Esther Choo, MD MPH Profile picture
Jul 8, 2018 13 tweets 4 min read Twitter logo Read on Twitter
Interesting question that gets at my central concern about declaring a major interest in advancing careers of #WomeninMedicine or #MinoritiesinMedicine, particularly as a research interest - cc @NarjustDuma
The last time I gave a talk on gender bias in medicine, a faculty member asked me if it had hurt my career to speak on this topic. I was taken aback, but then realized it was a smart question.
It’s a high risk topic for a number of reasons:
1. Speaking on the negative biases & inequities women in medicine face evokes skepticism and defensiveness, and the tendency to mentally (or even verbally) undermine the speaker higher than usual.
2. As a researcher, I risk aligning myself with what could be considered a “soft” topic. Unpacking that, I think it comes down to a) not a clinical topic b) rarely fundable as a line of research and c) even when funded, for small $$ (with rare exceptions).
3. Beyond the implications to a researcher, presenting these topics can misfire if:
- it lacks hard data
- there is zero audience buy-in
- it is seen as only benefitting women, rather than the whole workplace
- it focuses only on the challenges & needs of mothers ...
- there’s a “we got this covered” attitude in the institution, rather than “how can we be (even) better?”
- it’s perceived as being scolding or even punitive

Overall, many landmines & ways it can be poorly received by the very people you are hoping to impress / align with
So I’m not certain that the biggest barrier is overcoming one’s own fears about speaking up; I think the risk of being devalued is REAL.
So does that mean I think we can’t give these talks or declare our interest in promoting careers of women / minorities in med? Of course not. We need to open this dialogue, even routinize it. We need research & education & advocacy.
But thinking in terms of being effective AND protecting you all from the potential career harms, I’d advise a few measures, most alluded to above.
- be as rigorous on this topic as you are for any clinical or research topic; pair narrative w data
- do not hinge arguments for change on fairness
- find male champions, as this message can’t come from women alone
- don’t frame this as a women’s problem: it is everyone’s problem
- before going into a talk, gauge the receptiveness of the chair & audience. A talk to a precontemplative audience is different than a talk to one activated for culture change
- for most people (not all): have a “hard” area of expertise that gets you in the door
IMHO (perhaps a too-skeptical one?), addressing the inequities faced by #WomeninMedicine and #minoritiesInMedicine are things we can talk about once we have buy-in, rather than the things that will earn us the buy-in. At least for now.

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Aug 8, 2018
Thrilled to work with @DGlaucomflecken to develop an infographic about correct nomenclature when discussing gender bias in academia. Follow along.
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You all know this one... The Manel!
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