Okay, okay! We know that there is gender bias and discrimination in the House of Medicine. Anyone who fails to see that it still exists must be both blind and deaf to the reports that continue to assail us. The subject has been studied to death and yet gender bias still hangs on, not yet gasping its last breaths. From medical students just starting to mature faculty at the peaks of their careers, this proliferating field of study continues to try to provide us insight into how women in medicine are treated differently from, and have fared far worse, than men.

This week an article was sent to me by five loyal readers and colleagues. It’s title, “Gender Differences in Leadership Amongst First Year Medical Students in a Small Group Setting,” at first made me chuckle (okay, laugh out loud was more like it). And then it made me roll my eyes.

Why? Because, I thought, how much more circumscribed does the study question have to get before we have said enough about this topic? We need not just information but interventions that will work to change the imbalance in the opportunities available to women in all medical settings.

Well, given all the effort everyone put forth to send me this article, I sighed and then I actually read it. Merely minutes into the text, my heart started to race and I began to see a small glimmer of evidence that insight and information were going to be supplemented with action. Hooray!

This study, published this week in Academic Medicine, is very well designed. It had a control (non-interventional arm) and an interventional arm. The study was preformed twice, during two different academic years, and so the validity of its findings is strong.

These researchers gave basic instructions (control arm) about how the small groups were to form, each group having leaders and non-leaders. In the interventional arm the same basic instructions were supplemented with a “pep talk” about how important leadership experience was in a “safe” environment.

What happened? With this small “pep talk,” women stepped up to the plate and served in leadership roles at the same rate as the men. Without this “pep talk” gender “bias” occurred and women were significantly absent from leadership. (Their use of the word “bias” troubles me a tad except if they mean in this case, “pre-disposition”.)

I was astounded. How could such a simple intervention be so extraordinarily powerful? A little “pep talk,” a reminder that “yeah, ladies, you can (and must) do it, too.” It was subtle but profoundly important. Except perhaps it was the reassurance of the “safe” place that hit the home run for some.

So, like all good research, more questions remain than are answered. Here are but a few of the thoughts swirling around in my brain just ready to burst into the blogosphere.

Do women have to be reminded (and implicitly encouraged) that they can do it and, more importantly, that they need to do it? Why? Have men been primed at an early age to see leadership as necessary for advancement?

Are the structures governing the House of Medicine as yet untried, strange or uncomfortable for women? Do women need a safe place to try out their skills? Research shows that women have different leadership styles and groups of women govern themselves differently than groups of men. If the structure of the small group relied more on a male model than a female model, women might be unfamiliar, uncomfortable and hesitant, unless encouraged. Eventually, for some, the competitive spirit that got them into medical school in the first place was roused by a small reminder (a nudge) that assuming leadership roles is important (implicitly for their advancement). Competition to rise to the top trumps their inexperience or discomfort with this model of group dynamics.

Clearly “pep talks” are not enough to change the status quo in its entirety. And clearly both the individual and the institutions need to take action. So what are the actions, both large and small, that will result in change? This question is key to breaking through barriers, cracking the glass ceiling, navigating the labyrinth, and marching from understanding to action. Let’s expedite the inevitable. Women are not lacking the skills, the strength or the savvy. It behooves us to find all the ways, both large and small, that will lead to a not so distant future where gender bias is moot for women in medicine to the benefit of all who need their care.