Who Will Take Care of Me?

Foreseeing the needs and availability of anaesthesiologists across Europe is a challenging task. This is influenced by different factors that include the composition of the workforce and the organization and structure of health services in every country. Some trends call for attention, such as changes in work patterns brought about by an ageing specialist population, the increasing numbers of women in anaesthesia, or cultural and societal shifts towards work-life balance. Anaesthesiology is a challenging specialty with an expanding scope of practice, requiring highly motivated professionals, frequent long work hours, and addressing stressful situations often. To ensure quality anaesthesia provision, the wellbeing of this diverse population of anaesthesiologists should be addressed. Achieving rational and flexible work hours, adequate compensation, and promotion of a workplace culture that fosters safety, motivation to learn, and equal opportunities for leadership or academia positions are challenges to be addressed to make sure that excellence in patient care is maintained.

The Imposter Phenomenon in the Medical Profession

The imposter phenomenon, or imposter syndrome, is defined as an internal experience of feeling like an intellectual fraud, despite external evidence of an individual's accomplishments, and results in an inability to internalise a sense of success. It is common among high-achieving people, and appears to be more common in women and ethnic minorities. In this chapter, a systematic review of the literature will be presented on imposter syndrome in the medical profession. Topics covered include purported aetiology, implications (including the impact on mental health and career progression), limitations of research, potential coping strategies, and avenues for future research.

Parallels Between Improving the Culture for Women in Surgery and a Surgical Approach to Improving Health for All

Every person should be valued for their skills and potential, for every moment they are present. Training on Diversity and Unconscious bias is urgently needed. All staff must see themselves as role models, creating culture and reacting to another's name badge/role, with “fake it till you make it”. Those with poor behaviour may lack insight. Zero tolerance involves others taking a poorly-behaving peer for ‘a Vanderbilt cup of coffee'. Informal mentors should avoid gendered assumptions, e.g. all medical students need to scrub in. Leadership roles should have a clear application process. Inequality is not just a women's issue. Improvements must focus on the women themselves, the others around them, and the structures/processes. There are parallels with prevention in healthcare needing 3-pronged change: in individuals, society/culture, and organisations. More people being active can rapidly reduce the need for, and cost of, healthcare and social care by £Billions annually. The current paradigm of health is perhaps passive and paternalistic and a radical approach is needed.

Understanding the Value of Gender Equity in Healthcare and How to Pursue It

Female and male physicians practice medicine differently. Female physicians engage in different communication styles, allocate more time to preventative care, and show different leadership qualities. Because gender diversity is still lacking in the top academic and clinical positions, medical organizations are not fully benefiting from these strengths. This chapter will identify three barriers that prevent women from advancing to these positions: the double burden syndrome, sexism and sexual harassment, and gender bias. This chapter will take a critical look at organizational culture and propose changes that can contribute to the pursuit of gender equity.

Training Martians and Venusians on Jupiter

The challenge of diversification in the medical workforce cannot be ignored. Society and societal norms have also progressed at pace and terms and attitudes that were acceptable are now outdated. Trainers must be professionalised to ensure that training of trainees remains an exemplar role. It is accepted that boys and girls learn differently but have the same potential. Equity of opportunity ensures that the modern society retains and values all genders. By exploring whether these differences continue into the post-graduate education system, the medical profession can accommodate and mitigate to ensure equity. This chapter will explore the need for professional trainers, the educational needs of the modern-day medical trainee, and the challenges that need to be accommodated to ensure that the medical workforce retains a passion long into their careers.

Gender Inequity in the United States Surgical Workforce

Despite the consistently reported gender parity among accepted applicants to US medical schools, upstream parity in surgical training, academic promotion, leadership positions, pay equity, grant funding, and efforts to promote wellness specific to the needs of women surgeons is seriously lacking. Along with these known disparities, women surgeons disproportionally suffer from gender bias, micro-aggressions, bullying, discrimination, and harassment that together create an unjust, unsafe, undignified, intolerable if not hostile work environment. This chapter will explore these issues and offer a landscape that will set the stage for future initiatives to invoke change.

Gender Equity in Medical Leadership

Female representation in medicine is increasing, however women make up only a small percentage of senior roles in the NHS. Only 36% of consultants are female with wide variation between specialties ranging from 12% of surgeons to over half of paediatricians, gynaecologists, and directors of public health. Women comprise 77% of the NHS workforce and account for 44% of chief executives of all NHS Trusts and 47% of executive directors. This chapter analyses the role of women as leaders within the medical world and compares the representation of women in senior leadership roles within medicine and other parallel, male-dominated working environments. Alternative forms of leadership such as mentoring, coaching, and sponsorship are also considered.

Sexism in Medical Communication

Communication is one of the most essential skills of the medical profession, however, it is a tool through which sexism and gender discrimination are promoted and reproduced. There is often the perception in medicine and surgery that gender inequity centres on lifestyle, family responsibilities, and childcare issues. However, this chapter highlights that deeply engrained biases in medical communication still exist, and are perpetrated by institutions and individuals, women included. Awareness of gendered language must be raised and highlighted in order to make a change. It is achievable to speak in gender-neutral ways that are inclusive and precise as to not conjure biased attitudes towards women in medicine. Social change must be pursued at the level of the institution, the cultural structure, and at the interactional level of gender.

Parental Leave During Surgical Training

Work-family conciliation is currently in vogue. However, reality demonstrates that there is still a long way to go before being forced to make a choice between work, family, or personal life. Can a balance be achieved among the three? In relation to the medical profession, is there currently an adequate conciliation policy? Can these strategies be extrapolated to the training period? The proposal in this chapter consists in carrying out an up-to-date analysis on the parental leave situation during medical training as one of the main aspects of conciliation, by analysing parental leave policies and barriers faced by surgical trainees.

Gender Equity in Surgical Academia in Kuwait and the Arabian Gulf Region

Gender equity has been a topic of interest in medicine for decades; however, it has extended to include surgery, a field that has been dominated by men for centuries. Nowadays, gender inequity in surgery is a worldwide issue that needs to be addressed since significant disparities exist in the surgical field compared to the medical one. In this chapter, authors introduce the current status of Kuwait and the Gulf region regarding gender equality, and outline the history of women surgeons in the region. The evolution of medical education in surgery and the evolution of the healthcare system and how these relate to gender equity in surgical academia is presented. Challenges related to the uniqueness of the Arabic and the Islamic culture and the future directions of where the field of surgery is headed in relation to gender equity is discussed.