Mariam Baloch, MBBS, DR RUTH K PFAU CIVIL HOSPITAL, KARACHI
Whoever among you sees evil, let him change it with his hand. If he is unable to do so, then with his tongue. If he is unable to do so, then with his heart, and that is the weakest level of faith.Muhammad (PBUH)
Being a researcher and more so an avid reader, I had come across a multitude of papers by Dr Faisal Khosa, a well-known Canadian radiologist and researcher, dedicated to addressing gender and racial disparity in Medical and Surgical specialties across Canada and the USA. As a struggling researcher having a hard time getting my work published, the only lesson I acquired, without paying attention to the substance and issue, was that producing this kind of literature was an easy way to get published.
For those who are confused as to where I am going with this, allow me to introduce myself. I am Dr Mariam Baloch, a graduate of the Class of 2021 of Dow University of Health Sciences, Pakistan. Having completed my MBBS, I undertook the next step obvious step in my career – I started my internship in April 2021. An internship is a yearlong contract where recently graduated doctors rotate in different specialties across Medicine and Surgery to learn clinical skills as well as to ‘get a taste’ for the specialties before choosing one for their post graduate training. Therefore, my first three months were spent in Obstetrics and Gynecology (OBGYN), followed by a rotation in General Surgery.
Here in Pakistan, OBGYN is a heavily female dominated specialty with male consultants, resident trainees and interns being very few and far in between. To say that at the beginning of my placement in GS, I was ill prepared for the workplace dynamic would be a gross understatement. To be sure, one does hear the hush-hush whispers of the existing bias, but with being as entitled as we millennials are, it is unfathomable to consider ourselves to be the recipient of such experiences. So, I was initially blind to the subtle happenings in front of me.
I had been conditioned to think that doing more scut work would make the residents and the attending physician teach me more clinical skills.
I was in for a wakeup call.
Our male co-houseofficers (term used for doctors doing an internship) were held to a different level of standards. It was acceptable for them to be late, to not complete their assigned work and to skip calls. While the aforementioned might be frowned upon, the penance for the said recourse was nil.
A prevalent belief as put forth by a male houseofficer was:
Those who are unaware, the term shunting is a cant medicos use to indicate the act when a doctor intentionally bypasses or skips assigned duties, essentially perpetuating patient compromise. While potentially debilitating to the patient, this general behavior also translates into female house officers being more harried; by being given additional duties and scut work, not only leading to exhaustion and burnout, but also having to compromise on picking up significant clinical skills.
Now, there will be those who will tout something along the lines of ‘Not all men’. Assuredly, this is not untrue, however, our perceptions are built upon experiences and by evidence, and mine have not been pleasant.
I can vividly recall incidences, where residents re-assigned random duties of beds that were assigned to a particular male houseofficer, just because they were having too much of a great time in a non-work related conversation with the said male houseofficer.
In another event, a female resident (who surprisingly, are even more discriminating) had tried to deliberately sabotage a local operative procedure that was to be rightfully conducted by me.
Despite the fact that the whole rotation was not an utter waste of time, I will still always associate General Surgery with my introduction to workplace gender bias; with the warrior in me trying to combat it in anyway I can. If not by dedicating a research paper on the subject matter, then by writing a narrative blog for an international organization in the hopes of creating an opening dialogue and drawing the attention of the medical fraternity towards this concern.