Good post by skylizard. This is one of my favorite topics and one that we talk about quite a bit. So apologies in advance for the long (and possibly rambling) post...
I have never (and do not expect to) encountered any overt discrimination in the hospital. But there are subtle undertones. A lot of the older patients think I'm a nurse (even when I march in with my white coat and MD badge - go figure). I'm the only girl in my intern class, and at the last department function I watched the resident-vs-attending basketball game from the sideline with the wives. I was recently asked by an older attending what specialties I was considering, and when I said I was still open to a lot of possibilities, his response was, "Well, you don't have many options, do you? I mean you're a woman - that pretty much limits you to breast or plastics." Whenever I come onto a service, I usually hear a lot of grumbling from the nurses about how much they miss the male intern who preceded me, and often some grumbling from the attendings too (who apparently miss the cameraderie of an all-male service.) This came to a head on my last rotation, when another intern confided to me that the VA staff was "terrified" of having a female intern coming onto the service (seems they'd had all guys for 6 months). The same intern told me that the (male) medical students at the VA were also apprehensive at the prospect of having a "surgery bitch" responsible for their grades.
So...does internship/residency as a woman have to be a constant struggle against put-downs and favoritism? Absolutely not. And as skylizard said, a lot of what we hold up as "discrimination" is probably honest mistakes clouded by oversensitivity. The way I see it, a lot of my elderly patients hail from a time when the only women in a hospital were nurses. A lot of the older attendings trained in an era when surgery residencies were like a band of brothers. Like it or not, these people's perceptions were shaped by the eras in which they grew up (or in the case of the medical students, other residents with whom they've worked). You can either get frustrated by this, or you can accept it and work to change those perceptions (ouch...cliche, but true).
Speaking of cliches, I never really understood the concept of the female-surgery-resident-as-witch cliche until this year. In my opinion, a lot of women go into surgery with the attitude that they need to somehow prove themselves as better, stronger, and tougher than the boys in order to force the attendings to respect them. When I was interviewing for residency, I was floored by how b*tchy, catty, and cutthroat a lot of the girls seemed. They were constantly sniping at each other about their clothes, their CV's, their board scores. There seems to be this perception among male surgeons and residents in other specialties that female surgery residents are almost uniformly vicious, frustrated gunners that are constantly trying to prove that they are good enough to run with the boys. As much as I hate stereotypes, there were an awful lot of gals that fit right in with that one on the interview trail. And I can't exactly blame the "old boys club" for wanting them to fail.
My attitude about starting surgical residency as a young woman was that I didn't want to have to prove anything, and I didn't want surgical residency to turn me into a bitch. I think carrying yourself with class and quiet confidence goes a whole lot further than trying to prove that you're the best. Don't expect respect. Set high goals for yourself - read diligently, do research, run your services well - not because you want to prove that you're better than the boys, but because your training during these next few years is going to prepare you to go out into the big ol' world as a surgeon, and then it's not going to matter whether some elderly demented patient thought you were a nurse.
So I wear makeup to work every day; I coordinate my jewelry and my scrubs. I cry with my patients on occasion. I even carried one of those pink fluffy pens that Elle did in "Legally Blond" for the first week that I was at the VA (I couldn't resist. I read Glamour and US Weekly with the nurses when I'm on night call. (I also watch football with the ortho guys in the call room, because I'm a sports nut). Be yourself. Don't think you have to be one of the guys to somehow "validate" yourself as a surgeon. Yes, women in surgery are a relatively new development, and yes, the old guard can find that threatening. Depending on how conservative your program is, you may find some double standards. But YOU CANNOT CHANGE THAT. All you can do is treat everyone with respect, carry yourself with confidence, and be the best surgeon you can be.
Internship is a great year. Have fun!
