. Sit at the table instead of sitting in the corner of the room in a business meeting.
2. Make your partner a real partner at home.
3. Don’t leave work before you have to leave.
I don’t think I’ve acquired enough experience at this point in my career to make sweeping declarations about women in medicine, but I will share my own thoughts and experiences on each point in relation to medical school.
1. “Sit at the table”
During our third week of medical school, we were required to shadow third-year medical students in the wards to see what the big kids do. I remember wearing my brand new white coat in the children’s hospital where I joined a morning case session with other third-year students and the attending, hoping to sit in the back and be invisible. The attending began describing an adolescent female patient with male genitals who presented with abdominal pain. What is the differential? I must have reacted in some way at the case description because the attending stared straight at me and said, “This one looks like she knows the answer.” The third-year I was shadowing gave me a pitying look. I blurted out, “ Androgen … uhh … insensitivity?” I was terrified. The attending simply said, “Not a bad idea. It’s not the main problem here, but not a bad idea.” And then he moved on and my third-year gave me a low five.
From that day on, I learned that at least for now, it is better to be heard than not heard at all. Studies have shown that women tend to have more self-doubt than men. Even as medical students, admitting to our own intelligence is perceived as intense, or God forbid, being a gunner. However, thinking back on that morning report, sitting at the table meant making my presence known. It is one thing to study a subject, but it is another to apply and verbalize that knowledge in front of others. In our case, speaking up is not just about empowering us anymore. It’s also about the patient.
2. “Make your partner a real partner”
There was an article in The New York Times a while ago about the “Opt-Out Generation,” a group of professional women years ago who chose to be become stay-at-home moms at the peak of their careers. These women now want to opt back in to the workforce, many in the aftermath of a rough marriage. Sandberg’s point is to work with one’s significant other in the home so that neither has to sacrifice his or her career in the first place.
A year and half ago, I moved across the country to attend medical school in a state I’ve only visited once, with no relatives or friends in the same time zone. Since then, I’ve learned to appreciate the importance of making a few real partners in life. Those who know me well are aware that I sometimes have difficulties communicating my concerns and insecurities, which probably doesn’t help especially as a medical student. My friends know that I’m not perfect, but healthy partnerships consist of people who will provide the necessary tough love and will remain loyal even when you make mistakes. I’ve learned when to compromise and when I shouldn’t compromise, and that can only come from those who share the same ambitions in life. They are also the ones willing to share the cookie from a free lunch you missed.
3. “Don’t leave before you leave”
For the past year, people have asked me what kind of a doctor I want to be. No one is ever satisfied when I say, “I don’t know.” I will be the first to admit that when considering a future career, lifestyle is pretty high in priority. Lifestyle not as in the number of mansions I can buy, but my degree of flexibility and potential to raise a family. So I find myself saying, “Well I really like ____, but I’ll be working too much, and I can’t imagine myself being happy with that.” Sandberg says that women tend to think so far into their future “should be” and forget about the present “could be.” Subconsciously, I’m already ruling out medical fields that I haven’t even been exposed to yet. It’s practical yet illogical at the same time, although it’s still a concerted effort to tell myself to keep all options open.
An article in The Daily Mail from a surgeon in the United Kingdom mentioned the problem of how many female doctors working part-time ultimately harms the health care system. He says, “Women in hospital medicine tend to avoid the more demanding specialities which require greater commitment, have more antisocial working hours and include responsibility for management.”
It’s because of comments like these that fewer women are inclined to go into those fields that are traditionally a boy’s club. Still, why is it okay when men call certain professions “emasculating” but it’s considered weak when women deem certain fields “defeminizing?” Talk about a double standard. I can assure for the skepticals out there that those of us who like the more demanding specialties will not peace out until we can peace out with flying colors.
The final point I want to discuss is the accountability of educated women in a privileged society. Sheryl WuDunn also does a great TEDTalk that calls for providing education for women in under-developed countries. She highlights examples of women who taught themselves hard skills that are made into profitable businesses and created equal partnerships with their husbands.
What does this have to do with medical students?
Even though the number of female physicians is now exceeding male physicians, the highest positions are still held by men. As future physicians, we’re in a unique position where we have the opportunity to cross cultural and social boundaries because of the variety of patients we see. Not everyone has to volunteer in third-world countries or become OB/GYNs, but if my upbringing has taught me anything, it is that I have been extremely lucky in life. Everyone needs health care, and everyone has a story but not everyone can get a medical degree. Accountability is as simple as patient education. It’s a privilege that we have the ability to treat and pass on the necessary knowledge to women from all cultural and socioeconomic backgrounds so that they can better take care of themselves. In addition to patient education, we also have the power to shape the organization of modern medicine.
The song I picked this time is “***Flawless” by Beyoncé, which features a verse from the Nigerian writer Chimamanda Ngozi Adichie:
“We teach girls to shrink themselves, to make themselves smaller. We say to girls: ‘You can have ambition, but not too much. You should aim to be successful, but not too successful. Otherwise, you will threaten the man.’ Because I am female, I am expected to aspire to marriage. I am expected to make my life choices always keeping in mind that marriage is most important. Now, marriage can be a source of joy and love and mutual support. But why do we teach girls to aspire to marriage and we don’t teach boys the same? We raise girls to see each other as competitors, not for jobs or for accomplishments, which I think can be a good thing but for the attention of men. We teach girls that they cannot be sexual beings in the way that boys are. Feminist: a person who believes in the social, political, and economic equality of the sexes.”
This verse hits home for me because I was told very similar things growing up. Since then, my family has changed their tune a bit. I like to think that it’s partly because I wouldn’t take any of it, and partly because our social structure is slowly but surely changing. Granted, there are still a lot of data showing lower average salaries for women and fewer women taking on top executive positions, but there are concrete actions we can take to change those numbers: sit at the table and have our voices heard, strive for every relationship to be an equal partnership, and make no excuses. Leaning into medicine is not about beating the boys; it’s about raising our own expectations and taking ownership of our successes. Never apologize for being awesome.
Many of us go into med school with big visions for bettering modern medicine, but as we go through this journey, we realize that there is still a long way to go, and we can’t do it all alone. This column is not meant to be extremely profound or didactic but simply a reflection on the what it means to stay human in midst of society’s expectations and our own expectations.