CTA: What should male clinicians be doing to better recognize and correct their own gender bias?

Dr Duma: A lot of the solutions [for] gender inequality require a system change. But speaker introductions are easier. If you’re a chair and you’re introducing somebody, you just put the word ‘doctor’ in front of the person’s program and then you say doctor. Write it down so you don’t forget it. You can train your own brain. You can become conscious of your unconscious bias. Write the paragraph ahead of time, and that way you make sure you introduce everybody as ‘doctor.’

Gender bias in medicine cannot improve if there’s only one side fighting for it. If we work on this together, we will be able to make significant progress. Men and women are different,  but we’re equal.

CTA: Your team was careful to use the term ‘unconscious bias’ throughout your paper. Have you gotten feedback from male physicians that that reassured you that this is not conscious or deliberate — that this is truly unconscious bias?

Dr Duma: Yes.Many of the men [who introduced speakers] I have talked to, some of them feel horrified knowing that they did it. And some of them are very honest. Like ‘I just went back and did some introspection and I’m like, yeah, I just introduced my close friend as Julie and I feel so bad.’ And I think that’s great. That’s what we need.

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A few weeks ago, I wrote an email in which I addressed one of the women by first name and I was mortified. It happens to everybody. It happens to me. So, the majority of the time, I think it is unconscious.

CTA: You’ve said that gender bias is often expressed as ‘microaggressions.’ Can you elaborate?

Dr Duma: I think being introduced by your first name instead of your last name by title is a microaggression because it marginalizes a subgroup of people. And if you’re a woman, and you have a title and you are not acknowledged for that, it’s a type of microaggression. Cumulatively, these become a burden and sometimes it can affect how people see themselves. They may feel like they do not belong in medicine.

CTA: Were there other forms of bias you were unable to include in your team’s analysis on speaker introductions?

Dr Duma: One of the limitations of our study is that we couldn’t collect nonbinary genders. I think members of the LGBTQI [lesbian, gay, bisexual, transgender, queer or questioning, and intersex] community also encounter bias. I think gender minorities are also at high risk for bias.

References

  1. Duma N, Durani U, Woods CB, et al. Evaluating unconscious bias: Speaker introductions at an international oncology conference. J Clin Oncol 2019;37(15_suppl):10503-10503.
  2. Duma N, Durani U, Woods CB, et al. Evaluating unconscious bias: Speaker introductions at an international oncology conference. J Clin Oncol. doi: 10.1200/JCO.19.01608