Mean Girls in Medicine? Time to Get SMARTer

meangirls11I recently moderated the women’s networking luncheon at the American College of Physicians with Temple Program Director and dynamo Darilyn Moyer, whose enthusiasm is infectious.  In planning this luncheon, I began to think are these things necessary?  Females now account for nearly 50% of entering medical students.  I don’t think I ever really thought about going to a luncheon like this until this year – and it happens to be the year that I am going up for promotion and thinking about being a women hoping to rise up the academic ranks.  Of course, there is still a glass ceiling, especially in academia, and women are underrepresented in the upper echelon of faculty – like Professors and Department Chairs.  In my department, there is one female division chief.  While one could presume that say this will correct in time with all those younger women entering the medical workforce, many believe that this is not happening and women are being left behind. To make matters worse, new research suggests academic medical women work more but also make less than their male counterparts. 

So what can women do?  Well, Darilyn had some great tips for women who were negotiating to make us Get SMARTer.  (She apparently loves acronyms as much as I do).

S is for Strategic– timing, understand how the other party negotiates, choose battles wisely, get unfulfilling work off plate

M is for Mentors– use them, internal/external, personal/professional

A is for Achieve– common ground, a successful negotiation requires give and take with no party feeling smug at the end! Remember your BATNA (Best Alternative To a Negotiated Agreement)

R is for Rehearse– your negotiation with your toughest critics who know the other party and can anticipate responses

T is for Timeout– plan a pager/bathroom break about halfway through, timeout to check on short- and long-term goalsa set time as a ‘safety net’  (yes we have all done this)

In addition to negotiation, I also highlighted the need for women to celebrate each other’s accomplishments in the workplace since women don’t usually brag.  All too often, I also observed women undercutting each other and NOT being nice.  Apparently, I was not the only one who thought this – several women came up to me after and thanked me for brining this up, including the president of AMWA (American Medical Women’s Association) who said we definitely need to be nicer to our female counterparts.  So, I got to thinking why do women do this and when does it begin?  Every women has high school tales, but I distinctly recall being the sole female intern with all male interns, residents, and attendings in the ICU with – you guessed it female nurses.  I felt like I was not going to have as an easy of a time as my male counterparts, so I tried to stay under the radar, learn from the ICU nurses who knew way more than I did, and generally ‘kill them with kindness’ as a close friend says. 

Interestingly, there is a plethora of internet resources out there that highlight that women are not so nice to their female counterparts in ALL workplaces, not just the medical one.  A study by the Workplace Bullying Institute (who knew?) demonstrated that female workplace bullies (those who commit verbal abuse, sabotage performance or hurt relationships) target other women more than 70% of the time while males are more equal opportunity bullies.  To make matters worse, it’s not just at work either – women are equally mean to each other about motherhood as noted by CNN in an article that describes the “Mommy Mafia” quick to pass judgment about how others in the mommy brigade raise their kids, choose their childcare, and balance their work and life.  As one article so poignantly pointed out….

But to this day, a pink elephant is lurking in the room, and we pretend it’s not there. For years, I have heard behind closed doors from women — young and old, up and down the ladder — that we can be our own worst enemies at work.

So why do women do this?

Well, one theory is the scarcity excuse — the idea that there are too few spots at the top, so women at more senior levels are unwilling to assist female colleagues who could potentially replace them.  This could be especially true in medicine, given the lack of females at the top.

Another explanation is the D.I.Y. Bootstrap Theory,” which goes like this: “If I had to pull myself up by the bootstraps to get ahead with no one to help me, why should I help you? Do it yourself!”  Note that this theory is also often used to justify all of medical training to today’s younger hipper generation that values work life balance.

There’s even a biological explanation, which highlights that women may be uber-competitive with the other XX’s in the room during days 12-21 of their menstrual cycle, when their estrogen levels are the highest.  Apparently, in studies, women rated other women’s attractiveness much lower than when they were outside this phase of their cycle.

So, what should women in academic medicine do to avoid falling in to the mean girl trap? Here are some of the things that I have learned largely from trial and error in navigating this domain.

  •   Celebrate each other’s accomplishments.  Women are not good at bragging and can sometimes be perceived as arrogant or the ‘b’ word if they toot their own horn.  Pair up with female colleagues and let your friends know so they can brag for you.  Not only does it seem less weird, it also shows that you work in a collegial atmosphere.
  • Work as a team  Let’s face it – there is not enough time in the day to do the job in medicine.  Teaming up can not only boost your academic productivity but can also improve your morale since you’re not facing that uphill battle looking at the glass ceiling by yourself.  Moreover, when you work as a team, you can take turns taking the lead so that you’re not swamped all the time with all the hard work!
  • When in doubt, keep it professional Remember, you don’t need to be BFF with all of your female work colleagues.  You also don’t feel like you need to reveal EVERY detail of your intimate life to your work colleagues.  The more you keep it about work, the better you’ll feel.  It takes time to form true friends in the workplace so let time run its course to figure out who will help you out of a jam in the long haul.
  • Remove yourself from dangerous relationships  Some relationships are beyond salvage.  It may not be overtly obvious, but you probably have a ‘frenemy’ in your workplace.   If you find yourself in this situation, time to exit gracefully.   This can often be accomplished by letting someone know that you are swamped with work (usually not a lie), dealing with some family stuff or personal issues (code for need some time off), or taking another direction with your work.
  • Seek guidance from a mentor  Your mentor can be a man or a woman –but it should be someone who knows you, gives advice that you trust, and has your best interest at heart.  While many traditional mentors are very senior, they may be scarce so you may need to consider other types of mentoring (like mentoring from peers, groups, or teams) or even reverse mentoring (mentoring from a trusted junior colleague) for these issues.
  • Seek professional development opportunities The Executive Leadership in Academic Medicine (ELAM) (run out of Drexel University) and the Association of American Medical Colleges offer formal programs for women to enhance their leadership potential.  Many professional societies (like ACP) have resources for women in medicine like career profiles and tips for advancement.  Lastly, most academic institutions also have women’s committees to help promote networking with other women and discuss women’s issues.  The more secure you are in your own position in your organization, the better you’ll be able to help other women succeed too.

 After all ladies, if we’re not nice to each other, how can we expect anyone (especially the men on top) to take us seriously?   Despite the infamy, no one wants to work with a gossip girl.

–Vineet Arora, MD

For more detailed data see AAMC’s Women in U.S. Academic Medicine: Statistics and Benchmarking Report 2008-2009

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