How can we better support women in medicine? With Chelcie Jewitt

Mat: [00:00:00] Welcome to DoctorsWork. My name is Mat Daniel, and this podcast is about doctors’ careers. It’s part of my mission to help others create successful and meaningful careers. Today I’m having a conversation with Chelcie Jewett and she’s co founder of Surviving in Scrubs and we’re talking about how can we better support women at work. Now most women doctors have experienced sexism at work and face adversity ranging from microaggression to sexual assault.

What can we do about it? Chelcie tells me that changing the whole medical culture won’t happen overnight but there are small steps that each 1 of us can take. When witnessing discrimination, the least that bystanders can do is to acknowledge the event or the person on the receiving end, but it’s important to let the victim survivor decide what should happen next. Speaking up and listening to what others say is a key step, as is having an open mind and seeing things from the other’s point of view. [00:01:00]

Mat: Welcome. Tell me a little bit about yourself.

Chelcie: Um, hi. Yeah. So, um, I’m Chelcie Jewett. Clinically, I’m a emergency medicine registrar working up in Merseyside.

Just Just coming to the end of maternity leave, actually, so haven’t been doing much medicine recently. Um, I graduated from Liverpool and Fell in love with Scouser and have been here ever since. Uh, love working here. Um, and I also, um, am part of and 1 of the cofounders of, Um, the nonprofit campaign organization Surviving in Scrubs.

Mat: Tell me about Surviving in Scrubs.

Sure.

Chelcie: So, um, Surviving in Scrubs is, uh, an organization that myself and my friend and colleague, doc doctor Becky Cox, started, um, just over 18 months ago now. Um, Becky and I are so Becky’s a GP. She works down, um, in Oxford. She’s got a lot of other strings to her bow, so [00:02:00] she’d probably hate me reducing her down to to GP, but she’s got a lot of other things going on.

But, basically, we both have experienced Sexism, misogyny, um, and, unfortunately, harassment and and sexual assault at work. And, um, Becky got in contact with me Um, after the piece of work that I did with the BMA so I did a piece of work with with the the BMA, which Which was published in August 21, um, the sexism and medicine survey. So that was off the back of my own experiences, And that survey went out to, um, all all doctors in the UK. We were expecting about a thousand respondents, but we’ve got 2 and a half. And kind of, like, the headline news was that 91 percent of female doctors had experienced sexism at work.

Um, and there was, uh, you know, this was a a piece of work that hadn’t really been Number 4. And then Becky got in contact with me. We started chatting over Zoom because it was sort of on again, off again lockdown. Um, and then [00:03:00] we actually met up in person the following spring. And by this point, there’d been that initial show media interest, um, in this survey, in this piece of work, and there’d been some other bits of work going around.

But then nothing really seemed to be being spoken about, and it didn’t seem to be high on kind of the the medical agenda. Um, so Becky and I thought, what can we do? What’s gonna change things? What’s gonna make people, you know, stand up and listen? So that’s where we came up with the idea of Surviving in Scrubs.

So at our core, we are, At our core is our website, so surviving scrubs dot co dot u k, where anyone who works in health care because this isn’t just a, you know, sexism, misogyny, etcetera, isn’t just a doctor thing. It’s a well, it’s a societal thing, but it’s everyone in health care that it affects. So anyone in health care, irrespective of where they work, what specialty they work in, what their job role is, Can, um, can write to us anonymously. [00:04:00] Um, we do ask them if they feel that they want to to tell us Where they work, what they do. We don’t publish that data, but we keep that for for our records so we can have a look at themes.

But essentially, we want people to Tell us their story. Tell us their truths. Tell us their testimonies of what’s happened to them. And we now have a a collective narrative of over 210 Stories on our on our website at the, you know, at the time of recording this. And some of those are a couple of sentences, and some of them is a a a pages and pages long.

But Their voices are heard. Um, you know, we’ve we’ve got this collection of voices, of experiences of what is happening, And that’s enabled Becky and I to, um, to to lobby for for policy change, to advocate for these Survivors of of sexual misconduct at work. And that’s now our our campaign has Groan, you know, we’ve only been going for for just over 18 months, but we were knocking [00:05:00] on 10 Downing Street in December. So we’ve we’ve come Really far in that time, but we’ve got a long, long way to go to to keep this, you know, this on the agenda and to to bring about some positive changes. Actually, I

Mat: want to go back to your original research that says 91 percent of women have experienced sexism in medicine.

I mean, that that’s that’s astonishing, isn’t it? I think.

Chelcie: What what what yeah. I was gonna say astonishing. Um, I think it’s a I think it’s a shocking statistic, but I think it’s I think for for For women in particular, I don’t think it’s that surprising.

Um, in terms of the the sexism that I’ve experienced, I easily experience it At least weekly. Um, and then some weeks, it’s probably daily. It’s 1 of those things that as soon as your eyes are open to it, You can’t unsee it, and [00:06:00] it happens all the

Mat: time. I think that that’s probably 1 of the challenges maybe, you know, for For me as a man, be because I’m maybe I’m not on the receiving end of it, and maybe that’s why I I don’t see it. So the people that are on the receiving end, they they see it.

So perhaps what’s more astonishing maybe for a woman would you say is that all? Um, as a as a man, I’m thinking, gosh, that’s a lot. And maybe women are thinking, Well, the other 9 percent of the the the people walk around with their head buried in the sand. I mean, why why why Why are we only just now doing something about it? Oh,

Chelcie: I think that’s a really good question.

There there are so many barriers to to speaking up. I think the I think the fact that there are a lot more Women in leadership positions now, and there are a lot more female a lot more female consultants. There’s a lot more of a female presence in Not only hospital medicine, but medicine generally, as well as education. You [00:07:00] know, it’s not 50 50 in a lot of areas, but there is some representation of women. And I think that’s made it easier for people to start speaking up and talking about it.

You know, we know that in particular, peers talk about these things together. I I speak about my experiences to my friends all the time and vice versa. Um, and I’ve been doing that since I was a medical student. It was only when I got to f 4. I had a bit of time out between between, um, choosing my career, uh, training.

It It was at that point that I realized, actually, all these things that we’re all talking about that seem really normal to us, because they are normal, they are normalized, that is the culture in which we work, aren’t right, and they are sexist. It was that awakening, um, that kind of prompted me to wanna speak up and do something about it. But I think just Flipping that switch of the fact that, alright, this [00:08:00] is normal where we work, but it doesn’t mean that it’s right. Um, I think once that Once that switch has been flipped in people, it’s really hard to to flip it back, and I think that’s produced this This want for a lot of people to to talk about it and and to raise their voices about issues. Um, obviously, I’m talking particularly about gender equality, but we know that there’s other Inequalities as well within the the institution that that we all work in.

So what what

Mat: kind of things are going on that that men might not notice.

Chelcie: Oh, anything and everything. Um, it’s There’s an argument as to to whether it’s not being noticed or whether it’s being noticed and not spoken about. Um, there are Tell

Mat: me a bit more about that distinction.

Chelcie: I think so if I go back to your original question, then I and I’ll follow on to that 1.

So the kind of things that we get reported to on our website [00:09:00] or talking to, as I say, talking to peers or or talking at events to me when we go out and speak about these, um, these topics. It can range from, um, inappropriate comments, um, inappropriate jokes, Um, based around, you know, stereotypes, gender roles, etcetera that disadvantage women Or make women feel othered or not included within the workspace or that they are less valued. And then it can escalate. Um, it can escalate to inappropriate touching. It can, um, inappropriate texting.

Um, so, you know, an unwanted advances, um, that the the woman may be repeatedly saying no to, but it just keeps going, Keep going. Keep going. Harassment, in other words. And then we have had some reports, unfortunately, of of sexual assault and and Even rape in the workplace. [00:10:00] And I’m not saying that all of these incidences have been Been witnessed by someone else because we know that from the data that we have, we know that perpetrators Often do this on a 1 to 1 basis, but when things are witnessed by others, Particularly comments or or maybe an an inappropriate touch here and there.

It’s hard for Anyone to speak up about it, to speak up against the top a a culture. And I feel that that can be particularly Difficult for men sometimes because they’ve got the They kind of got pressures from both sides. They wanna be part of the they wanna be part of the team, but equally, they want to Be a nice a decent person, and there can be a conflict there, which makes it difficult. [00:11:00] And, um, we know that there’s there’s ways of going about Being, uh, an ally, you don’t have to call things out right there, right then. Um, you know, that even might be detrimental to to the The victim of these behaviors at that time.

But you can go and ask if they’re okay. And even just talking to to someone who’s experienced Either microaggressions or or of full on aggressions, just asking if they’re okay Makes them know that what you saw wasn’t right, and it makes them feel as though they matter. And I think that’s a real Huge. That has huge impact, um, on that individual, and I think it’s something that’s very simple and very easy To do in theory. Um, but I think when we all work within a culture of tolerance, [00:12:00] It’s hard to go against the grain.

Mhmm. So

Mat: the the Something there if something happens that that isn’t as it should be, then the least that somebody can do is check-in with that person and and acknowledge that something’s happened that that that that probably wasn’t wasn’t great. And you you you said sometimes challenging it there and then might not be the right thing to do. So so so I’m wondering, okay, If if I see something, then, you know, yes, I can acknowledge and, yes, I can talk to that person. But equally, I’m guessing there’ll be people thinking that say, well, if I saw something that’s wrong, I I need to report that.

So what what’s the problem with somebody else reporting it? So

Chelcie: Rep reporting things is fine. I’ve my, um, I always come from this from thinking about about [00:13:00] the the The victim, the survivor. And I’m of the opinion that everything should be focused towards them and towards their well-being. There is a want to to help people.

I think, You know, most of us in health care do want to help other people, and that’s probably why we’ve gone into health care. So when you see someone being wronged, you want to make things right. But what you think is right, I e, this needs reporting, this needs, you know, this person needs reporting to the GMC, they need their license taken away, you don’t necessarily have The power over that because that incident didn’t happen to you. As a witness, you absolutely definitely can do those things, but I think you you owe it to The person that’s had this behavior done unto them to make them aware of what you’re doing, Ask them if they want that to happen because, realistically, [00:14:00] reports probably aren’t gonna go anywhere unless they’re involved in that Investigative reporting process. And if they don’t want to go down that route, that’s absolutely their prerogative.

They don’t have to. But it may be that they don’t wanna do it now, that they need a bit of time to and this and this very often happens with with trauma. People need time to process it as an individual, you know, get their head around it. And then at a later date, they feel Able to or that they want to report things formally. So it’s very It’s very hard for me to give people black and white instructions of what to do because every incident is, um, nuanced, And there are different factors that that play into things, I.

E. Whether or not, um, it’s someone so the perpetrator is a consultant and they’re very junior. You know, that hierarchy [00:15:00] impacts potentially not only the the survivor’s, um, career, but it could have then affect Other people’s career who are who are active bystanders, etcetera. So there’s there’s so much that needs to be taken into consideration. But the thing that I would say that makes the most impact and is the thing that we all need to be doing irrespective of whether we are The respect of what our gender is is that we all need to be listening to people when they talk about their experiences And not necessarily wanting to fix things and make you know, go down that reporting route, but just listening and creating this Open and honest culture of what is actually going on.

And I think the more open and honest the culture Around, you know, in the NHS is about what’s going on in terms of sexual misconduct. I think The more people realize that there needs to be change, and that then leads to, you know, organizations [00:16:00] Making changes, but also individuals, if they feel listened to, are gonna feel more and more Able to speak up against people who are repeatedly perpetrating these behaviors, and and that will eventually be what That will eventually be what is going to change change the culture is the talking and the listening, which Seems really simple to me, but I, again, I’m aware that it may not seem simple to to other people because of the other Ashes that they’re under. I

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Chelcie: show.

Mat: I like that the the practical thing, which is the [00:17:00] the least that you can do is you can you can acknowledge with the person that that’s been the victim or the survivor. You can acknowledge with them that something’s happened and then then put them at the center of of whatever happens next.

You know that kind of that that strikes me as a really powerful starting point, isn’t it? And then it’s also it then It it becomes it becomes from their point of view rather than from my point of view. That makes sense because my point of view, you know, might might be way off or it might be irrelevant or it like what the other person wants to do. So you you use the term allyship. Tell me a little bit more about what what that is.

Chelcie: Um, so being an ally to me means listening to what People are saying amplifying their voices and doing what you can To to help them spread their message and and to [00:18:00] to just support them, basically. So I think it’s I think it’s pretty I think for for For for someone to be an ally, it just means believing someone and supporting them in in the simplest terms. And I think that’s most easily demonstrated, Again, by men talking about these issues, I think I think I am a woman, and I’m very much coming at this gender equality from a woman’s perspective. I am aware that that men Can have gender inequality as well. It’s a lot less common, and it’s very often a lot less violent than what women have to deal with.

Um, so though I’m I’m talking quite reductive in terms of this is a woman’s problem, it isn’t. It’s a problem for everyone, and men need to talk about it. Women talk about [00:19:00] this all the time. All the time. People women probably talk about with me with this all the time because this is all I ever talk about.

But women talk about this all the time, And men need to talk about it too. Men need to talk about the fact that their friend, who is a man, has just Assaulted someone and that wasn’t okay, or that man has said an inappropriate joke about that woman and that is not okay. And calling it out and just talking about it and And explaining why it’s not right and and saying, come on. It, you know, it doesn’t have to be a a full on lecture. It can just be a, mate, come on.

That wasn’t That wasn’t that wasn’t right. Or come on, mate. You know what I mean? So that’s kind of that’s that’s how I see it anyway. It might it might seem a bit bit simplified, but I’m a I’m a simple thinking person.

Mat: I’m interested in that culture because you talked about culture changes, you know, if we all talk about it and, you know, maybe women already talk [00:20:00] about it, perhaps men that don’t talk about it. So If more men talk about it, then that’s that’s how culture changes. But I’m interested in that you you said that sometimes People see it, but people just tolerate it or people say, well, that’s just the way it is. That’s the way that we do about it. You know, that that’s normal.

It’s okay. That’s what we’ve always done. I I mean, what what what do we do with that kind of just acceptance that this is how it is and therefore it’ll stay like that? Because lots of people say, well, this is just how it is, isn’t it? And we don’t do anything about it.

So what needs to change for people to start doing something about it?

Chelcie: So culture is the hardest thing to change. It is the hardest thing to change because it’s ingrained in everything. And, Realistically, it’s to to completely change culture, Um, 1, it’s probably nigh on impossible realistically, but 2, it’s gonna take a really, really, really, really long time. [00:21:00] And I think there is a lot of well meaning organizations, a lot of well meaning individuals who who wanna put This intervention in place and that intervention in place and but they want to make sure that it’s gonna completely fix culture.

It’s not. I’m gonna just tell you it’s not. There’s absolutely no point in in trying to have just this silver bullet that’s gonna automatically Change the culture of of health care. It’s just not gonna happen. But what we can all do is we can all do something because a little bit of something is better than doing nothing.

And, again, on that individual basis, it comes to talking about it and, You know, talking about it, listening to others talk about it, and reading up on it and learning About what is going on and thinking about things outside the box and looking at things from a different perspective. [00:22:00] And I think that’s you know, again, you don’t have to all of a sudden No scripture and verse of every, um, equality law within legislate Legislation. Um, but just knowing a little bit and being okay with the fact that you don’t know everything. I think, um, Probably in the high pressure of of medicine, you you just want to be an expert all the time, and you don’t feel fully Confident or comfortable going into something if you’re not a hundred percent prepped and you know the answer to every question. Whereas, actually, We all need to get a bit better at being comfortable with being uncomfortable.

Um, we’re all gonna make mistakes. We’re not perfect. And what we can do is we can learn from those mistakes in terms of, you know, you might make a joke at work that’s Inappropriate and offensive to someone. You learn from that. You don’t double down and say that joke was really [00:23:00] funny.

You learn from it and you say, I’m really sorry. That was inappropriate. I won’t do it again, and you’re reflecting it and you learn from it. And that’s you changing the culture because you’ve changed a little bit about yourself, and that has an impact. So it’s like these little, little changes.

Um, you know, we we need the big changes too, but, actually, it’s the little changes, the day to day interactions that are gonna be the thing that makes a big impact overall in the long term. Um, so, yeah, that that’s what I’d say for that. It’s

Mat: It’s actually also really powerful, you know, if a if a senior male consultant says, I’m sorry. That was really inappropriate. Not not only does the senior male consultant learn, but everybody else hears, okay, you know, this is a person who’s listened, And and next time, I can speak up because this is a person that listens and is willing to to to to change.

And there’s there’s a there’s a kind of slightly, um, there’s a there’s a weird thing I always think about diversity. I was talking to [00:24:00] medical students about that this morning That that lots and lots of literature from the kind of business world would suggest that the more diverse organizations, boards, senior leadership teams you have, The the the better the outcomes are. So it’s actually if if we create those kind of cultures where everybody can speak up And, you know, and and people get on with each other and people look out for each other, then then not only does that help, you know, the person that happens to be, you know, in a persecuted group. It actually helps the whole organization, um, and therefore, by extension, even the people that that might be in a position of power. So it it always kind of struck me as a bit weird that that that that because a lot I think a lot of this is a power about power, isn’t it?

Or I think, you know, you can come back to me, but that’s That’s how I see a lot of that. But the reality is that if you have that diversity in organization, it helps even the person that currently has the most power.

Chelcie: Absolutely. It’s all about power. And I [00:25:00] think if you’re gonna I think we need more diversity in medicine, generally speaking.

You know, there’s there’s a need to there’s a need to broaden out the people that could the the The cohorts that are coming into into medical schools, we need people from different backgrounds, not just affluent private school, um, Fourth generation doctors. I am not 1 of them, FYI. And, you know, they’ve got a place, but but they don’t represent or they don’t they haven’t got They can’t represent the whole of our population. I can’t represent the whole of our population. You know, we need Anyone from any kind of background coming and doing medicine, not only so that we can all No.

It’s not so that we’ve got a diverse team for for our own sakes so that we are aware of each other’s kind of different characteristics and, You know, we’re working well [00:26:00] together, but, you know, it goes down to patient safety. There’s data out there that about how there’s disadvantages For for women versus men, but also women of color versus white women in terms of their health outcomes. And I think the more representation we’ve got at At the the level of the the medics and and health care staff, um, out there who are making decisions about people’s lives and people’s quality of life, Um, it’s gonna have a better outcome on on patients. So there’s so many arguments for Changes to kind of the the structure of training, the structure of NHS to make it more Equitable for not only women compared to men, but for other protected characteristics as well, um, Because it it will have a knock on effect. Admittedly, it’s gonna take a while to get to the point where we have a real positive, um, knock on effect for our Our patient care, but it [00:27:00] is something that I think we should all be working towards.

Mat: Let’s let’s think about practical actions that, um, people can, um, take themselves. So, you know, let let’s maybe let’s sort of start With me, when I go back into the workplace tomorrow, what what do you think I should be doing tomorrow at work? I think

Chelcie: I think I’ve already said it, to be honest with you. I think it’s a case of listening to others, talking to others, and Educating yourself. So there’s so many resources out there now.

We’ve got some on our website about kind of What people can do, resources for people to go and look at, but also things like our social media posts. We start we’ve got some educational posts coming up in terms of what we mean by Sexism. What we mean by misogyny, what does that look like in health care? Um, so there are, you know, those are our resources, but there [00:28:00] are so many resources out there, Um, that are really that are free to access and easily easy to read and and, you know, even things like YouTube and podcast. It’s it’s just There’s so much data out there.

So just going looking and reading about it, um, and finding out about it, and then maybe bringing that into the workplace. Oh, I listened to this podcast. What do you think about this? And, actually, kind of signposting that you are open to these conversations and to these issues. No 1 would expect you to be an expert, but they feel then comfortable to talk to you about it.

And then that might then lead on to things that You could do practically at work, whether that be, um, organize some form of, like, awareness day or or training or, um, An educate you know, teaching session or something about it or even just somewhere where people can have a cup of tea and just have I talk to you about it so that they feel included and feel part of the team and feel valued. [00:29:00] Um, so They’re not they’re not massive things to do. Um, I’ve probably made them sound like massive things, but it’s it’s just, again, little things that do make a big difference. They

Mat: sound very achievable. What about for for the women listening?

Um, what would be your what would be your tips to them?

Chelcie: My tips to them would be talk. Talk. Talk. Talk.

Talk. Talk. Talk to each other. Um, talk to men. Make men listen.

If you are in a if you are in a leadership position as a woman, then, you know, help the women behind you, support women behind you. And, yeah, just keep spreading the word and and trying to do Anything and everything. No. Just just keep spreading the word so that we can try and make a difference to the to this culture because It we just need to keep going with it [00:30:00] and and put pressure on organizations where you can. And if you’ve got stories, whether you are a man or a woman or, um, non binary, whatever your gender, if you have stories of gender inequality, sexism, Um, misogyny, harassment, or or result, please, um, if you feel able to, submit them to our website because our collective narrative is is really, Really bringing about so much change, and we’re in so many meetings with large organizations, and they’re listening to us.

They’re listening to us, and they’re list so that means that they’re listening to people who’ve experienced this. And I’m very grateful, and I’m very aware that I’m I’m in a Privileged position for people to feel comfortable and confident enough to tell me their trauma, um, but it is going towards Change for the future. So so please feel free to, uh, to submit them. And

Mat: maybe my final [00:31:00] questions for the organizations, for the medical directors and the chief executives, for for those kind of people, what tips would you have for them?

Chelcie: Um, so, um, the first thing I’d say is get in touch with us because we have a big long document of recommendations for stations, and we’re more than happy to share that, and we’re more than happy help more than happy to help implement those changes.

But the 3 kind of areas that that we kind of want organizations to focus on is Educating and and training, um, the staff in terms of awareness of what’s going on, um, allyship that we touched on today, And, um, again, what organizations can do. We need improved support For people who do report issues, so that’s gonna be either peer or near peer support [00:32:00] Or links with psychological support, if that’s possible to to get going in your organization, please do that. And then the third thing is for for organizations to to look at their own internal policies. We know that very few NHS organizations in England, um, actually have a sexual safety policy. Um, a lot of these Issues of sexual misconduct actually usually fall under bullying policies where there is some role for that.

But From what we know in the literature and the research, actually, it needs its own policy because there are nuances to So sexual misconduct that aren’t covered and aren’t thought of. Um, so and, again, that that’s something that we can help with as an organization. Um, so yeah. So those 3 things. So training, support, and policy.

Mat:

Wonderful. Thank you very much.[00:33:00]