Smashing the Gender Pay Gap for Women in Medicine – Bonus Episode in Partnership with PMGUK

[00:00:00] Rachel: If you are a woman in medicine, you’ve probably dealt with your own fair share of sexism. Whether it’s unfair expectations placed on you or a colleague’s inappropriate behavior that’s gone unchecked.

[00:00:11] In 2020, our guest professor Dame Jane Daker, chaired a report into the gap in pay between men and women. Three years on from that report, what if anything’s actually changed? Are institutions implementing the recommendations the report made, or is it still business as usual and pay aside, why is it that so many women are taken less seriously in medical fields than men?

[00:00:34] For this special bonus episode, You Are Not a Frog is teaming up with the PMGUK Facebook Group. The PMGUK Facebook Group is a community of UK physician mothers who’ve come together to support each other through their personal and professional lives. Here’s Naz to tell us more about it.

[00:00:51] Naz: Thank you Rachel. I am Dr. Nazia Askari, consultant radiologist, mother of two girls and founder of Physicians Mums Group UK. In 2017, I founded the PMGUK group to provide a safe space, uh, where members can share their experience, offer emotional support and help each other, to navigate, uh, the complexities of balancing their career and family life.

[00:01:15] So over years of, um, running this incredible group of over 24,000 members, we have seen the challenges faced by women who are balancing a demanding medical profession and, um, motherhood and it is hard. It is, uh very hard at times. So the members wanted their own PMGUK podcast, and I have been working on it for a few months.

[00:01:42] So today I’m delighted to introduce our inaugural PMGUK, uh, podcast, uh, recorded in partnership with you, uh, Dr. Rachel Morris. And, uh, You Are Not a Frog. And this isn’t just any other podcast. PMGUK podcast topics are, uh, handpicked by our members, driven by our community. And we are bringing in speakers, uh, who we feel can truly do justice to these discussions.

[00:02:10] In this, our first episode, we are tackling the crucial issue for women of the gender pay gap, also called the authoritative gap or the power gap. And who better to talk about this than Professor Jane Daker, who has done a lot of work on this and has been involved in previous PNG UK conferences.

[00:02:30] Gender pay gap can be a emotive topic for many. However, it’s important to look back and see how far we have come in this journey. We have come a long way from where we started. However it is also crucial not to ignore how far we still have to go. And we need to keep talking about it.

[00:02:51] The more we talk about it, the more we raise awareness and it’ll help in uh, pushing meaningful uh, change towards achieving a true equality. So I sincerely hope, that you enjoy this PMGUK uh, bonus episode. And if you have any burning questions, then you know, feel free to discuss it on our own PMGUK Facebook group.

[00:03:15] Rachel: Thanks, Naz. And as with all are You Are Not a Frog episodes, you can download a workbook to fill in, which contains space for reflection, some personal development questions to work through and some additional resources so you can learn and claim CPD as you listen. To get this free worksheet, just click on the link in the show notes. Now on with the episode.

[00:03:34] If you’re in a high stress, high stakes, still blank medicine, and you’re feeling stressed or overwhelmed, burning out or getting out are not your only options. I’m Dr. Rachel Morris, and welcome to You Are Not a Frog.

[00:03:52] Jane: Hello. My name’s Professor Dame Jane Dacre. A bit of a mouthful, I’m afraid. I’m Emeritus Professor of Medical Education now, which means that I’ve recently retired from UCL and I have a portfolio of activities, a large number of which relate to supporting women, um, particularly doctors in the medical workplace.

[00:04:15] Rachel: Oh, it’s wonderful to have you back on the podcast, Jane. Thanks so much for coming back on. We had you quite a long time ago in, in June, 2020, and you were actually on one of our earliest episodes, episode 41, and that was just six months before your report on the gender pay gap in medicine was published, wasn’t it?

[00:04:31] Jane: Yes, yes, it was, uh, and, and it had rather a,, a rocky birth because all sorts of intercurrent events knocked the then government backwards and forwards, and it took them ages to get it out. And eventually it came out just before Christmas, which wasn’t a great time for anything to come out. And so it meant that it was relatively buried in terms of of publicity. However, we’ve been getting on with doing what it says on the tin since then.

[00:05:00] Rachel: And if anyone wants to listen in more detail to sort of stuff that was in their report, Jane talks in great detail about that in episode 41. then do check it out and we’ll put links in the show notes. But Jane, when it came out, I’m quite interested in, did you get any pushback on it? What was the general ception like, even if it was a little bit buried in current events and what has happened since in terms of that report?

[00:05:23] Jane: So when it came out, uh, actually there wasn’t much pushback and I think that was possibly because we got all the pushback before it came out. So when it came out, people were actually quite surprised and pretty determined to do something about it.

[00:05:39] And one of the problems with doing reports like this, and I, I’ve done a few of them now, is that people commission a report because there’s a problem. They get the report and they say, thank you very much. And then they put the report to one side and the recommendations don’t get implemented.

[00:05:57] So one of the things that we were really keen to do was to make sure that the recommendations were implemented. So I, I’m actually very grateful to the Department of Health for, uh, setting up an implementation group which I’ve been chairing ever since.

[00:06:13] For the last four years now, I’ve been running a leadership course for women because we know that if you get more women into leadership positions, that will also reduce the gender pay gap. So we’ve run four cohorts of that, about to start an another one for, for next year, uh, targeting, uh, women, particularly women from minority groups to try and encourage them, uh, to feel confident enough to get into leadership positions.

[00:06:43] But there are always things that come in and make things a bit more complicated. So paradoxically, the NHS people plan the, the, the workforce plan, if it increases the number of doctors and increases the number of women, it, for example, will increase the number coming into the profession at the lower grades, and that will widen the pay gap temporarily before it narrows again. And as particular specialties, for example, surgical specialties who’ve been working really hard on their pay gaps and on their equality measures, as more women are encouraged into those specialties and they start at the bottom, the gaps will widen before they narrow.

[00:07:31] Rachel: So there are some really tangible things that you can do about this, like rewriting contracts and, you know, the, those, those Clinical Excellence Awards and stuff like that. Were they the main sort of tangible things that they, that you could do? Or was there some, some softer stuff that actually is harder to address that does make a big difference to the gender pay

[00:07:51] Jane: Yes. There, there. So there are the concrete things there. There are some low lying fruit. Uh, there are some, some concrete things where you need structural change and, and although they’re obvious to address, they’re complicated to address because of the, the way that the government and the NHS works, and then there’s a whole load of cultural stuff.

[00:08:12] So the NHS was set up in 1948. And the culture in 1948 was that the women were mainly housewives. They did a lot of cooking and cleaning, and their husbands brought home the bacon. Their husbands went into work and were, uh, treated as the main person of the household. And that has changed in the 75 years of the NHS. But the NHS pay structures haven’t. So the NHS culture and the NHS pay structures haven’t kept up with the change in demographic that now sees women as the majority in, uh, most of the professional groups.

[00:08:52] The total numbers for the NHS are that women are about 80% now. And it, it, there’s something called gender segregation means me, which means that it’s different in different specialties. So in surgery, the, the number of women consultants is still, I think around 15%, quite low. But in, um, sexual and reproductive health, it’s about 70%. In public health, it’s, it’s higher. Those numbers have changed, but the culture and pay structures haven’t kept up with them, so they need to be modernized.

[00:09:23] Rachel: So it’s one thing to say that the, the pay structures should be modernized, but something that I’ve observed in my own generation, and I can’t talk about generations below me, that even though we are all going out to work and expecting to have good careers, the sort of societal expectations that the woman takes, the lion’s share of the childcare, the housework and the emotional load doesn’t seem to have shifted very much. And it’s a source of constant frustration for me. And the problem is you can’t sort of legislate for that, can you?

[00:09:56] Jane: I think that it is very difficult to change that kind of societal expectation and that kind of culture. And what we have to do is shine a light on it and to emphasize where things do need to be changed. And to change it within our own environment. And also to speak about it, to talk about what our expectations are and to encourage women to move forward.

[00:10:21] But I don’t think we should be too depressed about it. Because we are constantly looking at where we are now and looking at how we need to improve things for the future. But we’re not very good at looking back to see how far we’ve come. And, and I, when I do look back, we seem to. Than I might have thought, so we just have to keep rolling our sleeves up and keep getting on with it because the culture is changing, albeit too slowly for my liking.

[00:10:52] Some of the things that make it really difficult are the structural things. One of the things that allows the culture to, uh, be as retrograde as it is, I think, is the lack of good childcare provision. Various NHS organizations because of cost cutting measures of closing their nurseries, which is going to take things, um, down a, a peg in terms of culture. Because in relationships, if you have a high earning, uh, male who’s benefited from the gender pay gap, and a lower earning female, and the nursery is closed and you’ve got to shell out more for childcare, the financial logistics of that are that it’s the woman that cuts down on their employment and increases the amount of domestic work that they do.

[00:11:42] And with the difficulty in, um, things like the cost of living at the moment where, for example, some hospital trusts, Kings and UCH have, uh, are closing their nurseries. Well, if the nursery closes, the childcare externally is more expensive. If you are a woman in a specialty that earns less in relation to the gender pay gap compared to a male surgeon, for example, and you are in a partnership, it’s going to be the woman for economic reasons that that reduces their hours and reduces their salary. So, so those, uh, structural combined with cultural problems are very difficult to solve.

[00:12:30] Rachel: Yes, it’s, it’s really interesting isn’t it? These sort of very. Soft. Well, it’s not, I guess the economic factors are, are very hard and they’re very tangible, aren’t they? But there’s no denying that the women has to be the one to have the babies currently, uh, unless you are, unless you’re adopting. So you sort of forced to take maternity leave. And then the sort of the caring hormones kick in. And actually women do want to be off with their, with their children.

[00:12:54] If men were afforded the same amount of paternal leave or parental leave, would that narrow the pay gap, would that equalize things out or, or still not?

[00:13:06] Jane: I, I think sadly the answer is still, not theoretically it would, but in studies where men have been given, Paternity leave, they don’t take it. So, uh, the men don’t want to do it. And I think probably that’s, some of that is stigma.

[00:13:23] Rachel: Yeah, I was gonna say, is that cult, is that just because they don’t wanna be seen to be taken ’cause it hurt their career, or they genuinely don’t want to take it?

[00:13:29] Jane: Well, I think there’s still also a pay penalty, but I, but I think it’s, I think it’s hurting their career. It’s hurting their pay, and it’s also hurting their, their, um, feeling of being male.

[00:13:42] Rachel: Yeah, okay, pride, the old, the old, the old thing of pride. And that gets us quite nicely done to another thing I was reading in the report that you talk about the pay gap, this gender pay gap. And one of the things that contributes to the gender pay gap, obviously the fact that women’s career is interrupted and they might then take sort of lower level jobs, but then there’s this thing called the authority gap. And I was really quite interested in this, and I know this goes into the whole sec, sexual misconduct thing as well. Can you just tell us a bit about the authority gap? What do you mean when you talk about the authority gap?

[00:14:17] Jane: So the authority gap was, was a term coined by Mary Ann Sieghart, who’s a journalist who took a year, I think, a year out to actually write a, uh, an academic book that has been published, in mainstream, publishing. And it, it is the fact that whatever they do, women are taken less seriously than men. So there is a feeling that if you are in a room, the men in the room have more authority than the women. And she’s done a, a, a very forensic piece of work that shows that that pops up in, uh, all walks of life. And so, for a woman to be taken seriously, they need to work harder, , try to be better, be more conscientious, be more vocal than men.

[00:15:08] And there are all sorts of studies. Uh, for example, first author publications in papers are more likely to be male. Leaders for research, people that get grants. And we see it all around us where there’s what you might call a glass ceiling, where if you look at the top of organizations, they tend to be, uh, male. And that, uh, goes hand in glove with the, with the gender pay gap.

[00:15:37] Uh, sadly, I would also say that it goes hand in glove with some of the terrible stories we’ve been hearing recently about sexual misconduct because there’s a, a patriarchal society, uh, with, with men at the top and people who feel that they can’t challenge because of the power relationship when inappropriate things are being done.

[00:16:00] So the authority gap, the power differential, and the pay gaps all point to a world, a society in which women are less valued, both in, in monetary terms, but also in terms of what they have to offer society, uh, than men.

[00:16:19] Rachel: And so what can us women, the sisterhood of women, do about that do to support each other and do to, you know, get some of that authority back, or at least make it equal with those

[00:16:30] Jane: Well, it is, it is difficult.

[00:16:33] So, you know, I’m sitting here having. Been okay. I’m all right, Jack. Uh, I haven’t had huge problems in terms of my own career, so for those of us, us that, that have made it through and have made it to higher positions, I think we, we have a responsibility to support women coming through. That’s why I run my leadership course for women. That’s why I’ve, uh, developed a series of podcasts, of women who have had fantastic careers in medicine to show others that you can be normal and, and have a good career in medicine.

[00:17:09] There are various things that people talk about, uh, in relation to pulling up the ladder. So there are some women that think, I’ve worked hard to get here, so you’ve gotta work as hard as I did, so you’re not coming up the ladder unless, uh, un unless I think you are okay and work harder than me. There’s something called the Queen Bee syndrome where some women are criticized for the same thing for having got there and not encouraging others to come there. So we need to be aware of those. We need to recognize that women, I think, have a responsibility to support other women.

[00:17:44] But there are other things. I think women have a responsibility to try and speak out. Sometimes that’s very difficult. Um, we need to exhibit and support each other with a zero tolerance of, uh, banter, inappropriate behavior, uh, and, and find a way of, of dealing with that ourselves. And, and we need to do things like the, the fantastic women that reported the sexual misconduct in surgery, Tamzin Cuming and Carrie Newlands, to point this out with data and stand up and say, look, this is going on. Because when men hear it, they’re horrified too. And if we don’t speak out, people don’t know what’s going on.

[00:18:27] Rachel: And how would you practically recommend that a woman speaks out? ’cause that’s hard. If you’ve got this authority gap, this power gap, you see inappropriate banter, but you might not be the leader, et cetera, et cetera. How does one, how does one call it out without being called, oh gosh, here she is again, the feminist. You know that, that, you know, that sort of put down all the time that you get, right?

[00:18:48] Jane: So, so there’s another, um, another book called Unwell Women, which I’ve read recently about how, uh, essentially women throughout the ages have been accused of being hysterical and women that speak out or accused of being witches. I’m quite clear I would’ve been burnt at the stake in my early adulthood, I’m afraid.

[00:19:07] So being a bit, being a bit vocal. Is, is, uh, one of those things, but there are, um, there’s another group, I can’t remember what it’s called, where you, you work with allies. And if, if male and female allies, if somebody is speaking out in a way that is inappropriate, having allies in the room that are prepared to speak up for you and on your behalf is really helpful because then you’re not the only person that’s, that’s having to be strident in order to, to, uh, make things better.

[00:19:39] And people are more and more aware of that, and they’re more and more aware of speaking out. So if, if as a woman you are going into a meeting and you know that there’s going to be something a bit tricky, uh, it is worth priming your allies before you go in. I, I used to do that at the Royal College of Physicians. I used to say, look, I am going to get flack for this. I’m going to be accused of whatever I think I’m gonna be accused of. Please will you be my friends? Please? Will you be my allies? If so-and-so says what I think they’re going to say, can you speak out and support me?

[00:20:14] Rachel: Did it? work?

[00:20:15] Jane: Yeah, it does work.

[00:20:17] Rachel: And did you ask men or women or or both to be allies?

[00:20:20] Jane: There’s not that many women around.

[00:20:21] Rachel: Okay.

[00:20:22] Jane: So you have to ask men and women.

[00:20:25] Rachel: But I think what men, once, you know, once, once it’s sort of been revealed and shown and they’re asked to look out for it, like you said, men were horrified by the sexual misconduct reports, but I think they’re just, it’s just so prevalent in the societies, isn’t it? It’s just don’t,

[00:20:40] Jane: And we all know it happens.

[00:20:42] I mean, the interesting thing about that, uh, I was talking to a group of, of, um, foundation school directors yesterday, and they were saying, well, we all know it happens. We all know who it is. Um, and when somebody does call it out, everybody knows.

[00:20:57] One of the problems with the sexual misconduct is that, unfortunately people don’t want to hear it in people in positions where they can do something about it. And the report suggests that trusts, royal colleges, and even the GMC have not been good at listening to allegations and have tried to say either victim blaming the woman, are you sure you didn’t give him the come on? Or minimizing it, saying, I think he misunderstood what was going on. Or indeed just not dealing with it and not talking about it.

[00:21:33] And so since the, the Fantastic report has been published by the Women in Surgery Group at the Royal College of Surgeons, people have recognized the need to have a zero tolerance, and now good medical practice is going to include specific reference to sexual misconduct. So that the idea of having a zero tolerance is, is getting much better.

[00:21:58] It’s going to be asked in the next GMC trainees survey, so. I think slowly the culture will allow people to speak out more effectively. And also will deal with the perpetrators who have often been doing this for years. Sometimes they don’t really know that they’re doing something wrong. And nobody’s really spoken to them.

[00:22:22] And you can imagine in an operating theater, where you are scantily clad because you are wearing scrubs that of course were designed by men, and so they, the tops are too.

[00:22:31] Rachel: Yeah,

[00:22:32] Jane: left lung and, and, the

[00:22:34] Rachel: straight down.

[00:22:34] Jane: fit and all of that, all of that stuff. You are standing far too close to whoever you are operating with, are much closer than a social situation would find normal ’cause you are having to, to do whatever it is. And your hands are literally tied up because they’re holding onto something, or doing something crucial. And, uh, so you are really in, not in a very strong position If somebody wants to grab your bottom.

[00:23:01] Rachel: It’s just so depressing, isn’t it? I mean, in this day and age, it’s still going on with clever people, right? It is just like, It’s unbelievable, but it’s, it’s when, yes, this behavior has just been allowed and there is such a power differential in the training hierarchies and isn’t

[00:23:17] Jane: Well, one, one of the things that’s interesting, and I think actually quite sad is I suspect that the female people who were not doctors working in the operating theater must have suffered absolute hell. And what’s happened is that because of the change in demographic of the profession, there’s this group of feisty, high achieving women coming through as surgeons who are looking at this behavior and thinking what? Whereas previously that power differential has prevented people from speaking out.

[00:23:49] Rachel: So, you know, if, if someone is experiencing, you know, obviously in a way, if someone’s experiencing, like, high grade sexual misconduct, it’s a no-brainer of you go and you report that and you tell someone immediately, blah, blah, blah, but what about this low grade stuff?

[00:24:08] Jane: Well, one of the things that the report has suggested in its recommendations is that there ought to be anonymous facility for anonymous reporting in trusts. And that this should be monitored and it should be discussed at the trust board, so that where something has happened that’s made someone feel uncomfortable, they’re able to document it and, that documentation is taken seriously. A bit like, you know, freedom to speak up guardians or prevention of bullying and harassment. And I think that’s something that should be taken forward.

[00:24:40] Now, the report only came out on the 12th of September, so it’s, you know, it’s only a month old, so it, it’s going to take time for these things to be put in place. But at the moment, as far as I can see, there’s, there’s a lot of, of support. A lot of organizations are so horrified by what it said that they are working hard to try and make those changes in the, in the rules of organizations so that reporting, anonymous reporting can happen, things are discussed at trust board. At the moment, though that’s sadly not the case.

[00:25:14] Rachel: And one would hope that an an ICB as well would, would have a system like that for our colleagues working in general practice as well, so that they can, they can report it in there

[00:25:23] Jane: there is already a, an anonymous reporting website, which is called Surviving in Scrubs, set up by two people who were trainees who experienced some of these aberrant behaviors. One’s an an A and E consultant now. Um, and the other one was a surgical trainee, but actually stopped because they just thought this was not where they wanted to be. And I understand on that website you can report concerns.

[00:25:51] Rachel: So as you know, we are doing, uh, this podcast in partnership with the PMGUK Facebook group, which contains, as it might sound, it stands for Physicians Mums Group UK, lots of doctors with kids, um, all of whom are, you know, wanting to do their best for the kids and their best in their career as well. And, um, someone’s asked there, if we don’t mind just asking you a little bit personally about your journey. And did you have to do anything or relinquish anything or give anything up to, to get to where you are now as a woman that you think that men probably wouldn’t have had to relinquish or do or give up?

[00:26:27] Jane: So off the top of my head, yes, definitely. I nearly lost my career completely when I had my first child because I became terribly unwell. I, I mean, that’s another story, but I was one of those women that didn’t do well out of obstetrics. And, uh, I’ve got three children, but with my first child, I, um, was, uh, very ill and I was on, uh, I was on soft money doing a research grant and basically my bosses said, look, sorry, you’re never gonna come back, so that’s it. And I had to claw my way back into medicine. It sort of made me a bit more determined.

[00:27:07] In the end, I suppose what happened was that I was forced to become a lot more entrepreneurial than I might otherwise have been. I was going up, I was a rheumatology and general internal medicine registrar and I was going up up the ladder, but when I essentially lost my job Through having a baby, I had to think of doing things differently. so I cobbled together a bit of a portfolio to try and get my career back on track.

[00:27:37] And at the time I thought that would be the end of me career-wise. Uh, but actually it meant that I took risks. And so what I ended up doing was a job share. And you know, you don’t realize these things at the time, but the person who I shared the job with is Tim Specter of the Zoe app.

[00:28:01] Rachel: Oh, wow. How interesting.

[00:28:02] Jane: And so Tim and I, Tim wanted to do research and was beginning to get into his twins work and what have you. And I had been unwell and I’d struggled with, uh, having a baby and being terribly ill and getting back to work, but was very passionate about trying to get back to work. And I just thought that, that, you know, my career was gonna finish. But the two of us got together and applied for the same job as a double act, and for some reason they gave it to us. Um, and so we did, uh, a month on and a month off, and I also at the time, got a research job.

[00:28:43] It took me much longer than, uh, people might have anticipated for me to, to get my, my, um, research, my PhD. It was an MD actually in those days, uh, written up. And I really struggled actually, but in the end it taught me a bit about resilience, or a lot about resilience, and it also taught me that you can meander your way through your medical career thinking that things are not going to go well, but it turned all right in the end.

[00:29:19] Admittedly, I, I suppose, took what was then thought of as soft option, which was to focus and develop my interest in education rather than, uh, hard-nosed what I call small round cell rheumatology, which was the, the, the, the thing that everybody was doing then. And, um, I thought that would be me in a sleepy back quarter. Uh, not really getting very far. , But fortunately it didn’t turn out like that.

[00:29:53] Rachel: And part of your success, obviously, is being, you know, totally brilliant and seeing where the opportunities are and being there, but how much of that was thinking, well, I want to do that, I want to, you know, end up here, or how much was it? It was just like serendipitous?

[00:30:07] Jane: No, it was all, it was all serendipitous in, in my podcasts or in the leadership course that we do, it’s extraordinary how many of the women we talk to have had careers where they’ve meandered through. And there are some great quotes from young, some of the women, that really ring true I hope for other women. One is proceed until apprehended, which is if you’re doing something that works, don’t ask permission. Just carry on doing what you think works. Don’t worry about what everybody says or thinks or does. Just carry on. I think that was from Carrie McEwen who’s now the chair of the GMC.

[00:30:44] Another quote is opportunities don’t make appointments. And that is that if something comes up that isn’t, in the straight and narrow of medical training or isn’t something you would normally do as part of your, your, your training or your development as a doctor, but it sounds good fun, and it sounds interesting. Well just do it, because you never know where it’s gonna take you.

[00:31:09] Because if you are a woman and you’ve got children and you’ve got a career, it kind of doesn’t work out. So in order to make it work out, you need to be, you need to worry less, you need to be more flexible, and you need to, in a way, have a bit of cheek about the way you go about doing things.

[00:31:31] Now, when you are feeling as if you can’t hold body and soul together. You’ve got a young baby who’s not sleeping, you, your, uh, husband is out working and says they’re too tired to do any childcare, you haven’t got enough money to pay for a cleaner, et cetera, et cetera, all of that feels like a huge hurdle. But I would say to any women that are in that situation now, it doesn’t matter if you do something different for a bit. You can actually pop out, sort yourself out, do what you want to do, and then when you are ready and when you want to come back stronger, fitter, and proud.

[00:32:08] Rachel: I love that so many of us have this picture in our head that our career has to be like this and go like this, and as fast as possible in order to get to the top or whatever, but actually what you just talked about is you meander your way into these opportunities.

[00:32:23] And as you were saying that, I was looking at a question that someone else had asked, which was about the sort of financial impact of being less than full-time, which obviously has an impact. But I guess the advantage of being less than full-time is you can think, well, there’s that opportunity that’s come up and because I’m not stuck in this full-time job doing this where all of my time is committed, I may be able to take that opportunity or, or look at that thing and go about it in a little bit of an unconventional manner, right?

[00:32:51] Jane: Absolutely that. So, so I never had a career plan. Most of the women that I’ve talked to in my podcasts do not have a career plan. I think that’s a very boy thing to do, to say, right, I’m gonna be in charge. I’m going to be prime minister, whereas women just wanna survive. I just wanted to survive and be a good doctor. And that’s the case for the women that I’ve been, been talking to.

[00:33:16] But when I got the job share, uh, with Tim, I thought, right, this is it. I’m gonna carry on. I’ll be doing part-time work. Uh, then I also, because I applied for anything that moved at the time, I got a research grant. So I negotiated to do both the, uh, job and the research part-time. And so I ended up getting my clinical training and my research training in parallel.

[00:33:47] And then by the, by the time I’d done enough years, it was, it’s a bit more tricky now, but by the time I’d done enough years, I just applied for my CCT, ‘ cause I thought, well, what the hell? I’ve put in as many years as other people. Okay, I haven’t, I haven’t had a full-time senior registrar job as it was then, and I hadn’t finished my thesis, but I’ve put in my hours, I’m just gonna give it a go. And, and fortunately they gave it to me. I think they probably didn’t look at it terribly carefully.

[00:34:15] But in a way take a few chances because, because as a woman, you, you’ve actually got much less to lose by being a bit unconventional and, and taking a few chances.

[00:34:25] Rachel: I agree. I was talking to someone recently who, um, had been coaching someone who had said, well, I, this is what I really want from the job, but I, I’m not sure they’re gonna let me have it. And after a coaching session, she realized that, well, it was either that or she was gonna leave anyway. So she, she said, right, I’m gonna ask for the outrageous. And she went, she asked for the outrageous and she got it. She got it just because it was slightly different and they looked at it and went, well, why not? It’s either have her doing that or not have her at all. We’ll let her do that, and she hadn’t asked. she wouldn’t have got.

[00:34:56] Jane: Quite. And we are very bad at asking, one of the things that feeds into the gender pay cap is that women are very bad at asking for more money. And so we sacrifice, salary in order to have flexibility. And that’s something that, that we are creating that, that feeds into the gender pay gap.

[00:35:15] You, you briefly mentioned working part-time and, and, and yes, if you work part-time, you, your salary is pro rata’d down. One of the fantastic things that we’ve achieved since the gender pay gap, for which I thank Stuart Dollow, the ACCIA are after having quite significant heated conversations, is that if a woman is awarded a national award, the amount that they get paid should be based on a full-time salary, not pro rata’d down to how much they’re working. Because if you are worth an award, you are worth that award. You are not worth half of the award because you are working half time. And that was quite, that’s been quite a debate.

[00:35:54] Rachel: Yes, congratulations. That’s, that’s, that’s really good.

[00:35:57] Jane: Well, don’t congratulate me. I was just a bit stroppy about

[00:36:00] Rachel: Well, well done. Thank you. We need people, we need people to be stroppy because we don’t like being stroppy as women all making a fuss. Well, partly ’cause we, well, partly ’cause we get badged, you know, as, as nasty or whatever. Whereas the men are like, they’re just, I don’t know, strong and the women are just being irrit, i, I, I don’t know, but it, it’s harder to make a fuss as a woman, I think, and be taken seriously. And I guess that I remember hearing about the this authority gap that yes, it’s hard for women to ask for stuff and actually they’re not as likely to get it because of the, the perception.

[00:36:30] These interviews that you’re doing on your podcast with these women sound absolutely fascinating. You’ve given us quite a few quotes. What else have you, you know, what common themes have you got coming out from all these really successful women?

[00:36:44] Jane: Well, the first Thing is they all work incredibly hard, and so that’s a thing that you’ve gotta put in the hours. The second is that they have meandered through their careers, and some of them have had the most incredible experiences, good and bad, that has have shaped them into what they do. But when something bad happens, they all roll their sleeves up and get on with it.

[00:37:09] Another thing that comes through, which is a huge credit to all of the women, is kindness. They, they focus on being gentle and nice and kind, so they don’t try and be men.

[00:37:19] Rachel: Mm-hmm. Yeah.

[00:37:20] Jane: So they are themselves. So authenticity and kindness is, is something that, that really comes through.

[00:37:27] One of my colleagues who, uh, was on a train and forgot her book, decided to binge listen to the podcasts, and she sent me a note that said she was getting her CPD by binge listening to the podcasts. So what does she say? There’s no one model of success and that everybody’s got different strengths and weaknesses.

[00:37:51] Broadening access to senior roles is, is absolutely important as I’ve suggested. But also remember that if you think somebody is good and is able to, to do something, as a senior woman, you need to push them. So the, the concept of, of, um, sponsorship rather than just mentoring, so say you need to go for this job. You’ve got all the attributes because the women themselves won’t necessarily recognized that.

[00:38:15] And the other thing is that in terms of, of work life balance, don’t think there are any rules. Don’t let people judge you. Do what works for you when it works for you, and be, uh, in a way quite single-minded about how that works. And, and that, that’s, that, that applies to childcare, really.

[00:38:35] The other thing is that a lot of the women have said, and, and the majority of these women not all have children. And this is something I, I recognize from my own life, is that, you know, this maternal guilt, you know, when you, you miss a sports day, or, uh, you get called out and you’re not, you’re not there, uh, and you feel terrible, uh, or you haven’t made a cake for the school fate and the other, the other school moms are not kind to you because of it.

[00:39:04] kids don’t remember. And actually, at the end of the day, they don’t know and they’re incredibly proud of you for doing what you’ve done. And they don’t think that you are a boring mom, just like all the other moms because they can’t remember when you forgot their lunch, when they were going on a school trip or any of those things. Or all of the above. I have to say, I have done

[00:39:25] Rachel: Oh gosh, yeah. No cakes, forgetting parents, evening, all those, yeah.

[00:39:29] Jane: So don’t worry about it.

[00:39:30] Rachel: But they, do Google you. I find They Google you and then they come home going, mom, we were Googling you, and all we could see was frogs.

[00:39:38] Jane: Yeah, well, exactly. And they also say, oh, mom, one of my friends was trained by you, or whatever. So it it, you know, in the end, they end up being proud of what you’ve done. So don’t, don’t worry about that.

[00:39:53] Um, the other is that a lot of the women have talked about, you know, we, we don’t want to vilify men. That actually we’ve had some fantastic male colleagues and we’ve, we’ve got husbands, we’ve got partners. I need to give a shout out to my own husband who, who’ve helped us along the way, supported us when times are difficult. And also, uh, external men. So not all men are bad, and in fact most of them are good.

[00:40:17] And the other thing is that when you get into leadership roles, these are all that they’re, they’re sort of compiled thoughts of the women, the first 10 women that we’ve talked about, is to remember to enjoy it and see it as a privilege. You know, that, that, that being president of the Royal College of Physicians was the most fantastic time and fantastic privilege. And I feel blessed to have done it, and grateful to the profession to have done it. And It’s very sad to see people who are burnt out and feeling negative about being a doctor. We need to, to try as leaders, to, to, uh, show people that it is a privilege and that it, it’s all worth it.

[00:41:05] One of the great quotes from the women is actually a quote from an Indian, uh, an old Hindu script, which, uh, I heard in the best Marigold hotel that film, which is that it’ll be all right in the end, and if it isn’t all right, it isn’t the end. And I think that’s such a fantastic thing for women who are struggling through their careers to remember.

[00:41:28] Rachel: So Jane, you’ve done two seasons, you’re just recording a third season, but the first two seasons are out at the moment of the podcast?

[00:41:34] Jane: Um, season one is out. Season two is coming out. Whenever they finish doing the editing at UCL UCL are very kindly put, helping to put it all together for me. Season three, I am going to focus on younger women. So I want to do rising stars. Women who are on their way to doing great things, because otherwise it looks as if potentially there’s too big a gap between people of my generation and people might say, well, it was all right for you. People do say that, don’t they? You know, your house was cheap. You got live in accommodation. Your pension’s bigger, except. That brigades. So I want to also talk to some spirited women who are on their way up, who are still coping, with the, with those sorts of things, some, a better peer group than myself and my colleagues would make

[00:42:22] Rachel: Great. And what’s the name of the podcast?

[00:42:24] Jane: Medical Women Talking.

[00:42:26] Rachel: Brilliant. So we’ll put links to that in the show notes.

[00:42:28] Um, Jane, I’ve got, we’re nearly out of time, aren’t we? I just wanna ask you one last question. So you, you, you’ve talked about sort of your, a bit about your journey, the people you’ve spoken to on your podcast and the gender pay gap and the authority gap. If you were to write a letter to your, your younger self, maybe when you were a mum with small children, what would you say in it?

[00:42:48] Jane: I think I would use that Hindu proverb, um, and say, look, just don’t worry about it. It’ll be all right in the end. Whatever the end is, it’ll be all right in the end. And, and I think you need to learn, we need to learn not to be so hard on ourselves.

[00:43:03] You know, one of the things that spurs me on now, uh, is that I have two daughters, a daughter-in-law and four granddaughters. And we’ve got to make the world a more hospitable place for them. So part of it of that is through responsibility of those of us who’ve struggled through, but part of it is also to give people hope.

[00:43:26] Rachel: I think hope is. Hope is so, so important that, yeah, it feels really hard at the moment, but it doesn’t last forever because your kids grow up and then you’ll have a different issue to deal with.

[00:43:34] Jane: Yes. Well, quite.

[00:43:36] Rachel: That’s what I found, you know, just when you think, I can’t bear this anymore, it gets better and then you get something else to deal with. And then something else. And then something else.

[00:43:43] Jane: But you know, your journey through your career as a doctor has equipped you incredibly well for dealing with what my writer friend calls God’s left hook. You know when something just comes from nowhere to floor you, you think, well, okay, now how are we gonna deal with this one?

[00:44:00] Rachel: Yeah, absolutely. Absolutely. And I mean, the one, the one thing I think that if, if we could just learn to do it, would, would be helpful is just to embrace the guilt, is just to recognize we can never be everything to everybody all at once. You can never please all of the people all the time. So don’t even bother trying. And, and if you feel guilty, go, I’m glad I’m feeling guilty. ’cause that just means I’m a good person and not a psychopath.

[00:44:24] So Jane, thank you so much for being with us. Um, we’ll put all those links in the show notes. And, um, yes, wish you well for, um, the podcast and some other projects. Just very quickly, you’re telling me about your Dames Commanders group.

[00:44:36] Jane: Yeah, so, so there’s a group of, of Dames started off by the medical dames, who are now all getting to know each other. It, ’cause being a dame is a title, it doesn’t come with a role or anything. So we’ve decided that. These Dames ought to be doing some good, and we discovered that there is a group of knights who have dinner every so often, and one of them gives a speech, I think about how marvelous they are. And we thought, well, we’d like to get together and do some good. So we’re focusing on trying to influence society to improve things like women’s economic place in society and the the position of women, the role of women. So we’re all working together to come up with some projects to help support other women. Because we’ve all been really lucky in how our careers have gone. And this is not just medical dames, this is Dames from all different quarters.

[00:45:31] Rachel: Wow. Well that sounds wonderful. So yeah, we’d love to hear about that when. You, when you come out with your, uh, your strategy for sourcing that, that one

[00:45:37] Jane: Yeah. We’re working it out and we’re gonna try and be ready to support things like election manifestos to make sure that women don’t get forgotten.

[00:45:46] Rachel: Well, thank you so much for giving up the time to come on the podcast. Um, we’re very honored to have you on and it’s just been a really wonderful discussion. So thank you.

[00:45:53] Jane: It’s been a pleasure. Thank you very much.

[00:45:55] Rachel: Thanks for listening. Don’t forget, we provide a self coaching CPD workbook for every episode. You can sign up for it via the link in the show notes. And if this episode was helpful, then please share it with a friend. Get in touch with any comments or suggestions at hello@youarenotafrog.com. I love to hear from you. And finally, if you’re enjoying the podcast, please rate it and leave a review wherever you’re listening. It really helps. Bye for now.