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Virginia Slims used to use the tag line, “You’ve come a long way, baby” to highlight the accomplishments of women outside the home; in 1968, apparently, we’d come far enough to have a cigarette brand marketed specifically to us (!). In 2015, the American Association of Medical Colleges reported that 15.8% of the 9,405 practicing otolaryngologists in the U.S. were women, up from 0.3% in 1963. Of 1,472 active otolaryngology residents and fellows in 2015, 36.3% were women.
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April 2018Yes, we have come a long way. But the road stretches before us. And it seems long and winding.
In Canada, only eight out of 16 (50%) female applicants whose first choice of specialty was otolaryngology matched into it, while 19 out of 25 (76%) male applicants who chose otolaryngology matched into the specialty. The number of women in senior leadership positions is paltry, even accounting for the ‘shadow’ effect between entry into the specialty and the achievement of adequate recognition and accomplishment to reach higher echelons. Even accounting for hours worked, patients seen, and academic productivity, women surgeons are promoted less, paid less, and funded less than their male counterparts (JAMA Otolaryngol Head Neck Surg. 2017;143:796–802; Otolaryngol Head Neck Surg. 2013; 148:215–222). Jonas Johnson, MD, the Eugene N. Meyers, MD, Professor and chair of otolaryngology at the University of Pittsburgh, noted in a 2014 commentary that the proportional representation of female full professors was unchanged over 35 years (J Otolaryngol Head Neck Surg. 2014;43:14). He went on to state that failure to fairly promote women into senior academic positions represents a lost opportunity to benefit from talent of all academic physicians. I agree.
Women in all fields, including otolaryngology, are subjected to the psychic assault of what have become known as ‘manels’—male-only panels at scientific meetings. At this point, with the number of accomplished women in our rolls, the picture of four or six or eight men pontificating from the stage while expert women sit in the audience is more irksome than ever. Now, many men are voting with their feet and refusing to sit on manels, which will only help matters.
On top of this, women otolaryngologists report experiencing and seeing a remarkable amount of ongoing sexual harassment. This harassment is somewhat egalitarian, in that it is perpetrated on physicians both in training and in practice, on medical students, on nurses and operating room and office personnel, and on drug and device representatives.
With less pay, more unpaid and unrecognized work, and near-daily avoidance of some type of harassment, one might assume that women provide suboptimal care. That would be wrong.
Types of Harassment
There are different types of harassment, which need to be identified and addressed.