Dr Nadine Yamen: A pain medicine perspective

Growing up, I was always told I could have it all – a fulfilling career and financial independence, a happy marriage and be a loving mother to children. As I progressed through my medical training, I realised it was never going to be quite as simple as that. There is no doubt that it is hard to have it all at once and hard to have it all as a woman in medicine.

I was very fortunate to have been able to enrol in undergraduate medicine, be accepted on to a training program quickly and complete my fellowships prior to having children. I am in awe of our current trainees who are generally older and who often have to navigate pregnancy and having young children all while in training programs with overtime, exams and rural rotations.

Despite my good fortune, there were times when I found that being a woman in medicine was challenging. Once I was on a medical student ward round with a male consultant. All four students on this particular round happened to be female and we were enthusiastically seeing patients and learning, when the consultant turned to us and said, “I don’t actually know why I am bothering to teach you guys when its most likely none of you will end up practicing medicine”. Spoiler alert – all of us are currently working in tertiary institutions as medical specialists.

A colleague of mine was told “pregnancy is not a disease” when she suggested at nearly term in her pregnancy that her team take the hospital lift instead of the stairs. Another colleague was reprimanded after not disclosing her early pregnancy during a job interview.

Currently only 30 percent of pain specialists in Australia are female, and the percentage of interventional pain specialists is even lower. Even after fellowship, women are underrepresented in the college leadership. In clinical practice, female pain specialists are often the default provider for patients with undifferentiated pain, or pain with significant psychological comorbidity, necessitating longer consults and making it harder for them to earn as much as their colleagues.

All colleges are now recognising that both male and female doctors currently place more value on their time with their families than previous generations, and structural changes are necessary to recruit and retain quality medical practitioners.

I am encouraged by the fact that more women are choosing pain medicine as a career now. As a supervisor of training, it is heartening to see so many other female pain specialists taking on education and leadership roles within the college. All of this can only benefit our discipline and the patients we serve.