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My first insight into the gender pay gap came when I was elected LNC chair last year, during my second year of foundation training. I was appalled by the fact that applications for clinical excellence awards are treated the same, regardless of whether the applicant is less than full time. LTFT (less-than-full-time) doctors, many of whom are women, spend less time in the workplace, have less time to put their application together and less time in which to demonstrate ‘excellence’. How is this fair or even logical.
Today we mark Equal Pay Day, the day that women stop earning in the year, relative to men. This is not just about a gap in pay, though national data estimates that on average female hospital doctors earn at least 18 per cent less per hour than men. It’s also about a gap in our culture, a gap in opportunities, another block that contributes to the rigidity of our working lives – for women and for men.
Many of the inequalities in medicine are based on outdated customs and practices. A lot of these have evolved, apparently unintentionally, into the rigid ‘way that it’s always been’ so that meetings happen after work, networking taking place in the pub when many woman doctors have to go home and make their children’s tea.
The gender pay gap is the prejudice and discrimination that is casually dispensed in the workplace. I’ve been told that I am a pretty face, destined to crowd the world with pretty children. But I am so much more. I am passionate about my work, about research and want to make a difference without being patronised about how this will affect my physique.
The gender pay gap is the outdated system of maternity and paternity leave which forces many women doctors to take time out of their careers with long-term detriment. My male colleague who will become a father in a few months has told me about how he would like to split the care with his wife, as they both are dedicated to their careers. They will be reluctant to give up their baby’s first steps and first words to childcare. In reality, it's really difficult for fathers to take extra time out as shared parental leave. It's often easier for the woman to take maternity leave, but in too many cases her career then suffers as a result.
The gender pay gap is the rigid, inflexible approach to flexible working in medicine. I have heard colleagues say ‘working flexibly would be the perfect option for me, I would apply if I knew I could obtain it’. Why as a foundation doctor are you not allowed to work more flexibly than 100 per cent or 50 per cent? Why not somewhere in between? You can’t make people fit into slots like building blocks. The more flexible employers are, the more likely doctors will be to apply for jobs, to stay and to bring others with them.
We shouldn’t be condemning a dad that wants to take part in raising his children. We shouldn’t be stigmatising a woman who wants to prioritise her career, who wants to pursue a surgical specialty.
This culture in which ‘we don’t mention your children or you will be kicked out of theatre’, ‘pretty faces are not meant to do medicine’, ‘it’s not professional to show emotion’ is not healthy. Unless this changes, people will give up on their most prized passion that has driven many since childhood, and either change specialty or worse, leave medicine completely.
The independent review of the gender pay gap in medicine is looking at many of the issues which hold back women’s medical careers and affect pay. I got involved with the review because I hope that it will bring many of the outdated norms and practices to light, show the toxicity level of this rigid system and will be the base for change. The review has genuinely been listening to doctors like me, at all stages of training and working, and in different specialties.
Now the review team want to hear your views. A survey will be going out shortly to around 40 per cent of all doctors. If you get an email invitation to take part, please don’t delete it. Take this opportunity to have your say about important issues around working practices and culture that contribute to the gender pay gap. This is a once-in-a-generation opportunity to change the culture.
We are human, we have potential, and we all have a place in this system, we just have to be allowed to find it.
Cristina Costache is a member of Council and the JDC executive subcommittee and represents JDC on the BMA’s internal advisory group on the gender pay gap review.
For more information about the gender pay gap review see the BMA’s dedicated web page
Go for it!
Completely agree. There's too much "how it's always been" everywhere, we won't solve many of the world's most pressing problems with this approach. For what it's worth, I'm a man with children and I'd like to leave to see my children at the end of the day too!