Gender Hierarchy in Medicine: From University to Specialization

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This article was exclusively written for The European Sting by Ms. Thamires Manzano Fernandes and Ms. Gabriela Gonçalves Santana: Brazilian, two medical students of the 4th term (2nd year) at Centro Universitário de Maringá (UniCesumar), Brazil. They are affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Women have conquered their space in medicine. However, there are still barriers to be overcome for gender equality. Such gaps have been present since the beginning of education and are perpetuated even after medical specialization. In this scenario, it must be understood that the limitation of women’s access to specialties and areas of greater prestige and remuneration is a reflection of occupational gender segregation, initiated in higher education institutions.

The hierarchy of medicine is a consequence of the absence of a feminine gaze in educational institutions. Therefore, many women who occupy highly prestigious positions end up being labeled with stereotypes of masculinity, such as rigidity and hostility, to be seen as worthy of the position held. Otherwise, they are judged as fragile, since feminine stereotypes such as expressiveness, emotion, and affection are judged as characteristics of inferiority.

Based on this assumption, the gender segregation present in the medical culture of the teaching staff is transmitted to students who are conditioned to rank medical specialties according to gender. Therefore, areas of greater prestige and remuneration are encouraged for men with sexist justifications. An example of the aforementioned segregation is the male encouragement to surgery due to the need for strength and endurance. On the other hand, medical academies associated with female stereotypes such as vanity and motherhood, which would supposedly be related to getting along with children, are impelled to follow specialties such as pediatrics, dermatology, gynecology, and obstetrics. This mindset demonstrates that the hierarchy in medicine begins within the university itself and continues until the speciality choice period.

Furthermore, gender differences still persist after the residency period, which is possible to abstract from the recent article Prevalence Of Unprofessional Social Media Content Among Young Vascular Surgeons, published in 2019 by the Journal Of Vascular Surgery. The article’s purpose was  judgement of social media posts by female doctors, in which they dressed in swimwear outside of working hours, as “potentially non-professionals”. As a form of protest against this sexist concept, there was the emergence of the social media movement MedBikini, in which university, medical and other female students showed their dissatisfaction through photos dressed in swimsuits, illustrating that their professional capacity is not related to their clothing.

To sum up, some gaps have been increasingly filled in recent years, although there are still barriers to be overcome, and it’s extremely important to cut the gender hierarchy rooted within medical schools and specializations. In order to that, it is necessary to create a professional identity formation based on a more equalitarian gender model, in which there are greater representation and protagonism of female doctors in specializations surrounded by masculine stereotypes. Therefore, it is time to turn our attention to the reasons why some specialties are predominantly composed of women, and other by men.

About the authors

Thamires Manzano Fernandes: Brazilian, medical student of the 4th term (2nd year) at Centro Universitário de Maringá (UniCesumar), born on 20/09/1997 (23 years old) residing in the city of Maringá-PR and born in Marília-SP, Director of the Standing Committee on Medical Education at IFMSA Brazil UniCesumar.

Gabriela Gonçalves Santana: Brazilian, a medical student of the 4th term (2nd year) at Centro Universitário de Maringá (UniCesumar), born on 10/01/2000 (21 years old), resident in the city of Maringá-PR and born in Goiatuba-GO.

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