Are women represented appropriately in medical associations? Or more importantly perhaps, are their concerns taken seriously? In the context of the rape and murder of a Kolkata doctor inside the hospital, here's a deep dive into their lived realities.
Published Sep 04, 2024 | 7:00 AM ⚊ Updated Sep 04, 2024 | 9:40 AM
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“You ask me, why I should do what is not done by any of my sex? To this, I can only say that society has a right to our work as individuals. If anything seems best for all mankind, each one of us should try to bring it about.”
– Anandibai Joshi (1865-1887), the first woman from India to train as a doctor in allopathy.
Though these words were spoken in the 19th century, they resonate powerfully in the 21st century. Following the brutal rape and murder of a junior female doctor in Kolkata, these words echo even louder. Doctors across the country protested the brutal rape and murder of the trainee doctor, halting outpatient services at medical college hospitals. Many of these protests were spearheaded by doctors’ organisations.
However, despite how timely these issues are, representation of women in these organisations remains minimal and no leadership positions are held by women. In Telangana, where the Junior Doctors Association (JUDA) led the protests, and within the Indian Medical Association (IMA) – the largest and most influential doctors’ body in the country – the lack of women in positions of leadership is glaring.
In Telangana’s JUDA, the positions of president, chairperson and general secretary are all held by men. There is only one woman among seven vice presidents. This reflects the situation of women in relatively small organisations which represents thousands of doctors at the state level. On the other hand, in the Indian Medical Association (IMA), none of the leadership positions in the current committee is held by women either.
JUDA president Dr Kommu Rahul told South First that more women must step up and seek leadership roles. “I don’t know why women are not interested in leadership roles. We were all brought up by women, and I believe they can do anything. But if they don’t come forward, what can be done?” he asked.
He further said, “I can proudly say that we, on behalf of Osmania Medical College JUDA, supported a woman who came forward and took on the role of general secretary. She is leaving her mark, setting high standards. Motivated by her, two other women have also stepped up and are contributing to the organisation.”
A recent study, “Examining Representation of Women in Leadership of Professional Medical Associations in India,” published in the journal PLOS Global Public Health, reveals significant gender disparities in the leadership of professional medical associations (PMAs) in India.
PMAs play a critical role in shaping healthcare policies, medical education, and professional standards, making gender representation in their leadership essential for equitable decision-making.
Only nine of 46 PMAs (19.5 percent) are currently led by women. Additionally, half the leadership committees in these associations have less than 20 percent women, and nine PMAs have no women in their central committees.
The study highlighted that in the IMA, “Out of the 92 individuals who have served as presidents since its inception, only one was a woman.” IMA president Dr RV Asokan spoke about the study: “It is what I might term a squint viewpoint. A squint is when the eye is not properly aligned while looking at something. This viewpoint too is like seeing things with a limited perspective.”
Dr Asokan said IMA operates on a three-tier system, with strong female representation at the local level in towns and cities. Many women serve as presidents and secretaries in local branches, effectively balancing their home responsibilities, profession, and association duties. Hundreds of women lead groups of up to 1,000 doctors at this level, he said.
“However, representation decreases slightly at the state and national levels. This reduction isn’t due to barriers imposed by the IMA but rather the nature of the profession and personal choices made by the women involved,” he noted.
Dr. Asokan said women in medicine, particularly those specialising in gynaecology or paediatrics, have demanding professional roles that keep them closely tied to their hospitals or clinics. Their on-call duties and home responsibilities limit their availability for higher-level positions within the association. The study also found that even in associations focused on women’s health, such as obstetrics and gynaecology, men tend to dominate in leadership roles.
“The National Neonatology Forum has only one woman in its leadership committee, and in FOGSI’s 73-year history, only 15% of past presidents were women, underscoring the issue of men occupying leadership positions in fields closely related to women and children’s health,” the study noted.
Dr. Asokan pointed out that there is no formal barrier to the entry of women into leadership positions in IMA. “We encourage women to participate actively, and they do so in significant numbers at the local and state levels. We even have a women’s wing at the state level. But at the national level, we don’t treat women separately; we integrate everyone,” he explained.
He said that patient care takes precedence over association duties, and women take on the larger share of domestic responsibility too, leaving fewer women professionals in the national association. He said that the lack of women in leadership roles at the national level is a reflection of these practical realities, rather than a lack of opportunity or encouragement. “At the local branch level, women are thriving and contributing significantly. It’s only when you move to the state and national levels that their numbers diminish, primarily due to the demanding nature of their profession,” he said.
Dr Karishni Chittarvu, a former JUDA president of the Gandhi Medical College unit, said young women doctors must consider leadership roles as opportunities, and not see them as burdensome. “If we want effective resolution of our concerns, we must voice our concerns ourselves. If I had not taken the initiative and attended meetings, I would never have become president,” she told South First.
Dr Karishni said it would be hard for a male doctor to fully understand the unique challenges women face. “By having more women in leadership roles, we ensure that these issues are addressed from a place of genuine understanding. The more women who step up and take on these responsibilities, the better we can advocate for necessary changes and improvements. This is a voluntary organisation, and if we want changes, we must be proactive. Women should not hesitate to contribute because of fear of being judged. We are all part of a larger unit — the association — and our collective voice is powerful,” she said, explaining that leadership was an opportunity, not a burden.
On 20 August, while establishing the National Task Force to provide recommendations on ensuring the safety of doctors in medical colleges and hospitals, the Supreme Court noted that the Sexual Harassment of Women at Workplace (Prevention, Prohibition, and Redressal) Act, 2013, applies to all hospitals and nursing homes, including private healthcare providers.
According to the Act, every hospital and nursing home must constitute an Internal Complaints Committee (ICC). The Supreme Court stated that employers’ duties, as outlined under Section 19 of the Act, include organising sensitisation programmes and providing a safe working environment.
In India, the act mandates the formation of an ICC in all organisations, both public and private, with ten or more employees. The ICC must include a senior female employee as the presiding officer, at least two internal members with relevant experience or commitment to women’s issues, and an external member from an NGO or association focused on women’s rights. At least 50 percent of the committee members must be women.
The ICC is responsible for handling sexual harassment complaints, conducting inquiries, and ensuring compliance with the Act. Failure to establish an ICC can result in fines and the potential revocation of business licences.
However, junior doctors across Telangana this reporter contacted said the two major medical colleges in the state — Osmania Medical College and Hospital, and Gandhi Medical College and Hospital — have yet to establish an Internal Complaints Committee (ICC) for junior doctors, although Gandhi Medical College does have an anti-ragging committee that students could approach. Even so, a young doctor said the students are more likely to report such matters to the junior doctors’ association than approach the authorities.
On 1 July, the National Medical Commission (NMC) issued a directive mandating that every medical college establish an ICC. This came after the National Human Rights Commission pointed out to the NMC that they could not find any details about such committees on the medical colleges’ websites. The IMA and other voluntary associations like JUDA are not workplaces but voluntary associations, so they do not have Internal Complaints Committees, which are mandated for workplaces.
“The basic thing to understand is that we are a voluntary association. Workplace issues arise specifically in workplaces, not in associations. Most of the branches of IMA come together for two or three hours during Continuing Medical Education (CME) sessions. In these sessions, local branches gather — doctors from various towns or cities come together. The main work of the IMA in these local branches is to impart continuing medical education and exchange notes and experiences,” said IMA president RV Asokan to South First.
In 2022, during the hearing of a case concerning the establishment of an Internal Complaints Committee (ICC) in political parties, the Kerala High Court ruled that there is no formal employer-employee relationship among members of political parties. The court described political parties as associations of individuals with a common purpose rather than legal entities.
What action can a voluntary organisation like the IMA take against someone accused of harassment? IMA president Dr. RV Asokan said under IMA bylaws, action can only be taken if there is a conviction related to moral turpitude. “Mere allegations are not sufficient; there must be a conviction. If a doctor is convicted by either a court or the state medical council, he or she loses the registration number from our organisation. However, since we are a voluntary body, the IMA’s role is limited.”
He explained that the Medical Council operates under the National Medical Commission’s code of ethics. “While the Commission may address issues of ethics and conduct, disciplinary action primarily falls under the jurisdiction of the court or the council.” However, Dr. Asokan clarified that medical colleges have committees since they are institutions. “Hospitals, like mine, also have these committees. I run a hospital, and for my employees, who are mainly women, I have established a committee. These institutions are required by law to have such committees, with the State Medical Council serving as the disciplinary authority.”
“If a female doctor is harassed by a male doctor, she should report the matter to the Medical Council, which has the authority to revoke a doctor’s registration number — a powerful instrument that effectively removes the right to practise as a doctor. That is something even the courts cannot do.”
“So, we have our own self-regulating system. The profession is self-regulating, and these systems are in place,” he said.
One woman who held a leadership role said she would be invited for debates on TV, but that only caused colleagues to react adversely.
“In those early days, during interviews, I noticed that questions were often allocated strategically, giving some individuals more opportunities to speak. While I received praise and recognition, it was accompanied by jealousy and insecurity from others regarding my position,” a woman doctor who held the position of general secretary of the Telangana JUDA said, asking not to be named.
“Female representation in any organisation often remains symbolic,” the woman doctor noted. “Even when a woman is present, there is rarely meaningful involvement in core decision-making. Initially, I made decisions on my own without much support. I advocated for equal opportunities, but they were not provided. While I don’t dwell on it much now, it was disheartening at the time. Instead of focusing on substantial representation, people were preoccupied with trivial matters.”
This woman doctor has since moved out of her leadership role, and currently does not occupy any position in professional organisations. “In our society, there’s a tendency to take male representation more seriously than female representation,” she said.
Dr Karshini too stated that when women seek to represent larger groups, they are often perceived as individuals and not as representatives: “I once stood up for a male PG student, and was questioned by someone in authority about why I was so concerned about him. That is a question no male representative would have been asked. That line of questioning can be tricky, in a professional environment. What is more, even female colleagues sometimes adopt that line.”
“When women feel their efforts and voices are not valued, they may question why they should invest their time and energy. Drafting representations and advocating for issues is time-consuming and demanding, and it becomes even more challenging when faced with dismissive attitudes,” she said.
These challenges reflect broader societal issues, including persistent patriarchy and sometimes even resistance from other women. The societal expectation that men should lead still influences how women’s contributions are perceived,” she said.
(Edited by Rosamma Thomas)
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