Emergency medicine remains a numerically male-dominated field, with recent national surveys estimating women constitute only 33 percent of academic EM faculty and 35 percent of EM residents.^1,2 Compounding the lack of representation, female emergency physicians struggle to be recognized as doctors and are frequently mistaken for nurses or technicians.^3,4 Furthermore, female EM residents are rated as less competent than male counterparts, both by supervising faculty and by nursing colleagues.^5,6 In one recent survey of medical trainees, including EM residents, 86 percent of male respondents and 96 percent of female respondents reported observing or experiencing gender-based discrimination in the workplace.⁷

Despite increasing evidence highlighting gender discrimination in emergency medicine, as female physicians, we are often told problematic interactions are not related to our identity. As interns, we mostly stayed silent about discriminatory incidents. We were doubtful of our instincts and our perceptions—a common reaction among clinical trainees who face discrimination in the workplace.^8,9 As we progressed in residency, however, our cumulative experiences cast away self-doubt.

Beyond how these interactions affect our confidence, gender discrimination affects patient safety. When we are removed from critical conversations, orders go unrecognized or duplicated, and medications are administered without our knowledge. When colleagues assume control during resuscitations, leadership roles become muddled, and information risks being lost.

When we explicitly name a gender-based problem in a training environment, we risk being labeled a troublemaker—someone who is not adaptable, someone who is not a team player, someone who is fixated on inequalities. Despite the professional risk of calling attention to a challenging issue, we feel obligated to name these problems and advocate for solutions, for residents and patients.

A Better Approach

We have a simple message for emergency medicine faculty: When we reveal gender-based disparities occurring in our work environment, we are welcoming you into the conversation surrounding unacceptable interactions in female residents’ educational experiences. We invite you to listen and consider the possibility that what we are telling you is not happening in isolation. Even if the problem affects male residents, too, we want you to know we perceive that women bear the brunt of these problematic interactions. Regardless of your intention, the impact of the response, “It’s not a female resident problem,” is to dismiss a perspective that is based on a lived reality of daily discrimination. “It’s not a female resident problem” is a response that justifies inaction.

Strategies exist to reduce the impact of gender bias on female residents. Help assure roles are clarified and respected during high-stakes situations, such as resuscitations. Direct questions about patients to the female residents taking care of them, especially when we are in close proximity. Join residents in conversations with administrative team members about throughput and procedural needs.