Table 1. Themes, subthemes, and illustrative quotes.
We use ‘S’ to denote when a quote is from a student focus group and ‘F’ when a quote is from a faculty-student group. The number is used to distinguish between the student and faculty focus groups.
| Theme | Subtheme | Quotes |
| Obstacles | ||
| Microaggressions | “when you're a petite female … I used to always get, ‘Hey nurse, am I going to see a doctor?’” (F4) | |
| “whatever we were juggling, I always contributed, I always worked hard or as hard, if not harder, I think, than a lot of people, and to have little barbs thrown at you because you were on maternity leave or because you went to your child's kindergarten…performance” (F3) | ||
| “mind clutter, the worry you have to go through about ‘what am I going to wear today?’” (F4) | ||
| “…we have a patient presentation and they just say, "Dress professionally." If you look around the room, the men just get to wear a button up shirt and slacks, and that is professional and it's easy. And the women have to figure out, ‘Is this dress long enough? Is this dress too low cut? Am I going to get looked at because my shoulders are out? Is a pencil skirt unprofessional?’ … These are things that are both internal and external barriers” (S2) | ||
| Macroaggressions | “sometimes more overt comments about like ‘are we trying to hire a woman or are we trying to hire the best person for the job?’” (F3) | |
| “…I found out recently that there was a discussion that there should be a non-compete on my contract when I came here because I was going to get pregnant…but (it didn’t happen because)…somebody else had spoken up and said, "No, you can't do that, that's gender discrimination" (F3) | ||
| “I have had one patient where I had to stop standing at a certain part of his bed because he could reach my leg and he would like grab and pat my leg…I just started standing on the far end of his bed where he couldn't reach it” (S2) | ||
| Lack of women in leadership | “we still aren't seeing very many women leaders… there's systemic discrimination against women,” (S1) | |
| “I think this is an amazing institution, but … some of the things that frustrate me here are not indirectly related to (the fact that… department chair is) the only woman in that room where those decisions get made right now and that's just a problem” (F1). | ||
| Lack of role models | “(I did not) have any physicians in (my) family” (S3) | |
| “no one in (my) family…is in academia” (F4) | ||
| “growing up, I never saw a woman who's a minority in places that I wanted to be. I never saw a Latino doctor… I had so many questions growing up. Like ‘how do I even get to this place?’” (S1) | ||
| Personal characteristics that need to be overcome | “… a man is going to ... take charge, and people will maybe listen to him more, and that's a fear in the back of my mind…it's definitely something I consider when I'm like, oh should I go after this position? Maybe it's not a good fit for me, and I think I tie that into being a female” (S3) | |
| “(My) biggest barrier has been myself. But going back to what (she) … said is, self-advocating. If you look at studies, women have been known to be, to undervalue themselves” (F2) | ||
| Support systems | ||
| Sponsorship | “The most important factor for me was a sponsor…He had just, he only spent two years in our department, but I happened to be his chief resident. And he sponsored me. I would have never had the job I had without him. I am 100 percent sure” (F2) | |
| “it was actually my immediate…supervisor within my division who saw my potential from my clinical interests to take over and was very great about…guiding me…into that role” (F3) | ||
| Mentorship | “He also helped me say no to things and be like "You're too busy." So that was also, I think, a very important trait of a mentor, being interested and aware of everything that I was doing and to help me make the best choices" (S2) | |
| Allyship from men | “…(he) was actually really important for me because I didn't have female mentors because they didn't exist” (S2) | |
| “… it's kind of put me in this place where finding male mentors who recognize that it was harder to be a woman (is helpful)” (S2) | ||
| “it's hard enough to have to go learn all these things. I do Step studying. I didn't do anything useful. I didn't do the dishes. I didn't my laundry. My husband did it all for me. ... I think it's huge” (S1) | ||
| Gender-specific advice | “my mom would always say things like, "You're going to college," not like, "Are you going to college?...She was like, "…you're going to college, and you're doing it before you have kids. And you're not getting married before you graduate college’” (S2) | |
| “my mom was always the boss in my house, and she was always…the leader in any groups…And I would always see her running the show, and that was what I would look up to” (F3) | ||
| “I think the most helpful thing for me has been to see the behavior modeled by my attendings and residents to show how they handle it. Because unfortunately, it happens to them on rounds in front of the entire team, just as much as it happens to me alone in an exam room before I go get the attending” (S2) | ||
| Self-presentation | ||
| Being strategic | “Find what motivates you and then go for it. Totally unabashedly. Go for it.” (F1) | |
| “embrace…knowing who you are and being authentic to who you are. Don't try on somebody else's thing. And there's not a type of person that is a leader; the effective people are the ones that know themselves well and are comfortable with being that person in that leadership space” (F3). | ||
| Resilience | “roll with the punches instead of feeling flattened and demoralized” (F4) | |
| “I guess my own resilience and persistence has kind of kept me in the game. I'm also a little rebellious like, ‘You think I can't do this? Well, let me show you, I actually can’” (F3) | ||
| “I think we faced all these different challenges, but as I reflect, I think they've made me stronger, more resilient. All these little battles that you have to fight. All these little obstacles on the road, and you kind of just keep plowing through” (F2) | ||
| “looking back and see how far you've come can be a huge thing. Just remembering where you started and how hard it was just to get into medical school and how hard it was just to get through college…And just remembering that you can do hard things and you're totally capable” (S1) | ||
| Navigating social norms | “I went through this process where I got rid (of it)… I only wear black, gray, and blue because then I only need black belts and black shoes” (F1) | |
| “I went to Singapore and I got a tuxedo made. And I wore tuxedos for events for a number of years” (F4) | ||
| “pay other people to do all of that menial stuff for you, because you will be saner and calmer at the end of the day…If you were trying to do all the other stuff, you'd just be exhausted and frazzled and frustrated. (This way) you’re fulfilling your potential.” (F4) | ||
| Advocating for other women | “Someone told me ‘This is going to be hard. There's no such thing as a good time for when you have kids. There's no such thing, … you just do it when you're ready. And that was really reassuring to me…" (F3) | |
| “…I had a …situation where incidentally, a male in a position of leadership said, ‘Don't ask for that. Don't ask for too much; just be grateful of what you're getting.’ And I went to some other women colleagues, and they said, ‘Ask for it; you need to make sure you get what you're worth and ask for these different opportunities in your leadership position,’ and I took the advice I wanted and asked for it.” (F3) | ||
| “(women) have to identify and help each other and point out ways to improve and be better so that everybody can reach their maximum potential of where they want to be” (F2) | ||