When Madeleine “Maddie” Lee was ten years old, she decided she wanted to be a doctor when she grew up. It probably had something to do with watching ER on TV and the fact that one of her best friends, Elsie, had a dad who was a thoracic surgeon at a large public hospital downtown.
Whatever the reason, after earning an A in Organic Chemistry in college, Maddie went on to medical school and then landed a highly competitive residency in general surgery at MedCentral/St. Bridget’s (MCSB).
When she arrived in her white coat for her first day at MCSB, she had the feeling she was starting her medical education all over again. As an intern, Dr. Lee (from now on, we’ll refer to her only by her title, a mark of respect not every female physician is consistently accorded) rarely got to see the inside of the OR. She scrambled to update the morning surgical rounds group on overnight data for each patient; she hurried to various supply rooms when ordered; she took endless notes on her tablet and plenty more. By her third year as a resident, she was conducting simple procedures such as appendectomies and liver biopsies.
And she had found a mentor in the hospital—Dr. Shilpa Raganathan, an OB-GYN surgeon. It wasn’t only a medical mentorship or a surgical mentorship—it was, as one of the other women in Dr. Lee’s cohort called it, “a female-physician mentorship.”
Dr. Lee had had a few of the experiences she’d been warned about—a couple of patients mistook her for a nurse; another asked for “a real doctor” when she came to his bedside. On rounds it was typical for her to be introduced as “Madeleine,” or even “Maddie,” when men in her resident cohort received the “Doctor So-and-So” treatment. The banter among the male surgical residents and the more senior male practitioners was testosterone-heavy, with plenty of profanity (including the anatomical), and it made Dr. Lee uncomfortable; she didn’t want to seem standoffish or prudish, but also wanted to be true to her style and who she was.
Once she and Dr. Raganathan became friends, she shared these disrespectful moments and discomforts with the older physician, who typically rolled her eyes and nodded.
“Medicine is still a boys’ club,” she said once, “and surgery tends to be a bro’s club inside a boy’s club. I wish leadership had a better sense of what we deal with on a daily basis.”
“I don’t want to complain or seem petty,” said Dr. Lee.
“You’re not being petty,” said Dr. Raganathan. “Respect for each other’s sensibilities is just professionalism in my book. We’re held to incredible standards of professionalism in our work with patients, and that’s only right. So how about the same standards in our work with each other? And what’s also not petty is how we have to stand up for ourselves when it comes to time and money.”
“The women residents talk about that,” said Dr. Lee. “Less money for more work seems to be a thing.”
The residents’ stipends had been increasing modestly year by year, but Dr. Lee had heard when it came time to interview for her first job, she would probably be offered a lower salary than others. Regardless that she was unmarried and with no dependents to care for, she wasn’t sure how she would be able to advocate for compensation that was equal to what she deserved. With her background and experience, she knew she needed to negotiate for herself and an appropriate salary, but was unsure how to go about it.
“It’s not only what you need,” Dr. Raganathan told her on another occasion. “It’s what you are worth. We’re all socialized to give and give and give and be lovely icons of
selflessness—and that goes for women who haven’t chosen what is supposedly the most selfless profession of all. So you could double that expectation for those of us in white coats. But by the time you are out of here you will have spent about a decade learning how to be a good doctor, just like the boys have–and we are worth what they are.”
“I know,” said Dr. Lee. “But can we get it?”
“We need to learn how to fight for it,” said Dr. Raganathan.
Another important aspect Dr. Lee knew she needed to learn was how to advance in the organization once she was hired. One of the fifth-year residents, Dr. Elaine Melby, was raising two children with her partner, Angela, and she often vented with Dr. Lee about the stresses involved in that challenging task.
“Angela has a full-time job too,” she told Dr. Lee during lunch when both were eating outside and doing their best to enjoy a break and fresh air. “We’ve got her mom to look after the twins sometimes and I know she thinks I neglect them. I don’t neglect them, but I do miss them. I want to be a connected mom and a doctor too, and how do I do that after I’m hired? I limit my hours, and you know what happens when you limit your hours? You never make it to the list of people who might be a practice lead or a medical director one day.”
“Plus, you’re female,” said Dr. Christine Gao, who had joined the pair.
“Oh, yeah,” said Dr. Melby. “The old gotta-be-twice-as-committed-to-get-half-the-consideration routine.”
Dr. Lee, too, wanted a marriage and children. She was getting pretty serious about her relationship with Carl, a lawyer who shared her love of dogs and Beethoven. She and Carl might form a family—she wasn’t one-hundred-percent sure about that yet—but if they did, as that family grew and she honed her skills, Dr. Lee wanted her career to grow too. Clearly, there was going to be a lot of juggling of time, focus and ambition in her future.
The story continues in part two, when we see Dr. Lee five years later, juggling career advancement, parenthood and the solace she finds in a fellow peer coach.
Download our article How the Rise of Women Physicians Impacts your Healthcare Organization to learn more about this rising demographic of practitioners and how your organization can best support their greatest concerns.