What are the key challenges facing women in academic primary care?
The greatest challenge, particularly for women who have taken time out to be carers and to have families, is to be taken seriously when working part-time. Allowing women to work part-time has been normalised but there are negative perceptions that we need to shift. We are in a system that is a consequence of the people who set it up, and those people, our fore-bearers, are generally men who didn’t have the pressure to work flexibly. The culture of hard work and long hours is tied to being visible in the office. A trusting acceptance that professionals often work well flexibly, remotely, those things should mean we are moving swiftly towards accepting part-time and flexible working as entirely appropriate, constructive and helpful. But, it feels to me, like we have still got quite a long way to go. Technology should be our biggest ally in this regard. People working online are visible and can communicate via phone, instant messaging or skype, so why is there an inherent distrust of people who are working flexibly? How has the culture within academic primary care changed with more women appointed in senior positions? I always feel like sweeping generalisations are grossly unfair to many of the individuals being generalised about. It always makes me think of the many men who are incredibly collaborative and women who are incredibly protective. Collaboration is undoubtedly a powerful driver for influence because when you collaborate you tend to have a stronger voice. In my experience, the benefits of working together have always outweighed the sacrifices I have made in terms of autonomy. However, that isn’t always a gender related trait. In my current role there is a move amongst leaders of the medical Royal Colleges to be more collaborative, recognising that when you are under great pressure, the power of collaboration outweighs the benefit of complete independence. Women generally tend to be more open to collaboration from the outset and in the current climate that strikes me as a very constructive way forward.
What is your advice to junior doctors?
We often create barriers for ourselves in terms of gender stereotypes. My advice is not to let gender define your aspirations or achievements. If you really want something, then go for it. When I have come across situations where I have thought that my gender is an issue, then I have named it. There aren’t any glass ceilings that I haven’t managed to deal with. Don’t compromise like our predecessors, who fought these gender battles, did and who made many sacrifices. If you do perceive it as an issue, then call it out and name it. Talk to people about it. The advice to male doctors is the same. Don’t let your gender define you. If you feel that the macho culture means you should work or behave in a certain way, don’t feel that you have to. This is particularly relevant in a society of more gender fluidity. Confronting problems doesn’t have to be adversarial. Someone recommended a book to me a good few years ago called ‘Nice girls don’t get the corner office’ by Louise Frankel. It was helpful because it highlighted a few generalisations - women don’t generally apply for promotion until they are over qualified for the job they are applying for whereas men apply before they are qualified to do the job. That spoke to me about the gender culture in the workplace and encouraged me to make the most of my opportunities earlier than I would otherwise have done.
Would this have been different 20 years ago?
I think women would have had to be feistier to succeed 20 years ago. If you were going to play with the boys, you had to be more of a boy. I don’t think that is the case anymore, things have evolved since then.
What were pivotal moments in your career?
I have always been very respectful of hierarchy. Having the confidence to not take the advice I was given by someone quite senior - in doing so I learnt to manage upwards and to respectfully challenge those in positions of seniority - this was quite a big step forward for me. Realising that if I used my emotional intelligence with professional respect, I can achieve far more. So I am particularly careful about being very professional, very respectful and very dignified, but I won’t be compromised on my principles. Another pivotal moment is recognising the power of being controlled in a situation when others are losing their heads. I also learned how to put things in a box and move on. Recognising there are situations that are not about me but about factors that are out of my control. If I can’t control it then I don’t waste time worrying about it.
100 years after women first got the vote in this country, how can they be most effective in bringing about change?
Women must hold people to account in terms of truth and values, and should not compromise on their principles. Women can play into their strengths by keeping dialogue open and to never underestimate the power of their own influence. Those women who are in more senior positions should keep giving support and mentorship to those who are coming through the system. Encouragement, particularly to those who are isolated. Throughout our careers, we should be looking forward, but not forgetting to also look back to see if there are others we can help. Medical students looking back at 6th formers for example, junior doctors looking back at medical students, senior doctors looking at juniors. It is important to look at those who are following behind us, as they are the leaders of the future.
Do you support programmes that encourage widening participation?
I am very supportive of widening participation initiatives, not only in medicine but all the sciences, engineering, and the STEM subjects. I was brought up by two teachersas parents in a reasonably deprived part of south Wales and went to a typical comprehensive. Gender was never a problem, there were great role-models including fantastic women science teachers. It was when I attended medical school that I first heard people talking about women as a minority. I think that by the time people were starting to address gender inequality, I was part of the transforming gender landscape, and still am.
Why is it important for everyone to be updated on what sexual harassment in the workplace is?
We are at a fascinating time because the workplace landscape is shifting very fast. I have had some very constructive and honest conversations with male and female colleagues on harassment who are not sure what is acceptable anymore. The things that they thought were completely acceptable and neutral, are being perceived by some as not quite right. This means they are withdrawing from interacting with groups of people because they are unsure of how their interactions will be interpreted. This represents a very fast shift in society’s norms and expectations and if that is inhibiting frank dialogue and engagement, it worries me. So, training and provision of helpful updates on best practice when working with colleagues in all areas would be helpful and necessary.
What further changes would you like to see across academic primary care?
Recognition and celebration of the importance and value of high quality teaching as opposed to just research. Understanding that flexibly working is not inferior working. Unfortunately flexible and part-time working disproportionately affect women because of their role as mums and carers. Working flexibly should not be the preserve of women, I know many male colleagues who work part-time because of caring responsibilities and they generally find it very rewarding and a great way of keeping their professional energy up, whilst doing something else with a chunk of their time. It has allowed two people to stay in the professional workforce whereas in the past one would have given up their job and struggled to get back in at a later stage. Empowering more people to stay in the workforce by being flexible to allow others to share.
What brings me joy in the profession is delivering person centred care – and doing what’s right for that person.