Doctors – Mrs. Miss. Mr.

By- Dr. Suranjana Basak

Consultant Physician, Reliance Hospital Navi Mumbai

Chief ICU Intensivist, NMMC CIDCO Covid ICU, Navi Mumbai

Dr. Akash Lobo

Intern, DY Patil School of Medicine, Navi Mumbai

When the first Indian college of modern medicine was set up in 1835, women were not allowed to enroll. It was only half a century later that this restriction was eased and Kadambini Ganguly joined as the first female Indian student, albeit to much opposition. Did you know that up until a decade ago, the number of male medical students enrolling was far more than females? Today, while there are more female students joining medical colleges, certain deep-seated issues still pervade the system.

If we were to observe a day in the life of a female medical student, it would not be altogether unusual for her to walk into the wards and be referred to as ‘sister’ or ‘nurse’. Her problems, however, only start there. When she steps forward to examine the patient, her competence is immediately under question. She has undergone the same training as her male counterpart but must bear the burden of societal prejudices for no fault of her own. Despite this inequity, she works hard and graduates medical college to become a full-fledged doctor. This time she walks into the wards with the title ‘doctor’ displayed proudly on her scrubs, confident that her qualifications will be respected, only to be faced with other biases that carry a much larger impact. 

Research shows that female doctors are, on average, paid twenty percent less than male doctors. While part of this might be explained by specialty choice and different working hours, a large portion of the pay gap goes unexplained. Women are also less likely to rise up the ranks to realise this higher pay. When 11 of India’s top medical institutions were studied, only 1 was found to have a female director. This could be attributed to a lack of trust or a general unease in being subjected to female authority by the male incumbents. India was one of the first countries to be led by a woman prime minister and it would only be fitting if we were to extend that parity to the field of medicine.

After internship we are faced with the great choice, the choice of speciality. It is apparent that the thought process is different among the sexes. Women are encouraged to pursue specialities that have fixed working hours and many women are discouraged from a postgraduate degree altogether. By the time they graduate, they are in their mid 20’s and often the ideal Indian age for marriage. The societal concept of “What will further education even do?” has been imbibed from such a young age that even completing the first step of medicine feels like an achievement. To a point that the girl often believes that she’s fulfilled her dream of becoming a doctor and that now she should cater to her family wishes of getting married. While there’s still a significant population of female medical graduates who pursue post graduation, 54% of them stop at MBBS and further 38% of them stop practicing medicine altogether. Retrospectively, is it a waste of those medical seats? Is this what contributes to the ever growing doctor patient ratio?

72% of India’s population lives in rural and under-developed areas where basics are such a scarcity, let alone healthcare services and education. It is observed that patients often choose the male doctors for their ailments. Women’s security, safety, “what will people think” and societal judgement (for choosing to practice medicine while also looking after her kids and household matters) are some factors which prevent them from practicing. It is unfortunate that the crux of the issue is rooted deeper than it appears.

Women doctors are still responsible for managing the day to day activities of the household, and cannot always rely on their spouses for the same. This gets worse after pregnancy, with the workplace seldom making compromises with respect to working hours and rarely providing facilities such as creches to assist the working mother. This is despite such facilities being legally mandated. The months of work lost to childbirth can be detrimental in certain surgical specialties where constant practice is required, and retraining workshops would prove helpful to these mothers.

It is important to remember that these are all issues that she has to deal with in addition to the general challenges that come with being a doctor. That said, the medical field can be a beautiful thing for a woman in India. Her knowledge and status give her many freedoms that her non-medical peers do not enjoy, in her career as well as socially. She is free to bring up her child in the manner she desires and her spouse is more likely to support her career for the benefit of the family. She can ultimately live the life she wants to live and pursue her career to its fullest. 

The society in India needs to understand the big picture. The wage and leadership gaps must end, with merit taking the driver’s seat. We must work towards creating a respectful and inclusive work environment where everyone feels comfortable enough to give their best for the benefit of the patient. No one understands discomfort as a woman does. When a baby is born and can’t speak, it is the mother who understands the language. It’s a mother whose advice you heed as a kid when she raises you, her “kadha” you drink when your throat’s down, yet after you’ve grown up, your prejudices seem to have too. Just because it’s been going on, doesn’t make it correct. As we head towards the millennial future, it is time we change our thinking and evolve from our prejudices.

References : 

  1. https://blog.doximity.com/articles/doximity-2019-physician-compensation-report-d0ca91d1-3cf1-4cbb-b403-a49b9ffa849f
  2. https://medicine-matters.blogs.hopkinsmedicine.org/2021/06/closing-the-gender-pay-gap-in-medicine-identifying-drivers-of-inequity-and-devising-solutions/
  3. https://blogs.bmj.com/bmj/2015/07/31/anant-bhan-gender-gap-in-medical-education-leadership-in-india/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004221/
  5. https://www.researchgate.net/publication/23468594_Women_physicians_in_India

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