On our own terms
Authors: Jane H Roberts
Journal: Journal of the Royal Society of Medicine (2007)

A feminist critique of the 1990s pop group the Spice Girls would have probably applauded their promotion of ‘girl power’ even if doing it on their own terms invoked a heavy call on overt sexuality. Do we have something to learn from those deposed icons of the pop world in academic medicine?

As an advocate of promoting the career progression of women clinical academics I would suggest there is much to be said for creating our own model and resisting the temptation to play the boys at their own game.

No one in medicine can have failed to remark the increasing feminization of the profession,1 which has not always been portrayed in a positive light.2 A negative take on an increasingly female medical work force may well be the response to continuing to view the world from a patriarchal position. If we only value the traditional model, ‘it's a man's world’, then the strengths and differences of a matriarchal culture are easily dismissed.

That men and women both see the world and live in it differently has been a phenomenon since we lived as hunter gatherers 10,000 years ago. Even then the kudos of bringing home ‘the bacon’ is interpreted as having greater prestige than gathering the fruits, herbs and vegetables which allowed us to enjoy more balanced diets.3 It also underpins much of our humour.4

If, however, we can only accept that our current way of working is the only option then women will continue to hit the glass ceiling. This is not to deny the progress that has been made: women are beginning to occupy the echelons of power within medical academia and present a powerful, visible female image to the outside world. Baroness Finlay presides at the Royal Society of Medicine, past president of the BMA is Parveen Kumar; Yvonne Carter is the first female Dean of Medicine (Warwick) and Amanda Howe is the MB/BS Course Director at University East Anglia. The appointment of these women represents a turning point for medical students, who at last have evidence that women too can reach positions of power.

However, we need a note of caution and an ability to resist the temptation to only see success as that which follows accepted patterns. I have been a member of the project steering group of the BMA research project ‘Women in Academic Medicine’, a HEFCE-funded leadership and governance initiative which recently proudly presented its findings at a national conference held at BMA House.5 The project aimed to test personal and institutional assumptions, identify barriers to women's careers, provide a baseline database for future studies, identify solutions and facilitate the sharing of good practice. The day was a great success. It was well attended and we were applauded for our ample provision of opportunities for participating delegates (almost all women, not surprisingly!) to contribute, question and challenge.

I would like to take this opportunity to give voice to a quieter dialogue which was heard at the conference, and elsewhere, but which is often subjugated in the louder discussion of wanting to hold our own and keep up with the boys. This is the voice which argues for proclaiming our dual roles as parents and doctors. It offers the increasing evidence that providing parents the opportunities to care for their offspring in their earliest formative years is one of our surest ways of promoting the emotional well-being of our children into their adult years. This back-stage voice foregrounds our role as parents at important stages in our family lives. It does not, however, suggest that women who pursue academic careers are selfish or that we should all return to the kitchen. Rather, it purports to offer a healthier work/life balance for both sexes by advocating a model that would have both parents involved in childcare, with men working fewer hours outside of the home.

It is not a popular perspective, since it challenges the hegemonic tradition that we can be successful as a mother-academic despite having a family. Family friendly policies have no real currency in the present world of academic medicine. To assert one's commitment to one's family, over and above one's desired career trajectory, is to ring the death knell for a possibly golden career. But there is no absolute reason why this should be so. Why should becoming a professor at 50 be viewed any less positively than becoming a professor at 40? As long as we continue to deny the lived reality of many women academics' lives we will continue to stymie their potential career development.

It is impossible to undermine the energy involved in navigating the unexpected events and varying levels of chaos which are a feature of normal family life. This spent energy means it is impossible to maintain the same momentum as a colleague whose domestic life is looked after by someone else or perhaps—regrettably—has chosen not to have a life outside of academic medicine. The hurly burly of family life is also, however, a joy and source of inspiration and not simply an obstacle to our stellar careers which has to be constrained and above all never alluded to in our CVs or at appraisal. There is nothing more disingenuous than the oft employed term ‘family comes first’ when there is nothing about the academic career structure in the UK which supports that meaningless phrase.

Women in academic medicine might be on an upward turn and we certainly need to build on the recent BMA conference and the slowly growing profile of women leaders in medicine, but I would add that this is also a time to present an alternative model which values our dual responsibilities and needs to challenge the status quo of the successful academic. To be actively engaged with academic medicine, the lifeblood of clinical medicine, is an enormous privilege and intellectual pleasure. However, the primacy of our role as engaged, responsible parents must also be recognized and valued. If we ignore the emotional well-being of our children then we do so to ours and society's peril.