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friend asked me to give a pre-med student some advice about a career in medicine. That request made me think about the one thing I most wish someone had told me about: the challenges of being a woman in medicine.

One issue I often encounter is being mistaken for a non-physician staff member. I used to gently correct these errors and continue on with my day. But one comment from a patient made me change the way I approach these situations.

I had been taking care of a pleasant elderly gentleman who was in the hospital after a leg amputation. It’s not uncommon for patients to meet several physicians during a hospital stay, so I re-introduced myself the second day I saw him. “Hello,” I said. “I’m Dr. Julia Reilly.” I didn’t expect his response: “Oh. I’ve been picturing Dr. Reilly as a strong, male doctor.”

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I’m not sure why that was my “tipping point,” but it was. It made me look back and think about how incidents like that have affected me, consciously and subconsciously, over the course of my training. It also made me wonder what I would have wanted a medical student to have learned from the situation if one had been in the room with me.

Such interactions aren’t rare. Last week, I spent 75 minutes with a new patient and, after we had discussed his assessment and treatment plan, he asked to “speak with a physician.” Last month, a different patient told me he preferred male physicians because he felt he could “trust them more.”

Each time I’m not recognized as a doctor, or a patient dismisses my advice in favor of a male physician’s, I question myself.

Much attention has been drawn to “impostor syndrome,” a phenomenon characterized by feelings of self-doubt and fear of being discovered as an intellectual fraud. Imposter syndrome is troubling for various reasons. One is that it is highly associated with burnout, and is the strongest predictor of psychological distress among medical, nursing, and dental students.

I’m not surprised that women in medicine demonstrate higher levels of impostor syndrome than their male colleagues. Perhaps these feelings of self-doubt are responses to the obstacles that women in medicine face, such as a dearth of women physicians holding top department leadership positions, the gender pay gap, and, as my research group discovered, being underrepresented as recipients of recognition awards from medical societies.

Until this year, I had not discussed my experiences with implicit (unconscious) bias or workforce disparities with any of the medical students I had mentored, and I had seldom discussed these issues with my mentors. Yet these discussions are an essential part of medical education.

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I have been fortunate to be mentored by an experienced physician who has kept open an honest dialogue with me about the nearly universal hurdles that women physicians face today — and that are even more profound for those who are also facing other challenges, such as having a disability or being a person of color. Indeed, overlapping social constructs often elevate the barriers that women physicians encounter. With my mentor’s guidance, I have become more educated about diversity and inclusion and therefore feel more empowered and prepared to succeed in academic medicine. I have also become more vocal about my experiences as a female physician.

Sadly, not all my colleagues have had this kind of opportunity

I believe that mentors should initiate honest discussions with their female trainees about the unconscious biases and workforce disparities they may face. That way, trainees can feel primed for the challenges and supported in knowing they are not alone. I encourage female physicians to speak more candidly about their experiences in medicine — good and bad — and to share them with their colleagues through various mediums. I have started to have these discussions with the younger physicians I now mentor.

I support increasing communication and networking between women physicians in different fields of medicine, as well as with those in different health care professions. An excellent way to participate in this effort is to join the virtual community across all fields of medicine that has developed around the #ILookLikeASurgeon and #ILookLikeAPhysician campaigns on Twitter.

These discussions aren’t just for women. Male physicians should be part of them, as they share in the responsibility to mentor and support female trainees. I am encouraged by Dr. Douglas Merrill’s recent opinion piece in the Journal of the American Medical Association, which urges physicians, especially male physicians, to speak up when they see abusive behavior directed at the their colleagues, as well as by the #HeForShe campaign.

At the end of my email to the pre-med student, I added a short paragraph in which I asked her to start thinking of herself not only as a future physician, but as a future female physician. I indicated that her experience in medicine would be different than that of her male colleagues. I suggested that she seek out strong women mentors and encourage her friends to do the same.

I also told her that I thought there has never been a more exciting time to be a woman in medicine, and I cannot wait to see the type of change this generation will make.

Let’s have honest conversations with this generation and the next so we validate the experiences of all women in medicine and they know that they are not alone — or imposters.

Julia M. Reilly, M.D., is a third-year resident physician in physical medicine and rehabilitation at Spaulding Rehabilitation Hospital in Boston and Harvard Medical School.

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  • This happens to me all the time. I’m not a physician yet, I’m a med student. But every time I’m with a patient they assume I’m a nurse, and I thought it was because I live in a developing country (because the stereotypes are usually stronger). Hopefully the stereotype will fade with time, as more women are empowering themselves.

  • Agreed. And the experience for physicians of color is multiplied several-fold. We really need to have this discussion more in medicine, so that policies and infrastructure starting in early schooling ensures at the very least structural equality (since pay is still unequal and advancement and hiring practices are still unequal— and yes, with equal work and hours taken into account for the mansplainers out there).

  • Dear Doctor Julia. Don’t give up such patients. I have 2 daughters in the medical profession. I am proud of them. 1 is a doctor and the other is a physio. From my view you have done everything and if these silly guys can’t except it their loss. Take care Doctor Julia.

  • Dr. Reilly; let me say two things to you. First, it has been my experience in life that women tend to work harder, be more detail oriented and take a much greater pride in their work than men, in general. Second, if you really want to be taken seriously in your career in medicine and to be respected for your achievements and the integrity you carry with you as you move through your medical career, do the following: When you make a mistake – and you will, we all do – and especially if that mistake causes serious harm or death, be an adult with regard to that situation. Stand up, be humble, take responsibility for your actions, apologize and be ready to pay the consequences, if there are any, for your actions. That is the sign of a mature adult; and it will have an affect on the person or his/her loved ones that were most injured. This profession is filled to the brim with physicians and other medical personnel who are willing to lie, evade and run at the first sign of trouble. Do not be one of them. Otherwise, this profession is heading for the cesspool.

  • Get over it. You are greatly privileged and talented. You are in a prestige training program. Your future is assured. Your career will be financially and personally rewarding. No less than 50% of medical school admissions are women and people’s attitudes are changing.

  • According to the AARP article, “50 Great Ways to Live Longer” (March 2017), Harvard researchers found that “patients who received care from a female physician were more likely to survive and less likely to be readmitted to the hospital within 30 days of discharge. About 32,000 fewer people would die each year if male physicians achieved the same outcomes as female physicians.” “Previous studies have suggested that female doctors are more likely to follow clinical guidelines and more effective communications.”
    With that in mind, my husband and I just sought out our third female internist, after our previous ones retired.

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