A  
    friend asked me to give a pre-med student some advice about a    career in medicine. That request made me think about the one    thing I most wish someone had told me about: the challenges of    being a woman in medicine.  
    One issue I often encounter is being mistaken for a    non-physician staff member. I used to gently correct these    errors and continue on with my day. But one comment from a    patient made me change the way I approach these situations.  
    I had been taking care of a pleasant elderly gentleman who was    in the hospital after a leg amputation. Its not uncommon for    patients to meet several physicians during a hospital stay, so    I re-introduced myself the second day I saw him. Hello, I    said. Im Dr. Julia Reilly. I didnt expect his response:    Oh. Ive been picturing Dr. Reilly as a strong, male doctor.  
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    Im not sure why that was my tipping point, but it was. It    made me look back and think about how incidents like that have    affected me, consciously and subconsciously, over the course of    my training. It also made me wonder what I would have wanted a    medical student to have learned from the situation if one had    been in the room with me.  
    Such interactions arent rare. Last week, I spent 75 minutes    with a new patient and, after we had discussed his assessment    and treatment plan, he asked to speak with a physician. Last    month, a different patient told me he preferred male physicians    because he felt he could trust them more.  
    Each time Im not recognized as a doctor, or a patient    dismisses my advice in favor of a male physicians, I question    myself.  
    Much attention has been drawn to impostor syndrome, a phenomenon characterized by    feelings of self-doubt and fear of being discovered as an    intellectual fraud. Imposter syndrome is troubling for various    reasons. One is that it is highly associated with burnout, and is the    strongest predictor of psychological distress among medical,    nursing, and dental students.  
    Im not surprised that women in medicine demonstrate higher levels of impostor syndrome    than their male colleagues. Perhaps these feelings of    self-doubt are responses to the obstacles that women in    medicine face, such as a dearth of women physicians holding top    department leadership positions, the    gender pay gap, and, as my research group    discovered, being underrepresented as     recipients of recognition awards from medical societies.  
    Until this year, I had not discussed my experiences with    implicit (unconscious) bias or workforce disparities with any    of the medical students I had mentored, and I had seldom    discussed these issues with my mentors. Yet these discussions    are an essential part of medical education.  
    I have been fortunate to be mentored by an experienced    physician who has kept open an honest dialogue with me about    the nearly universal hurdles that women physicians face today     and that are even more profound for those who are also facing    other challenges, such as having a disability or being a person    of color. Indeed, overlapping social constructs often elevate    the barriers that women physicians encounter. With my mentors    guidance, I have become more educated about diversity and    inclusion and therefore feel more empowered and prepared to    succeed in academic medicine. I have also become more vocal    about my experiences as a female physician.  
    Sadly, not all my colleagues have had this kind of opportunity  
    I believe that mentors should initiate honest discussions with    their female trainees about the unconscious biases and    workforce disparities they may face. That way, trainees can    feel primed for the challenges and supported in knowing they    are not alone. I encourage female physicians to speak more    candidly about their experiences in medicine  good and bad     and to share them with their colleagues through various    mediums. I have started to have these discussions with the    younger physicians I now mentor.  
    I support increasing communication and networking between women    physicians in different fields of medicine, as well as with    those in different health care professions. An excellent way to    participate in this effort is to join the virtual community    across all fields of medicine that has developed around the    #ILookLikeASurgeon and #ILookLikeAPhysician campaigns on Twitter.  
    These discussions arent just for women. Male physicians should    be part of them, as they share in the responsibility to mentor    and support female trainees. I am encouraged by Dr. Douglas    Merrills recent opinion piece in the Journal of the    American Medical Association, which urges physicians,    especially male physicians, to speak up when they see abusive    behavior directed at the their colleagues, as well as by the    #HeForShe campaign.  
    At the end of my email to the pre-med student, I added a short    paragraph in which I asked her to start thinking of herself not    only as a future physician, but as a future female physician. I    indicated that her experience in medicine would be different    than that of her male colleagues. I suggested that she seek out    strong women mentors and encourage her friends to do the same.  
    I also told her that I thought there has never been a more    exciting time to be a woman in medicine, and I cannot wait to    see the type of change this generation will make.  
    Lets have honest conversations with this generation and the    next so we validate the experiences of all women in medicine    and they know that they are not alone  or imposters.  
    Julia M. Reilly, M.D., is a third-year resident physician    in physical medicine and rehabilitation at Spaulding    Rehabilitation Hospital in Boston and Harvard Medical    School.  
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I wish someone had told me about the challenges of being a woman in medicine - STAT