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Changing Laws Is Not Equal to Changing Minds: 22 Years of Women in Surgical Fields in Iran

Mostaan, Leila V. MD

doi: 10.1097/ACM.0000000000001271
Letters to the Editor
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Associate professor of otorhinolaryngology–head and neck surgery and fellow of head and neck surgery, Cancer Research Center, Omid Hospital, and Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; vazifel@mums.ac.ir.

Disclosures: None reported.

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To the Editor:

Reading “Reducing Implicit Gender Leadership Bias in Academic Medicine With an Educational Intervention”1 brought on a flashback.

Twenty-two years ago in my country, changing laws facilitated the entry of females into surgical fields. This new policy was based on religious beliefs and the preference of female patients for female doctors, especially surgeons.

I was the first woman who graduated as a head and neck surgery fellow in my country. After 13 years as a faculty member, one could say I am a role model for female medical students, but am I really? If I were, what would be my real story?

At a glance, I have attained an academic position and met the technical challenges of my field. However, there is much more to see: hard work, low income, and little appreciation from the work environment.

Female pioneers in a male-dominated profession must address sexism by trial and error. False beliefs and resistance against change are two daunting barriers which raise the bar for women and pressure them to be perfect. With no exact definition, perfection is perceived differently for men and women. Behavior esteemed in men is criticized in women: An assertive woman may be called aggressive and rude.

In traditional societies, figures of authority are commonly male and women are viewed as weak in challenging situations. Consequently, when a petite female frame signifies weakness and incompetence, it is not strange that female doctors are addressed as “Mr. Doctor.” Witnessing such behavior, boys grow up with a strong sexist mentality which influences future decision making, both professional and personal. As a result, it is common that a woman who enters a predominantly male field is considered an “other.”

Being ignored as an “other” is the most serious social bias in societies where connections speak louder than CVs. You might think achievements are earned by hard work, but you may see that achievements are given to men as their right.2 Even in failure, men are brought up to believe that they can come back and play again. However, failure leaves women on the bench to watch the game. There are no second chances. Laws should prevent such inequities, but laws are often in the hands of men. The only consolation is the promise of “next time,” but next time never comes.

My experience shows that women cannot easily overcome such biases, and laws alone cannot break down invisible barriers. Only by vigilant awareness and vocal intolerance of injustices can women fight sexism, even when that fight is a double-edged sword that can define women as whiners.

As a role model, you encourage others to challenge traditional gender patterns, but how can you be convincing when, as a woman, you only hold a pseudoleadership position and still struggle to establish yourself?

Overcoming sexism requires changing society’s mentality from the core of the family so that children will learn that the value of an individual’s work performance is not determined by one’s gender.

Leila V. Mostaan, MD
Associate professor of otorhinolaryngology–head and neck surgery and fellow of head and neck surgery, Cancer Research Center, Omid Hospital, and Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; vazifel@mums.ac.ir.

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References

1. Girod S, Fassiotto M, Grewal D, et al. Reducing implicit gender leadership bias in academic medicine with an educational intervention. Acad Med. 2016;91:11431150.
2. Yedidia MJ, Bickel J. Why aren’t there more women leaders in academic medicine? The views of clinical department chairs. Acad Med. 2001;76:453465.
Copyright © 2016 by the Association of American Medical Colleges