Themes and quotations
| Theme | Representative quotations |
|---|---|
| The pervasiveness and invisibility of sexism | |
| “This research endeavour is so painful, and then you add in all the other layers around sex and gender. It’s harder, it’s just harder for a woman to become a clinician–scientist. I see it. … they have to work harder, they have to be better, they have to sacrifice more, it’s just harder. (P21) “... doing this type of intensive training, especially for a woman, this might be the time when you would be thinking about starting a family, so there are all the challenges that go along there too, so you understand, you know what the challenges are. I had, I was in the US doing my fellowship, doing my research training, I had both of my kids when I was doing that and it’s challenging, it’s very challenging cause you’re trying to, you know, adjust to all of that, figure all of that out and that’s the time when your colleagues would be really generating lots of data as a trainee and even as junior faculty.” (P24) | |
| Work–life balance | “I mean, in medicine, in all the health sciences, even with the majority of women there is still this sense of you can have it all, right, you can’t — you can have a family, be healthy, and still be a brilliant scientist and produce medicine science, right? So there’s a heavy weight on that I think, and yeah, it’s the type of pressure and biases that I think will only go away the minute we acknowledge and keep talking about it until it becomes a place where it’s acceptable”. (P13) “If you are a woman [who wants children], at some point you have to take a break from whatever it is that you are doing. The thing is that any career that is demanding is something that doesn’t intuitively open up these opportunities, it’s something that you really have to carve out and really work the timing perfectly and it’s something that I think you have to realize that you are entitled to, because no one around you will give you the legitimacy of doing it”. (P6) “I can’t afford to lose those connections by taking a year off [for maternity leave], … it’s just our bodies are made for babies unfortunately, so our husbands, they can do lots of the other things like cooking and cleaning maybe, but they’re not physically breast feeding, especially in those first few months, the baby is all on you and your body.” (P22) “I’ve been at my institution for 17 years — lots of amazing women being recruited with an interest in being a clinician–scientist but eventually giving up the research piece because, you know, the barriers were too great as they had children, I mean not unlike what I chose to do, right? Something has to go. In my case I gave up the clinical piece, but often people are choosing to give up the research side, and that’s a huge loss, after years of training and we need all those brains and ideas at the table.” (P23) |
| Compromises to career and family | “At some point, early in my career I had to recognize, this is all I can do and put boundaries and say, look, I work 8 to 6, Monday to Friday. I’m happy with the success I can achieve within those hours in terms of productivity. I will not let that spill into my weekends or my evenings because I have young children and they need me all day everyday all that they can, they need food, they need entertainment, they need their mother.” (P25) |
| The invisibility and visibility of racism | |
| “Is it a welcoming, diverse field? Or, you know, would people of Indigenous [background], would they feel comfortable or not? And our ways of doing science, are we being inclusive enough, or are we very cut to the Western traditional scientific way of thinking? Or if someone with Indigenous ways of knowing wanted to engage in research, would we be ‘yeah that’s good’?” (P7) | |
| Uneasiness challenging racism and bias | “We don’t really talk about culture or race or ethnicity. It’s so unclear to me why. It might be its uncomfortable for supervisors to have that conversation, it might be uncomfortable for classmates and peers to have that conversation. I understand that it could be really uncomfortable for some people, but I also think what that ends up doing is just kind of quieting the voices of others.” (P20) “I think it doesn’t make me feel very comfortable talking in classes for sure, stops me when it comes to issues of diversity depending on who I know is in the classroom. I often will not say anything because I know that there’s specific people, I don’t really feel safe sharing my experiences with.” (P20) |
| Questioned credibility | “This has happened to me on numerous occasions and continues to happen to me on a daily basis, even at this level, where because of my appearance, my intellect is not appreciated or dismissed right from the beginning until I open my mouth, so that has to stop.” (P25) “So that’s always a consideration as a minority or especially for someone who’s not proficient in the language. Sometimes I second guess myself if I misinterpreted this message so and I say that I would convince myself not to participate in a conversation that I feel like I have not fully understood. So that’s more internal, and my experience is that that’s not uncommon for ESL [English as a second language] speakers. So, what then translates in a clinical setting or a training program is that because of, you know, communication difficulties, sometimes we come across as not as engaging of a learner or not as collaborators of a team. So that is something, it is more of an awareness, I would say, and I think that translates to cultural differences too.” (P13) |
| Proposed individual-level solutions to the pervasive problems of sexism and racism | |
| Identifying mentors with shared experiences | “I think having a female mentor also helps — I only had women supervisors, so I don’t know if that would be different for having a male supervisor in terms of — I would think so right, but perhaps it’s an awareness — like ‘what does it mean to have your children during your graduate studies, during your training, during your early career years?’ — I always saw babies and pregnant women in the forum so I know it’s a possibility, but perhaps it’s a flag to make sure that this is an environment that allows for that, because those are the years that women are having children, right?” (P13) “I don’t think there is a single woman of colour in my core clinical faculty, so there is no way I would ever see myself being a part of my own department after I graduate because I’ve been in my department for about 10 years since my undergrad and I’ve never seen anyone that I would be able to identify with in that way.” (P20) |
| “As long as you don’t have role models that have you know, ‘walked the walk,’ as long as you don’t, you know there’s still not going to be any change.” (P11) “I’m very fortunate to have a female supervisor in my school program who has talked to me about [parenting] you know. It’s important too. She officially did her internship as a new parent and it was just like, knowing that people can go through that at all stages of having a family, I think, is important. I think there is, I would imagine, unique challenges or demands on one’s time. I don’t know if taking time away from the field, what does that look like as well? What professor talks about that? Not somebody I’ve been mentored by. But just the types of questions about publication output if you’re on mat leave or things like that, I guess you just don’t think about that, or what kind of support is helpful from a partner?” (P19) “EDI [Equity, Diversity and Inclusion], as we start thinking about the kinds of mentors in EDI it’s become a much more prominent topic … you know people with colour et cetera, they may choose to have mentors that have some of that lived experience that can help them navigate that portion of their career, that again someone who hasn’t had that can’t help them with, right? So, I think we need very different mentors and different mentors at different stages in our careers, so I think mentors are really, really important.” (P17) “I think there is lots of structural and systemic reasons why the majority of our trainees are white and then that re-perpetuates itself at the post-doc level and it re-perpetuates itself at the faculty level. We have, I honestly can’t think of a clinician–scientist who is in a leadership position who is a member of black, Indigenous or people of colour community, at least in our department.” (PC9) | |
| Proposed institutional and system-level solutions to address the pervasive problems of sexism, racism and the leaky pipeline | |
| “I am known for being highly supportive of female graduate students. All my graduate students, they all say the same thing, ‘we want to work with you because you are very pro female academics, we can do this,’ and I think because I had children, I am a better researcher. I think that my work is viewed in a different light in the public because people know that I am a mother and I think it is only helping the academy, it’s not a hinderance.” (P3) | |
| Individual efforts to create safe spaces and meaningful conversations | “I think I’ve incorporated this as part of my lab culture, like I think we need to have this type of training because it’s the real reality and we end up grouping all sorts of different trainees with the same realities right, women, and having their kids during their training.” (P13) “I have been having conversations where a lot of people were uncomfortable, there was a lot of eye-rolling, and I felt very much defeated coming out of those conversations, but those same people who were somewhat defensive are now putting together grand rounds about EDI and inclusivity and anti-racism and medicine. And so, I’m thinking okay maybe they had a hard time digesting when I put it out, but it did stay with them and influenced their activities and their planning. So, sometimes you don’t get the positive feedback as you do this work, but you need to keep on going.” (P10) “I do think that cultural change is critical and there’s little pieces that we don’t even realize that are impacting certain populations more than others. Certain ways we think, certain ways we act, certain conclusions we come to that it’s not a short-term fix, it has to be consistent.” (P4) “Now we spent the summer doing journal club on anti-racism, and we are implementing an extra set. So, we use the usual checklist for our critical appraisal of articles, but now we also add an extra set which there is no checklist, so that might be an area we can actually innovate here is the critical appraisal checklist — none of them have anything about race, now we’re adding critical race theory to the checklist, so when we review any articles on any topic we will spend some dedicated time to look at the race question and how the research was designed to include or not include elements of race and how racism may play in the research.” (P1) “Safe and comfort are not the same thing and there’s no way that if you’re really engaged in any of this work and you really want to make change that you cannot feel uncomfortable — you have to feel uncomfortable and that’s not the same as safe. And so, when we talk about safe spaces, I had this conversation with a department chair last week who really wanted to make sure we were creating these safe spaces for people to challenge, so we went and we talked about this and it’s not really about safe spaces, it’s about brave spaces.” (P24) |
| Strategies to address the leaky pipeline | “A lack of diverse mentors makes it so that individuals who do enter a pediatric training pathway don’t see, you know, physician scientists as something that is possible for them to achieve because they don’t see mentors that look like them. Again, they don’t have mentors who necessarily see all of the biases and hurdles they are facing, that they might not have faced in their pursuit of a clinician– scientist career.” (P4) “I do think that sometimes it can feel like too much and why would you want to put yourself in an environment where it’s already hard. Grad school’s already really difficult and to have an added stress that maybe others aren’t experiencing might not make it work.” (P20) “And I think women, I think are a special issue, you know trying to have a family at the same time that you’re in graduate school, this is really tough, really tough, so I think we lose women as well, and I think that’s a real pity and a problem, so we need to sort of fix that leaky pipeline.” (P18) “…we need to recognize that because of that implicit bias many people are rooted out right from the beginning, they’re not even given the opportunities that somebody else may know how to work the system, has the right contacts and get moving up. So, that is something that I think we need to work on, provide opportunities early in training for people to see what is possible in an academic career, that’s important.” (P25) “I think certainly for people of colour and women of colour, you know one of the major challenges are that there are no, there are so few role models out there that you don’t really have necessarily folks, well you don’t have folks that look like you who you can say, you know what? That’s who I aspired to be, or I aspired to be like that and that is true not only in your home institution, but that is true at conferences, and so all of that networking.” (P24) |
| The need for institutional change | “Several sources will suggest that one needs to be really active at trying to recruit people you know, people of colour, people that have been marginalized and haven’t been and not, because the easy thing to say is well we put this out there and nobody applied, so this is what we’ve got, right?” (P17) “I think first of all, and I know this isn’t changing current faculties’ mindset, but I think it, well it might but I think a big thing is hiring more faculty members that are more diverse in their identities.” (P20) “I think that if I can speak to my own kind of ethnic background, I think that, you know, we should try and make these positions, these opportunities more easily available and accessible to people from ethnic minorities and to women, and there should be a very dedicated effort towards that. But I hope that in 10 years ... a legacy of [clinician–scientist training programs] is … who we trained should look very different than the first 20 years. So, that is what I hope all this work will lead to — that there is an equalization and an acceptance of all types of scientists and the value we place on them.” (P25) “Make exceptions to the usual admissions process and pluck these people and really support them. So, we had a, and I kick myself on this, we had a young man from Africa who was interested in research, and he just did not do well, it did not work out. And as I reflect upon it now, it is because I think we all treated him with the same lens we would with all clinician–scientists and did not make an exception for him. He needed more time, for example, he needed to publish more … and I just don’t think we gave him the, we didn’t accommodate him and we should have accommodated him and I’m upset with myself about that.” (P18) “The evidence suggests that the best way to compose those committees are both with people of colour, but also with people that haven’t had lived experience, you know so we work together as a team, that you shouldn’t say, well, I haven’t personally had lived experience in this particular thing so, I can’t be passionate about that, of course you can. But the other thing is that you know, we don’t always know what someone’s experience was.” (P17) “We rely too much on recruiting American and recruiting British clinician–scientists and do not grow our own, and I think Canada suffers as a result of that. So, I think we need to work more closely with the residency postgraduate training programs, the graduate training programs like psychology and social work and educate them about the crisis in training a clinician–scientist and particularly those of colour, Aboriginal, et cetera, and start a conversation about what we can do to improve the situation.” (P18) “Where are these people going, where are we losing them, how are we turning them away? It’s incredible just the systemic barriers and challenges, so I think that this is a space that I am interested in taking much more a critical eye to within our own funding opportunities … I mean, there are so many barriers and so how do we address each one of those throughout the system, how do we recruit more people with diverse backgrounds, how can we be more inclusive, how do we retain, how do we acknowledge the different needs of different groups?” (P23) “The one the faculty must embrace is, technically there has to be pipeline programs, you know, [you] can’t just start this when you’re 30 years old, or 28, this has got to come when they’re, they’re beginning, they’re getting into their original schooling, I don’t mean like kindergarten early. But I do mean when somebody’s coming into school of social work, so number one it’s got to be clear that the [faculty] ... has an openness around what it means to embrace diversity and to have an admissions process that in the most obvious way recognizes the diverse backgrounds that people come from and the pathways that they can take, so it’s not just cookie cutter admissions … I think all of that is important for generating diversity. Otherwise, people are just locked out.” (P17) |