#even the faculty that I do really admire and respect seem entrenched in some of these attitudes

[nerdgirlnarrates]

Even though it's been months since I switched from neurosurgery to internal medicine, I still have a hard time not being angry about the training culture and particularly the sexism of neurosurgery. It wasn't the whole reason I switched, but truthfully it was a significant part of my decision.

I quickly got worn out by constantly being questioned over my family plans. Within minutes of meeting me, attendings and residents felt comfortable lecturing me on the difficulties of having children as a neurosurgeon. One attending even suggested I should ask my co-residents' permission before getting pregnant so as not to inconvenience them. I do not have children and have never indicated if I plan to have any. Truthfully, I do want children, but I would absolutely have foregone that to be a neurosurgeon. I wanted to be a neurosurgeon more than anything. But I was never asked: it was simply assumed that I would want to be a mother first. Purely because I'm a woman, my ambitions were constantly undermined, assumed to be lesser than those of my male peers. Women must want families, therefore women must be less committed. It was inconceivable that I might put my career first. It was impossible to disprove this assumption: what could I have done to demonstrate my commitment more than what I had already done by leading the interest group, taking a research year, doing a sub-I? My interest in neurosurgery would never be viewed the same way my male peers' was, no matter what I did. I would never be viewed as a neurosurgeon in the same way my male peers would be, because I, first and foremost, would be a mother. It turns out women don't even need to have children to be a mother: it is what you essentially are. You can't be allowed to pursue things that might interfere with your potential motherhood.

Furthermore, you are not trusted to know your own ambitions or what might interfere with your motherhood. I am an adult woman who has gone to medical school: I am well aware of what is required in reproduction, pregnancy, and residency, as much as one can be without experiencing it firsthand. And yet, it was always assumed that I had somehow shown up to a neurosurgery sub-I totally ignorant of the demands of the career and of pregnancy. I needed to be enlightened: always by men, often by childless men. Apparently, it was implausible that I could evaluate the situation on my own and come to a decision. I also couldn't be trusted to know what I wanted: if I said I wanted to be a neurosurgeon more than a mother, I was immediately reassured I could still have a family (an interesting flip from the dire warnings issued not five minutes earlier in the conversation). People could not understand my point, which was that I didn't care. I couldn't mean that, because women are fundamentally mothers. I needed to be guided back to my true role.

Because everyone was so confident in their sexist assumptions that I was less committed, I was not offered the same training, guidance, or opportunities as the men. I didn't have projects thrown my way, I didn't get check-ins or advice on my application process, I didn't get opportunities in the OR that my male peers got, I didn't get taught. I once went two whole days on my sub-I without anyone saying a word to me. I would come to work, avoid the senior resident I was warned hated trainees, figure out which OR to go to on my own, scrub in, watch a surgery in complete silence without even the opportunity to cut a knot, then move to the next surgery. How could I possibly become a surgeon in that environment? And this is all to say nothing of the rape jokes, the advice that the best way for a woman to match is to be as hot as possible, listening to my attending advise the male med students on how to get laid, etc.

At a certain point, it became clear it would be incredibly difficult for me to become a neurosurgeon. I wouldn't get research or leadership opportunities, I wouldn't get teaching or feedback, I wouldn't get mentorship, and I wouldn't get respect. I would have to fight tooth and nail for every single piece of my training, and the prospect was just exhausting. Especially when I also really enjoyed internal medicine, where absolutely none of this was happening and I even had attendings telling me I would be good at it (something that didn't happen in neurosurgery until I quit).

I've been told I should get over this, but I don't know how to. I don't know how to stop being mad about how thoroughly sidelined I was for being female. I don't know how to stop being bitter that my intelligence, commitment, and work ethic meant so much less because I'm a woman. I know I made the right decision to switch to internal medicine, and it probably would have been the right decision even if there weren't all these issues with the culture of neurosurgery, but I'm still so angry about how it happened.