// PERSPECTIVES
GI Jane: Life in the Trenches ACG Women in GI Committee Reflects on Barriers to Success for Female Gastroenterologists and Offers Strategies for Change
INTRODUCTION This is an exceptional time of change and progress for women in all spheres of medicine, but especially in the field of gastroenterology. Although more than 50% of medical students are women, only 25-30% of GI fellows are women. This is an improvement since 2016, when it was reported that only 15% of GI fellows were women. The reasons are multifactorial, but even amongst those women who choose to pursue a career in GI, many of us face significant barriers to success throughout the years. We discuss our experiences in private, amongst our friends and trusted colleagues. Members of the ACG Women in GI Committee believe, however, that these experiences may be more commonplace than previously thought. Discussing some of these experiences and offering advice as colleagues who have “been there” may provide validation to many of our members as well as equip our fellow gastroenterologists to deal with these
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issues constructively. As part of the work of the ACG Women in GI Committee, we collected examples of experiences reported by female colleagues (who remain anonymous in this article), and we offer commentary and strategies for constructive action, as well as references. We hope you enjoy our spotlight on some of the challenges of “life in the trenches” as a woman in GI and that these reflections spark further conversations about solutions. —Lavanya Viswanathan, MD, MS
LET'S STICK TO THE CV By Pegah Hosseini-Carroll, MD, FACG A woman in gastroenterology recalled: “One of my earliest fellowship interviews started out benign enough. We initially engaged in some introductory small talk followed by the obligatory, 'Why GI?' question. I waited for at least one question about any number of my publications, research projects, or health policy advocacy initiatives. Instead, he asked me if I had a family, to which I
replied, 'No.' The PD gave a perfunctory nod and the APD squirmed in his seat, understanding that his colleague had just broken the law. I decided that I had no interest in the program by that point, so I said, 'I guess that's why I had so much time to publish and engage in research, as I'm sure you might have noted from my CV.' Both men laughed nervously while I wondered why I had bothered blocking off a day for this. I attended a different training program, where my educators saw me as a person, not a 'female fellow'. They took interest in my career goals, rather than my reproductive ones. I gained important insight from that interview: to make sure to go where I am valued and respected.” Dr. Hosseini-Carroll: There are state and federal laws designed to protect against discrimination related to marital status, sexual orientation, and whether you have or plan to have children. Unfortunately, questions related to these areas are frequently still asked in interviews. The author did not have to answer the question and could have declined. However, declining to answer during an interview for a highly competitive fellowship would have been tremendously difficult. The program director asked a loaded question designed to extrapolate whether this applicant may have competing priorities, less time to dedicate to the program, and the likelihood of whether she would become pregnant. The United States consistently lags behind other nations regarding support for family-friendly leave and work policies. Positive steps have been taken in the world of graduate medical education for parental leave recently, but we have a long way to go. In general, there remains a significant gender gap which has persisted over decades. Women are paid less than men, promoted less than men, and hold fewer leadership positions, despite their growing representation. Women who choose to have children are especially at a disadvantage when it comes to career advancement. The disadvantages continue even during