Women doctors still face a frustrating gender bias. Here's how they keep moving forward.

If you had a heart attack right now, what do you think your chances of surviving would be?

Obviously that would depend on a number of factors, including age, lifestyle and medical history, but gender also plays a part. And we're not just talking about your own gender:  the gender of your attending cardiologist can have an impact too — especially if you're a woman.

According to a study that was published this month in the Proceedings of the National Academy of Sciences, a woman is more likely to survive a heart attack if her attending physician is also a woman.


Photo via Pasárgada Comunicação/Flickr.

The study was based on data collected from 1991 to 2010 with 582,000 patients. Its results suggest that women are less likely than men to survive cardiac arrest in general, but the survival rate gap between genders was largest when the attending physician was male.

However, both men and women's survival rates were higher when they were in the care of a woman physician.

Since women physicians are so adept at saving the lives of heart attack patients, you'd think there'd be a lot of them. But cardiology remains male-dominated: only 10% of cardiologists are women.

It's a frustrating reality that hasn't changed much in decades.

That said, there are inspiring women who are making their way in the field and doing their part to help other prospective women cardiologists follow suit.  One such cardiologist is Dr. Nicole Harkin of Manhattan Cardiovascular Associates.

Photo via Dr. Harkin.

Ironically, Dr. Harkin was always in the presence of a lot of women on her journey to becoming a doctor. She was at an all-girls high school when she realized she loved science and wanted to go into medicine. When she attended medical school at Boston University, her graduating class was 60% female. And when she completed her fellowship at New York University, the class was a 50/50 gender split.

Here's the thing: Dr. Harkin's experience isn't unusual.

"There’s a fair amount of women training to be doctors, they’re just not going into different specialties in an equal proportion," she explains.

Dr. Harkin postulates this may have something to do with the fact that certain areas of medicine — like cardiology — still feel like boys clubs at times. And, even though some fields can be more competitive than others, there's no reason women should feel like they don't belong there. However, because of the perpetuation of outdated stereotypes, that's exactly what happens.

Fortunately, Dr. Harkin wasn't really intimidated by her field because she was lucky enough to train in an incredibly supportive environment where there were other women fellows and mentors.

"My mentors and my strong educational background made me confident in my skills," she explains. "And my passion made me persevere."

Still, gender stereotypes pervade all aspects of medicine, often making women doctors feel like they're not regarded with the same level of respect as their male colleagues.

Photo by Martin Brosy/Unsplash.

For example, when Dr. Harkin was going through the interview process to become a cardiology fellow, she remembers feeling like some of her interviewers were trying to suss out whether or not she was planning to have kids soon.

"That definitely rubbed me the wrong way," she recalls. "I wondered if I were a man if I would’ve been asked that."

And when it comes to patient care, she can't count the number of times she's been mistaken for a nurse, especially by older men.

If that's not bad enough, according to a 2017 survey, women doctors make $105,000 less a year on average than men doctors.

Photo via US Army Africa/Flickr.

Yet, despite all that, there have been numerous studies that suggest women doctors may be better caregivers than their male counterparts because they're more likely to adhere to clinical guidelines, are more focused on preventative care, and communicate more with their patients.

In fact, communication may be an important factor in whether or not a cardiac arrest patient survives.

Dr. Harkin believes that women patients may feel more inclined to discuss their symptoms with a female doctor because there is a perception that a male doctor might dismiss or downplay them.

This could be exacerbated by the fact that the early symptoms of a heart attack can present differently in women than in men. For women, the signs of a heart attack can include jaw or shoulder pain, shortness of breath and nausea. Sometimes, it just feels like a bad case of indigestion.

It doesn't help that women appear in cardiovascular studies far less often than men, so the details around their symptoms are still less widely known. More medical studies that represent both genders equally would serve all doctors, not just male doctors.

The medical community still has a long way to go to close its gender gap, but women like Dr. Harkin are doing what they can to move the needle forward. And they're saving countless lives in the process.

Medical students graduating in Cuba. Photo via undp timorleste/Flickr.

She was a chief fellow in her fellowship program, and often spoke with other women fellows about their concerns with cardiology, the work-life balance, and what they need to do to achieve their goals.

"I think that’s huge in terms of fostering women and encouraging them to go into some of these specialties," Dr. Harkin notes.

After all, Dr. Harkin's own mentors were instrumental in her succeeding in her field.

"It fosters that sense of 'hey, I can do this too.'"

What's more, organizations like the American College of Cardiology (ACC), the American Heart Association (AHA) and the Cardiovascular Research Foundation (CRF) now have a number of women in leadership roles in order to help keep gender equality a constant part of the conversation while the field of cardiology evolves. Hopefully soon, with their guidance, the disparities in pay, family planning, and respect will be a thing of the past.

Clearly women doctors are just as competent as men doctors, and their presence within a medical community can only help that community do better by its patients. It's time they're treated like they deserve to be there.

Family

A celebrated teacher's 5-point explanation of why she's quitting has gone viral.

"The school system is broken. It may be broken beyond repair."

Talented, dedicated teachers are leaving public schools because the system makes it too hard to truly educate kids.

When I studied to become a teacher in college, I learned what education can and should be. I learned about educational psychology and delved into research about how to reach different learners, and couldn't wait to put that knowledge into practice in the classroom.

But after graduating and starting to teach, I quickly saw how the school system makes it almost impossible to put what we know about real learning into practice. The structure and culture of the system simply isn't designed for it.

The developmental default of childhood is to learn. That's why four-year-olds ask hundreds of questions a day, why kids can spend hours experimenting and exploring in nature, and why kids are so much better at figuring out how to use technology. Children are natural, fearless learners when their curiosity is nurtured and they are given an environment where learning can take place.

Most teachers know this. And many find themselves so frustrated by trying to teach within an outdated, ineffective system that they decide to leave. I only lasted a couple of years before deciding other avenues of education were worth exploring. A viral post written by a celebrated teacher highlights why many teachers are doing the same thing.

Michelle Maile was a first grade teacher before she resigned this month, and her 5-point explanation of why she did it is resonating with thousands.

Maile shared on Facebook why she, a celebrated teacher in a great school district, decided to turn in her classroom keys. Her post has been shared more than 67,000 times and has thousands of comments, mostly in solidarity.

"Why would a teacher of the year nominee, who loves what she does, who has the best team, the best students and parents, and was lucky enough to be at the best elementary school not want to come back?", she wrote. "Let me tell you why….

1. Class size. Everything in my training, what I know about kids and what I see every day says that early childhood classes should be at 24 or less. (ideally 22 or less) Kids are screaming for attention. There are so many students who have social or emotional disorders. They NEED their teacher to take time to listen to them. They NEED their teacher to see them. They NEED less students in their class. The people making these decisions are NOT looking out for the students' best interests, and have very obviously NEVER taught elementary kids.

2. Respect. I feel disrespected by the district all year long. They don't trust that I know what I am doing. I have a college degree, go to trainings every year, read books and articles about kids, and most importantly, work with kids every day. I KNOW something about how they learn and what works best for them. Please listen to us.

3. Testing. Stop testing young kids. It doesn't do anyone any good. Do you know which kids slept poorly last night? Do you know who didn't have breakfast? Do you know whose parents are fighting? Do you know who forgot their glasses and can't see the computer? Do you know who struggles to read, but has come so far, just not on your timeline? You don't, but I do. I know some of my best students score poorly on their tests because of life circumstances. I know some of my lower students guessed their way through and got lucky. Why stress kids out by testing them? How about you ask ME, the professional, how they are doing? Ask ME, the teacher who sees these kids every single day. Ask ME, the teacher who knows the handwriting of all 27 kids. Ask ME, the adult in their life who may be more constant than their own parents. Ask ME, then let me teach.

4. I felt like I was drowning. So many things beyond teaching are pushed on teachers. Go to this extra meeting, try this new curriculum, watch this video, then implement it in to your next lesson, fill out this survey monkey to let us know how you feel (even though it won't make any difference), make clothes for the school play, you need to pay for that yourself because there's no money from the school for it. There's no music teacher today, so you don't get a planning time. There are weeks I truly felt like I was drowning and couldn't get a breath until Friday at 5:00. (NOT 3:00)

5. Pay. I knew becoming a teacher would never make me rich. That has never been my goal. I wanted to work with kids. I wanted to help kids. I wanted to make enough money to take care of my own kids. Sadly this isn't the case for so many teachers who have to work two jobs to support their own families. This isn't right."

Maile says the system may be broken beyond repair, which is why she's tapping into a growing educational movement.

"The school system is broken," Maile continued. "It may be broken beyond repair. Why are counselors being taken away when we need them more than ever? Why are art and music classes disappearing when these forms of expression have been proven to release stress in an overstressed world. Why are librarians being cut when we should be encouraging kids to pick up an actual book instead of being behind a screen? Do you know how many elementary students are on anti-anxiety and anti-depression medications? Look. The number will astound you.

So where am I going? Because I still love kids and want to help them with their education, I will be an online charter school teacher. I will be helping families who have chosen to homeschool their kids. They also see that the school system is broken. When I told my school I was leaving, I had multiple veteran teachers say, 'I would do the same if I was younger.' 'I am so glad you are getting out now.' 'It is only going to get worse.' 'I don't see it ever getting better.'

It makes me sad. I have three kids that are still part of this public school system. If you are a public school parent, fight. Fight for your kids. Fight for smaller class sizes and pay raises for overworked teachers. Fight to keep art and music in the schools. Please support teachers whenever and wherever you can. I have been so lucky to have so many amazing parents. I couldn't have done what I have without them. I am sad to leave, but happy to go."

What do you do when an enormous system has so many inherent flaws it feels impossible to change it?

What to do about public education a hard question. Many former teachers like myself strongly believe in public schooling as a foundational element of civilized society, but simply can't see how to make it work well without dismantling the whole thing and starting over.

When I chose to educate my own kids, I was surprised by how many former teachers end up in the homeschooling community. Many of the most well-known proponents of homeschooling were or are public school teachers who advocate for more effective models of education than what we see in the system. There's a lot that could be debated here, but alternative models may be the best places to look for answers to the question of how to fix the system.

At the very least, until we start moving away from copious amounts of testing and toward trusting educators (and paying them well) to do what they've been trained to do, we're going to keep losing great teachers—making an already problematic system even worse.

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