Why don't more women go into EM?

[ENT Doc]

Urogirl wrote:

ENT Doc: I agree with most of your points especially the point of having an honest conversation.

“My point was to say that there will naturally be skewed interest in any field, and that because a percentage different from 50 exists doesn’t imply unfairness.” –It also does not imply fairness.

I don’t believe the world will be perfectly balanced.”Most of these coders are self-taught, so I’m not sure what kind of exposure you think would have leveled the playing field. It’s not like society refused to allow girls access to computers the last 3 decades. “- I appreciate your honesty, but there is evidence that exposure does increase interest. ie Girls Who Code.  “Society” did not refuse access, but it did not encourage it. Elementary schools in my area are now requiring coding/computer science classes.

I think the bottom line is that men and women are different. Each person will gravitate toward a comfortable environment. That will likely be an environment they have been exposed to in the past or one in which they see those similar to themselves.

 

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I agree that exposure increases interest, but the playing field was fair before in terms of getting interested in coding - it's just that boys decided to geek out on their computers late night more than girls did.  Society said nothing of a male/female preference.  Any discrimination, if present, on the downstream end should be the aim of correcting differences.  Instead, the mandated exposure you speak of is simply trying to create a mandated level playing field dissociated from natural free will, all because Silicon Valley didn't have a perceived appropriate number of women.  When will the clammoring stop?  When women are at 25%?  30%?  Something tells me those who deemed Silicon Valley not diverse enough won't stop until it hits 50%.  And that is sad, because it disrespects natural differences between groups, which is OK - that's what makes us interesting and complex.  The focus should only ever be on fair conditions, not on "fair" outcomes or a means to achieve them (which mandated coding for all constitutes to the extent the purpose is for diversity rather than having everyone learn a very important language).

[Urogirl]

ENT Doc: I agree with most of your points especially the point of having an honest conversation.

"My point was to say that there will naturally be skewed interest in any field, and that because a percentage different from 50 exists doesn’t imply unfairness." --It also does not imply fairness.

I don't believe the world will be perfectly balanced."Most of these coders are self-taught, so I’m not sure what kind of exposure you think would have leveled the playing field. It’s not like society refused to allow girls access to computers the last 3 decades. "- I appreciate your honesty, but there is evidence that exposure does increase interest. ie Girls Who Code.  "Society" did not refuse access, but it did not encourage it. Elementary schools in my area are now requiring coding/computer science classes.

I think the bottom line is that men and women are different. Each person will gravitate toward a comfortable environment. That will likely be an environment they have been exposed to in the past or one in which they see those similar to themselves.

 

[LizOB]

Something that I don't think has been brought up as a reason why more women don't do EM is that women (on average) probably place a higher value on having ongoing relationships with patients. Just like things like lifestyle, procedural or not, and other factors play a role in specialty decision, so does whether or not you see the same patients over time. This can be a double-edged sword of course, but most of the time I really enjoy seeing follow-ups as an ob/gyn. I actually considered EM but this was one of the reasons I decided against it.

[Zaphod]

Urogirl wrote:

And what exactly do they say about Urologists?

I can tell you that working in a field that is 93% male is “interesting”. Specialty choice is culturally biased. But also your medical school experience is biased. I hated OB since the female residents were also horrible to me as a woman. In another location, that experience may have been exceptional.

ENT Doc, your comments are full of bias

“Do we honestly think that boys/girls will care equally about slaving in front of a computer learning code, showing the willingness to not do homework or drop out of school because they are so engrossed in their coding? Girls have a natural tendency to do well and prefer a structured environment. Coding and the tech industry is anything but. Do we honestly think that men/women will be equally attracted to waste management, forestry, and construction?”

Yes. I think people who are exposed to coding, tech, waste management and construction can develop an interest. I don’t believe in quotas or forced equal representation. But I do believe that exposure is key..and then let the “natural tendency” gravitate people to their intended field.

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To pretend that people have zero innate set of proclivities and if just offered the opportunity it would be perfectly balanced is counter factual. Yes, I agree that the rates are all messed up given social and cultural norms but that doesnt mean they are an even 50/50 outside of this.

Men and women are different, and do have different interests and natural tendencies and this will bear out in all kinds of disproportionate ratios in life aspects.

I mean, why arent there more women serial killers, bombers, and school shooters? Why is it mostly men try to kill themselves doing stupid activities that end them up on the darwin awards type pages?

[Hatton]

This thread is sad to me.  I see several male docs commenting again (and one female urologist) about how horrible their experience was as a student on a OB/GYN rotation.  I am now 60 (next week)  and this is really a turnaround in medicine.  Few women did OB when I decided to do it so you had to interact with your male cohorts in a friendly manner if you wanted to survive.  I think maybe behavior gets out of control when things are out of balance.

[ENT Doc]

Urogirl wrote:

And what exactly do they say about Urologists?

I can tell you that working in a field that is 93% male is “interesting”. Specialty choice is culturally biased. But also your medical school experience is biased. I hated OB since the female residents were also horrible to me as a woman. In another location, that experience may have been exceptional.

ENT Doc, your comments are full of bias

“Do we honestly think that boys/girls will care equally about slaving in front of a computer learning code, showing the willingness to not do homework or drop out of school because they are so engrossed in their coding? Girls have a natural tendency to do well and prefer a structured environment. Coding and the tech industry is anything but. Do we honestly think that men/women will be equally attracted to waste management, forestry, and construction?”

Yes. I think people who are exposed to coding, tech, waste management and construction can develop an interest. I don’t believe in quotas or forced equal representation. But I do believe that exposure is key..and then let the “natural tendency” gravitate people to their intended field.

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As I stated, to have an honest conversation I need to hear those advocating for coding exposure and the like for women yelling just as loudly for having women exposed to the less "desirable" and far less well diversified fields such as construction, waste management, etc.  Otherwise it's a disingenuous focus on only the more high profile and glamorous jobs.  As for my bias, the structured learning environment I spoke of where girls tend to do better in is not opinion - it's well-documented.  Most of these coders are self-taught, so I'm not sure what kind of exposure you think would have leveled the playing field.  It's not like society refused to allow girls access to computers the last 3 decades.  My point was not to say women shouldn't or can't code.  They can and should if that is their desire.  My point was to say that there will naturally be skewed interest in any field, and that because a percentage different from 50 exists doesn't imply unfairness.

[Urogirl]

And what exactly do they say about Urologists?

I can tell you that working in a field that is 93% male is "interesting". Specialty choice is culturally biased. But also your medical school experience is biased. I hated OB since the female residents were also horrible to me as a woman. In another location, that experience may have been exceptional.

ENT Doc, your comments are full of bias

"Do we honestly think that boys/girls will care equally about slaving in front of a computer learning code, showing the willingness to not do homework or drop out of school because they are so engrossed in their coding? Girls have a natural tendency to do well and prefer a structured environment. Coding and the tech industry is anything but. Do we honestly think that men/women will be equally attracted to waste management, forestry, and construction?"

Yes. I think people who are exposed to coding, tech, waste management and construction can develop an interest. I don't believe in quotas or forced equal representation. But I do believe that exposure is key..and then let the "natural tendency" gravitate people to their intended field.

[ENT Doc]

Zaphod wrote:

I agree with your statement, however will point out a conundrum.

As these obvious proclivities in interests end up in some skewed distribution of one thing or the other, the culture then adapts to that ratio and then influences the marginal (as in last couple % one way or the other) candidates to/away from that field. Chicken or the egg. So I think your point about culture/etc…is a great one, those need to be destroyed, but we should expect skew.

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I see your point, but I think you can have skew without it influencing people to not go into the specialty based on bad culture.  Someone may not be so inclined to work in a field that's 90% male/female for no other reason than they're "uncomfortable" with that.  That situation is fine with me.  What's not fine is when the 90% create a bad atmosphere for the minority and make it uncomfortable for legitimate reasons.  Whether a few bad apples or not, it's always everyone's responsibility to ensure we are all treated with respect and fairly.  Same rules applied to all.  As long as the those positive conditions hold, I could care less about skew.  And without question we should expect some.  I just have a huge problem with people saying we "need" more XYZ in a certain field, as if they know what societal prescription is optimal rather than leaving it to individual choice.  Their efforts would be more efficiently and justly spent addressing things that improperly create that skew rather than trying to change the skew itself.  At the risk of seeming political, which I do not intend to be, my thoughts on this are better summarized by a man whose writings I respect tremendously, Dr. Thomas Sowell:

http://www.tsowell.com/spquestc.html

 

[TheHappyPhilosopher]

Radiology has an even lower percentage of women, and I don't really understand it. Last I  checked it was around 25%. If I had to hazard a guess, I would speculate that for a greater percentage of women, direct patient contact is important. Radiology has little of this outside of IR. It does come with the possibility of flexibility with a shift-work friendly format similar to ER.

[Craigy]

Interesting old thread.

One random theory why more women don't see the benefits that the ed points out:

The feeling I got from a lot of the women in my wife's medschool class is that very many felt inherently guilty about making a career choice based off of the perks of the job, period.  There were certainly guys that felt this way too, but they were few and far between. This feeling wore off as the years went on, but for many it didn't wear off until people had matched and started residency, or beyond.

The smarter ones were able to shed that guilt a lot quicker, or never had it.  Got very high step scores and were on their way to specialties like derm, rads, anesthesia, or the one girl going into ortho, etc.  On the other hand, a lot seemed to already know they would be choosing psych, peds, internal med, etc. and knew they didn't have to push as hard on usmle, so perhaps that's a bit self-fulfilling.  By the time they thought they might want to choose something else, they were looking at a low step 1, possibly step 2 score and the options weren't really there.  That said, I know a couple girls with very high step scores who chose peds and family med anyway.

So yeah, there's plenty of factors, but I think that female med students, in general, are less willing to consider job benefits like schedule and salary over perceived enjoyment, societal value, or general interest in a particular specialty, etc.

[Strider_91]

EPs like the great outdoors.

Orthos all played a sport in college.

Anesthesiologists like to complain about Obamacare and midlevels online.

And according to one of our lectures, over 50% of psych residents abuse benzos.

There are outliers of course.

 

 

I feel that I need to give EM waaaaay more thought after being active on these forums. It seems that everyone on these boards who does EM is basically a cloan of me.

 

every Anesthesiology board is EXACTLY what you are saying. I hear they also like to talk about the stock market.

[Zaphod]

I agree with your statement, however will point out a conundrum.

As these obvious proclivities in interests end up in some skewed distribution of one thing or the other, the culture then adapts to that ratio and then influences the marginal (as in last couple % one way or the other) candidates to/away from that field. Chicken or the egg. So I think your point about culture/etc...is a great one, those need to be destroyed, but we should expect skew.

[ENT Doc]

To the extent that a culture and/or men are creating barriers for entry this is unfortunate and needs to be addressed.  However, we must recognize two things in order to have an honest discussion - there will always be a natural tendency for one group to prefer one specialty/job over another job, and that to the extent a culture and/or women create barriers for entry in women dominated fields this should ALSO be addressed.

The first item is important to recognize because we shouldn't push for equal representation in all fields - men and women are different and have different needs/desires.  Thus, there will be a tendency to gravitate towards different fields.  Again, correcting the inappropriate barriers/culture issues is all that we as a society/physicians should attempt to correct IMO, and not all of the disparity should be attributed to such barriers.  We see this in the tech industry these days.  Do we honestly think that boys/girls will care equally about slaving in front of a computer learning code, showing the willingness to not do homework or drop out of school because they are so engrossed in their coding?  Girls have a natural tendency to do well and prefer a structured environment.  Coding and the tech industry is anything but.  Do we honestly think that men/women will be equally attracted to waste management, forestry, and construction?

The second item is to the point WCI brought up re: specialties like OB/Gyn.  That is perhaps the most toxic environment I've ever encountered as a male.  Not only was it dominated by women who had NO problem talking down to me as a medical student (including nurses), but I literally had a (female) OB/Gyn stop in the middle of rounds, put down her glasses, look me straight in the eyes and say "that's the dumbest question I've ever been asked" to a question that was completely harmless, non-offensive and had to do with the mechanism of action and long-term effects of a medication.  Needless to say, I stopped asking questions.  So the door swings both ways.  And to the extent bad culture and poor mentorship exists in those fields it should be addressed as well.  To only focus on the male side of things comes across as disingenuous, even though there may be a more historical basis for doing so.

[Miss Bonnie MD]

eas90596 wrote:

As a female ER doc, I would have to say one of the drawbacks of the gig is that since it is predominantly male, I feel like I’m always in the good old boys club. There are countless inappropriate jokes and profanities passed around during shifts amongst male staff. It takes a certain type of female, with a certain type of personality, to survive in this culture. It is also not generally accepted to have an emotional response to tragedy (which can be hard for many women). The amount of grief and tragedy to which you are exposed can make it hard to not have it take an emotional toll on you. Women can absolutely do the job, but given that women for the most part (of course there are many exceptions) tend to be more emotional human beings, it can be hard emotionally. OB/gyn you see babies and bring life into the world, pediatrics you get to see cute kids, family practice you’re seeing both healthy and unhealthy individuals. They are different kinds of gigs than EM/critical care. EM is a male dominated specialty, work conversations can get very inappropriate, and you do often see people at their worst and when they’re scared.

Also, during my training I was often told I was too peppy and it was recommended to me that I needed to be more abrasive at work in order to be taken seriously. I was encouraged to tone down the femininity to be more “serious.” I was told this by female EM physicians. I find this to be incredibly sexist, that I have to lower my voice to sound more confident and serious to other ER docs. I doubt pediatricians and OB/gyns have to lower their voices to be taken seriously at work, as it is common for women to have higher voices than men. Alas, it is what it is. I think this culture is a result of it being male dominated for so long.

It certainly is not all bad. There are many reasons why I love my job. You do have the privilege and opportunity of making a significant impact on patients during a scary time and truly making a different every day, shift work, good income, no shift is the same/variety, etc.

I also agree with the above mentioning there just aren’t as many female mentors. A lot of the females that I work with are divorced or never married. There are exceptions, but for the majority, I haven’t found a female role model. I hope with more women going into Emergency Medicine, this will change. I’m hoping to be a woman in Emergency Medicine that women can see as a role model (we’ll see!) to work on changing this.

There is a website called feminem.org that explores a lot of these issues/topics of women in Emergency Medicine.

Until there are more women in EM, I suspect the culture of the specialty will not change much, but it is changing-SLOWLY.

 

 

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Hi! I am not EM, but are you familiar with FemInEm? I recently heard about it via @CarrieMD's podcast interviewing the founder, Dara Kass. It addresses exactly what you are saying

[eas90596]

As a female ER doc, I would have to say one of the drawbacks of the gig is that since it is predominantly male, I feel like I'm always in the good old boys club. There are countless inappropriate jokes and profanities passed around during shifts amongst male staff. It takes a certain type of female, with a certain type of personality, to survive in this culture. It is also not generally accepted to have an emotional response to tragedy (which can be hard for many women). The amount of grief and tragedy to which you are exposed can make it hard to not have it take an emotional toll on you. Women can absolutely do the job, but given that women for the most part (of course there are many exceptions) tend to be more emotional human beings, it can be hard emotionally. OB/gyn you see babies and bring life into the world, pediatrics you get to see cute kids, family practice you're seeing both healthy and unhealthy individuals. They are different kinds of gigs than EM/critical care. EM is a male dominated specialty, work conversations can get very inappropriate, and you do often see people at their worst and when they're scared.

Also, during my training I was often told I was too peppy and it was recommended to me that I needed to be more abrasive at work in order to be taken seriously. I was encouraged to tone down the femininity to be more "serious." I was told this by female EM physicians. I find this to be incredibly sexist, that I have to lower my voice to sound more confident and serious to other ER docs. I doubt pediatricians and OB/gyns have to lower their voices to be taken seriously at work, as it is common for women to have higher voices than men. Alas, it is what it is. I think this culture is a result of it being male dominated for so long.

It certainly is not all bad. There are many reasons why I love my job. You do have the privilege and opportunity of making a significant impact on patients during a scary time and truly making a different every day, shift work, good income, no shift is the same/variety, etc.

I also agree with the above mentioning there just aren't as many female mentors. A lot of the females that I work with are divorced or never married. There are exceptions, but for the majority, I haven't found a female role model. I hope with more women going into Emergency Medicine, this will change. I'm hoping to be a woman in Emergency Medicine that women can see as a role model (we'll see!) to work on changing this.

There is a website called feminem.org that explores a lot of these issues/topics of women in Emergency Medicine.

Until there are more women in EM, I suspect the culture of the specialty will not change much, but it is changing-SLOWLY.