Women in Medicine – The Sunday Guardian Live

BENGALURU: Hardest part of being a doctor is you could be the difference between someone living and someone dying!

Dr. Abhaya Rami was a young, promising house physician at RG Kar Medical College in Kolkata, India. On August 8, 2023, she was tragically found dead in seminar room under mysterious circumstances. The case shocked the medical community and led to widespread protests demanding justice.

Initial reports suggested that Dr. Abhaya had been facing immense stress and harassment, allegedly from senior colleagues, which might have driven her to take her own life. However, the investigation took a darker turn when evidence of foul play was discovered, pointing towards a possible murder. The case garnered significant media attention, highlighting issues of mental health, workplace harassment, and the safety of medical professionals in India. As of now, the investigation is ongoing, with authorities working to uncover the truth behind Dr. Abhaya’s untimely death, while the medical community continues to demand accountability and systemic reforms.

The recent years have seen a rise in attacks on doctors / medical establishments. While this issue has several facets to its increasing trends, it is worrisome to notice the impact it may have to practice of defensive medicine or reluctance on medical fraternity to treat patients boldly.

Justice Katju in the supreme court judgement brought to light a pertinent issue “When a patient dies or suffers some mishap, there is a tendency to blame the doctor for this. Things have gone wrong and, therefore, somebody must be punished for it. However, it is well known that even the best professionals, what to say of the average professional, sometimes have failures. A lawyer cannot win every case in his professional career but surely he cannot be penalised for losing a case provided he appeared in it and made his submissions.”

Women face numerous challenges when pursuing careers in medicine and becoming doctors. These challenges are rooted in social, economic, cultural, and structural barriers that can significantly hinder their access to education and professional development. Below are some of the key issues:

1. Socio-Cultural Barriers
Gender Roles and Expectations: In many countries, traditional gender roles often dictate that women prioritize family responsibilities over career aspirations. Women are expected to marry and raise children, which can limit their ability to pursue lengthy and demanding medical education.
Discrimination and Bias: Women often face discrimination both in educational institutions and in the workplace. This bias can manifest as discouragement from pursuing higher education, limited support from family, and fewer opportunities for professional advancement.
Safety Concerns: In many regions, women face threats to their safety, including harassment, violence, and lack of secure transportation, which can deter them from attending school or working late hours required in medical training and practice.

2. Educational Barriers
Limited Access to Quality Education: Girls and young women in many nations often have less access to quality education compared to their male counterparts. This can start from primary education and continue through secondary and higher education, creating a significant gap in qualifications needed to enter medical school.
Financial Constraints: Many families prioritize the education of male children due to limited financial resources, leaving girls with fewer opportunities to pursue costly medical education. Scholarships and financial aid specifically for women are often inadequate or non-existent.
Inadequate Support Systems: The lack of female role models, mentors, and networks in the medical and surgical field can make it difficult for women to envision and achieve success in medicine.

3. Economic Barriers
Economic Dependency: Women in many nations are often economically dependent on their families or spouses, which can limit their ability to make independent decisions about their education and career. The high cost of medical education and the long duration of training further exacerbate this issue.
Opportunity Cost: The opportunity cost of pursuing a career in medicine can be prohibitive for women, especially in societies where they are expected to contribute economically to their households at a young age. The lengthy and expensive process of becoming a doctor may be seen as an unaffordable luxury.

4. Structural Barriers
Lack of Infrastructure: Many nations often have inadequate healthcare and educational infrastructure, which can limit access to medical training facilities, clinical experience, and modern educational resources.
Policy Gaps: Many nations lack policies that promote gender equality in education and professional fields. There may be insufficient government support for initiatives aimed at increasing female participation in medicine, such as scholarships, affirmative action, and childcare support for working mothers.
Workplace Challenges: For those women who do succeed in becoming doctors, the workplace can present additional challenges, including unequal pay, lack of maternity leave, and limited opportunities for career advancement. The medical profession in many countries is also male-dominated, which can create an unwelcoming environment for women.

5. Psychosocial Barriers
Lack of Social Support: Women pursuing medicine often lack social support from their families and communities, which can lead to stress, isolation, and burnout. The absence of mental health resources and counseling services exacerbates these issues.
Psychological Pressure: The combination of societal expectations, discrimination, and the demanding nature of medical education can lead to significant psychological pressure. This can manifest as anxiety, depression, and other mental health challenges, further hindering women’s ability to succeed.
While it is prudent to take necessary steps to punish unethical practices, it is also our duty to protect the rightful ones who may hesitate due to fear of attacks. Several instances have been heard where the hospitals feared admitting the patients in emergency due to fear of mob attacks but referred to other centres leading to loss of life and severe adverse effects to life function.

Towards this and to protecting healing hands the state government brought into place “THE KARNATAKA PROHIBITION OF VIOLENCE AGAINST MEDICARE SERVICE PERSONNEL AND DAMAGE TO PROPERTY IN MEDICARE SERVICE INSTITUTIONS ACT, 2009”. Section 3 of the act makes any attack on the doctor or hospital property a cognizable and non bailable offence. To strengthen the implementation of this act, Director General of Police on request letter from Indian Medical Association issued a order to all the police depts across the state to strictly implement the act. Every act of violence against doctor should be condoned. Any grievance on part of patients or family should be addressed to appropriate authorities and with a legal course respecting the individual rights rather than resorting to physical harm to life or property.

Through our medical training and career we have all been inspired by great teachers – surgeons and physicians alike. Those who toiled their days and nights caring for patients, comprising family time and life, to bring a smile on lives of patients to thus touch their lives. Every time such a instance of heinous crime happens to a doctor like Dr.Abhaya, it hurts the very soul of art and science of medicine, demotivating an entire fraternity. Healing the wound of a patient is a doctors foremost duty, but it is equally vital for them to maintain their dignity and stand for their rights when he performs the act of service.

Dr Vishal Rao is a surgical oncologist and robotic surgeon.