Radiation oncology is an attractive field for female medical graduates. Why are so few women in industry leadership roles?
In a 1949 article about some of Australia’s first female radiation oncologists, Sydney physician Dr Sylvia Bray lamented the fact that she couldn’t find any female medical students who wanted to become radiologists.
“Radiology is a very good field,” Dr Bray told the reporter at the time.
“Its scope has increased tremendously during the last 10 years and it is a pity so few medical students are interested in taking it up.”
The article goes on to note that, of Australia’s seven female radiation oncologists, just one had a hobby outside of work.
Most of the women were married, and as such were expected to manage their homes and children “with the minimum of help”.
The article itself ran sandwiched between an ad for washing detergent and an ad for hat covers.
There have been many changes to radiation oncology in the intervening 73 years, but echoes of the environment that Dr Bray and her colleagues worked in still linger.
Across Australia, New Zealand and Singapore, women represent 40% of the radiation oncology workforce, but statistics indicate that Australian female radiation oncologists only have around half the average taxable income of their male counterparts.
In terms of formal leadership roles, just one third of Australia’s public RANZCR radiation oncology departments are run by female radiologists.
This year, there were no women on the eight-person RANZCR Board of Directors, although one woman will be joining the board for 2023.
Still, radiation oncology is considered to be an attractive specialty for women; the 2022 training cohort was very close to an even split between men and women.
The hours, for a start, are comparatively better and more flexible, especially for women who want to start a family, according to Sydney radiation oncologist Dr Mei Ling Yap.
“Most of the time that we spend [working] is within daytime hours,” she told Oncology Republic.
“We’re not expected to go in in the middle of the night so much … in that sense, it probably is considered to be one of the more family friendly careers, than surgery or anaesthetics or something like that.”
Dr Yap, who co-authored a recent paper in the Journal of Medical Imaging and Radiation Oncology which examined the gender pay gap in the field, said that the disparity may stem from the fact that women are more likely to work in the public sector.
“Increasingly, more people are going into the private sector, and a lot of people are … working at the public [hospital] some days and then at the private [hospital] on the other days, and that’s where people’s income stream can potentially increase,” she said.
“The data showed that women are more likely to exclusively work in public, rather than working in both public and private.”
Even among doctors working exclusively in the public health system, there are roadblocks to career progression which may be more common for women to encounter.
“Going up a [pay] level in the public system depends on the time you’ve accrued,” Dr Yap said.
“If you have a woman who’s had unpaid leave at any point – let’s say for parental leave – and then has been part time at some point, then [that accrual] will take longer.”
Dr Yap relayed the story of a junior doctor who had been told by a colleague that she would reach a certain level of seniority in five years.
“The colleague was a man who said, ‘don’t worry, in five years, you’ll be on this level’, and I was like, ‘no, no – if you’re working part time, that will take you much longer,’” Dr Yap said.
“Then it was like, ‘okay, lightbulb moment’ [for my junior colleague], but I don’t think all our men colleagues are aware of these differences – some think that we’re all on the same trajectory.”
Change, though, is in the wind.
As more women work through training, Dr Yap said, the numbers in leadership will eventually have to even out.
Adjunct Professor Lizbeth Kenny AO, a past president of both RANZCR and the Clinical Oncological Society of Australia, said the college is working on putting together a taskforce to specifically look at gender balance in the field.
“We have also clearly identified that the panels that interview for positions – be they in training or in consultancy – need to … be very carefully comprised,” she told OR.
“And that’s actually important across all aspects of employment … the diversity of an interview panel is critical in providing a rounded assessment of who you might employ.”
There are also plenty of female radiation oncologists, according to Professor Kenny, who may not get counted as a department head or board member, but are role models and leaders nonetheless.
Examples, Professor Kenny said, include people like Melbourne oncologist Dr Bronwyn King AO, who founded an organisation that works with financial organisations to disinvest from tobacco products.
“Next year, at the women in leadership meeting … we will have some extraordinary women leaders with us,” she said.
“We have women in senior leadership roles, some of whom have profoundly changed the way that companies and institutions work.”
Going forward, the Brisbane-based radiation oncologist said, the college wanted to use examples of extraordinary women at all levels to help inform the support it offers.
Speaking on a panel at the RANZCR Annual Scientific Meeting in Adelaide last month, final year trainee Dr Sarah Robertson said she felt lucky to have had strong female consultants as role models throughout her training.
“A lot of junior doctors haven’t considered our profession at all, which is a real shame,” she said.
“I think just seeing … someone that looks like you, as a woman, doing this career and doing amazing things, is really helpful.”