WMHSIG 25th anniversary reflections – Dr Ros Ramsay

It’s been a pleasure and an honour to be asked to write for the 25 Women blog. Being part of the original Exec, then secretary and later chair, were responsibilities that meant a lot to me at the time and were huge learning experiences too. Reading the 25 Women stories is so women-affirming and I’m very aware of the compassion and care these psychiatrists demonstrate towards their patients and friends, families and colleagues, as well as their ambition to make improvements in how care is delivered.

The 25 Women stories have prompted me to reflect on my own life and the common challenges women have faced in the profession. The barriers to women weren’t obvious to me growing up in effectively single-sex environments. I have two older brothers who I followed to an almost-all-boys’ school until 11; I assumed I was on a level playing field with boys. Later in a girls’ secondary school we were encouraged to believe, ‘if you study hard you can choose any career’, and so off to University and then medical school. It was only in my clinical training that I started to see the barriers that women could face as doctors – I’m remembering, for example, the plastic surgeon who criticised me, the only female medical student in the group, for crossing my legs when sitting in a teaching session – what a cheek!

At medical school, I was inspired by the obstetrician Wendy Savage and became aware of the need to have more women doctors in this branch of medicine that sees only women patients. I decided to train in obstetrics and gynaecology but had a last-minute change of heart to switch to psychiatry: no procedures to master and more time to explore ideas; I was also influenced by some of the evenings spent discussing different ethical issues with the London Medical Group.

After my first maternity leave, I benefited from the part-time training scheme which was a fantastic opportunity as it allowed me to continue to enjoy the final years of training. Having completed training, the question then, as now, was how to work less than fulltime as a consultant. I was appointed to a fulltime post; it was left to me to find another doctor to take on part of the work if I wanted to reduce my hours. I was lucky to meet Anne Cremona at the first Women In Psychiatry Special Interest Group (WIPSIG) meeting, as she was looking for some NHS sessions and was able to join me as a job-share partner. I was keen to engage more with the new SIG and Anne and I could use our catch-up time to brainstorm ideas for the group as well as discuss shared clinical issues.

The SIG started at a time of wider change for women patients in psychiatry. By the time we celebrated the SIG’s 10^th birthday in 2005¹ there had been some important changes. A standard had been introduced to eliminate mixed-gender accommodation for inpatients by 2002 and other documents were evidence of a commitment to gender-sensitive and gender-specific services and raised the profile of women and mental health. In practice, even more was probably happening in forensic services, particularly at the low secure end, with new women-only units opening in parts of the country.

As for women psychiatrists? In 2005, SIG membership had grown to 1,277, and women accounted for 40% of College members in the UK and Ireland. Women performed better than their male peers in College exams, while looking at the highest echelons of the College, the President, Registrar and Treasurer were all women. In 2003 over 60% of accepted applicants to medical school were women. However, difficult questions were being raised in the media – in particular, by Professor Dame Carol Black who asked what the impact of the increasing feminisation of the medical profession would be on the status of the profession.

In 2001 the College had commissioned an external review into its structures to identify any discriminatory practices to address. This led to the President, Professor Sheila Hollins, putting forward a gender equality statement of intent and developing an action plan. I think this demonstrated a recognition of some of the difficulties with the status quo and a willingness to make changes.

Looking back to my time on the Exec I remember the fun we had working together to achieve our shared ambitions and how much learning there was for us as a group in lobbying for what we thought was needed. I was juggling an almost full-time post with three children, but leading the SIG in the mid 2000s felt like a core part of what I was doing and worth making time for.

In the years since 2007, I spent time as one of the Medical Women’s Federation officers and also trained as a coach. My current College role is as the Specialist Advisor for the Psychiatrists Support Service. Reflecting on my career over the last 25 years since the SIG started, there’s been a red thread of joy at work and doctor development running through the different things I’ve done. My day job as Deputy Medical Director for the medical workforce in my Trust links in well, as again I’m thinking about how to support and develop psychiatrists. Alongside growth, my other value is about sustainability and the environment, but I’ve more to do to bring this into my work life.

I continue to read a lot by women authors and to end this posting thought I’d share my top reads from this lockdown year – Americanah, Why I No Longer Talk to White People about Race and Girl, Woman, Other. All three are by black female authors and highlight issues about intersectionality; this links to Black Lives Matter and the College ambition to reduce racism and discrimination for patients and psychiatrists through the Presidential Leads for Race and Equality.

1. Women in Psychiatry: ten years of a special interest group, R Ramsay, APT 2005, 383-4.