Starting surgical residency was a dream come true. I had a vision of residency where we would work as a team and learn from engaged senior residents and faculty. My residency class was three women; 100% women and we became fast friends. Then reality hit for all of us.
Day One: ‘1 in 3 women drop out of surgery. Which one of you will drop out?’ was the welcome we received from a male senior resident, ‘You aren’t women here, you are surgeons,’ and ‘I better not see any pink around here,’ said others.
I thought it was an initiation and laughed it off.
This could not be real, but it was.
“Call me if you need me, but you better need me if you call,” was a common refrain. The chief residents were only seen if there was an operative case and the mid-levels were only available if you needed to be supervised. Otherwise, you were on your own to cover…everything plus a full lineup of cases every day, even post call. We stayed until the work was done, usually late, despite our duty-hour logs that said we left promptly on time. These heavy schedules and late nights caused issues for our home life. During our five years of training, there was one new baby, three weddings, and two divorces between the three of us. Once I left a little early to take my school-aged daughter to a school event and my senior resident made me come back to sign out in person.
The behavior from the senior residents was learned from the top, faculty were just more subtle. I was not spoken to unless absolutely necessary. There was no friendly banter on rounds or in the operating room, I just received judgment and criticism, or worse, silence with no feedback at all. Even socially, my classmates and I were excluded.
Faculty would regularly invite the guys for drinks, golf, and boy’s nights. As time went on, it became clear the male residents were given leeway in their behavior and progressive responsibility in the operating room.
Bad behaviors seem to have no adverse effect on the guys, as they were even praised for their leadership and control of the situation. The women were chastised for being too aggressive and were not trusted with even the most basic of cases. No misbehavior was tolerated from the female residents as we were continually called to the program director’s office for seemingly benign interactions and incidents.
In the operating room, the male residents would position the patient, start the operation, and perform as the primary surgeon. Operating room responsibility was stagnant for us ladies. Faculty would re-position the patient, even if what we had already done was perfect, and rarely let us take the role of primary surgeon. Even on small cases, the attending would lead, not giving me a chance to prove my skill, despite the fact I was a senior resident who had done many of these cases. This lack of autonomy was not restricted to me. After my classmate had her baby, she was relegated to retractor holder for her remaining time in residency.
I spoke with the director of education and human resources outlining my concerns. Initially, they were supportive of my concerns, but as I was be openly criticized at faculty meetings, the original support from the education director turned to comments such as “maybe you are a bad resident.” This level of disrespect and degradation of your reputation wears on you. It was an institutional form of gaslighting. They made me feel crazy and destroyed my reputation, despite valid concerns.
Please do not misunderstand—it was not all bad. This narrative is a 20/20 hindsight realization.
My classmates and I stuck together, women are resilient.
I was assigned a mentor because of my perceived failings as a resident, however he was very helpful and very nice to me. There are a few very supportive faculty—one even told me, “You will be fine once you are out of here.” We have all gone on to become great surgeons, respected by our patients and colleagues.
Our refrain when things got bad was, “They can’t stop the clock.” Residency one day will end, and we will get through this, and no one can stop us.
This post is an abbreviated post from the "#MeToo in Surgery: Narratives by Women Surgeons" Narrative Inquiry series in Bioethics, Volume 9, Number 3, Winter 2019. For the full article, and additional posts- please go to: https://nibjournal.org/voices