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June 28, 2017

At grand rounds, he's 'Dr. Smith'—so why is she 'Mary?'

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Female doctors are less likely than male doctors to be introduced as "doctor" at grand rounds, according to a new study led by physicians at Mayo Clinic.

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How the study came about

At grand rounds, doctors, researchers, and medical students present on medical problems and treatment. The setting is a "premier educational venue at academic medical centers," according to study author Sharonne Hayes, a physician at Mayo and director of the clinic's Office of Diversity and Inclusion. 

After noticing gender differences in conference introductions firsthand, Hayes and two female Mayo physicians decided to research differences in how male and female doctors are introduced at grand rounds. To do so, the researchers looked at footage of 321 speaker introductions at 124 internal medicine grand rounds at Mayo campuses in Minnesota and Arizona between 2012 and 2014.

How female doctors were introduced differently

According to the study, female physicians introduced by male speakers were less likely to be introduced with their professional title than male physicians introduced by men.

Specifically, the study found that:

  • Female physicians introduced male physicians as "doctor" 95 percent of the time, and introduced female physicians as "doctor" 97.8 percent of the time; and
  • Male physicians introduced male physicians as "doctor" 72.4 percent of the time, and introduced female physicians as "doctor" 49.2 percent of the time.


Hayes said, to her mind, the casual introductions wouldn't be an issue if both male and female physicians were introduced similarly. "It's the inequity and the context," she said. "I don't mind being called 'Sharonne'—it's my name!—but if all the men are being called 'Doctor Jones' and all the women by only their first names, that's offensive."

Hayes argued that while an introduction might seem a small thing to notice, it can influence someone's performance at an important, sometimes stressful event. "Grand rounds is kind of a high-stakes event," Haynes said. "As the speaker, you've spent hours preparing for it, may be a little nervous in front of the podium, ready as an expert, and then somebody says, "Here's 'Sharonne.' You're immediately put off a bit and may not be at your best performance."

Separately, Julia Files—an associate professor of medicine at Mayo and lead author on the study—said, "It gets down to perception of expertise, perception of competence." She added, "We know that in other settings, choices of words really impact women's progress in careers."

Anupam Jena, an associate professor at Harvard Medical School, added that while introductions alone might have a small direct effect on female physicians, "the general attitude within medicine that drives these differences is probably what's most important." He added that if the issue is resolved in one professional arena, the results could "spill ove[r] to all sorts of other interactions that would happen in a hospital."

Changing the practice

At Mayo, administrators decided to implement guidelines for introducing speakers at grand rounds. The protocol calls for using the title "doctor" on first reference. The speaker's first name or a nickname may be used in later references, if appropriate (Neumann, Washington Post, 6/24; Lombrozo, "13.7 Cosmos & Culture," NPR, 5/22).

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