“The most challenging relationships I had with my fellow residents were with other women,” remarks Dr. F, an attending general surgeon, as we wait for morning didactics to begin. She shares anecdotes of passive-aggressive behavior from women colleagues and a lack of support during difficult situations — like the time her car broke down in a snowstorm on her way to the hospital and she was curtly told to “just figure it out.”
Among medical students, we’ve had similar conversations about how certain women surgeons, residents, APPs, nurses, or surgical technicians seem to exhibit noticeably different, and often better, behavior toward male colleagues or students, without any clear explanation. This behavior pattern is not always exhibited among peers or from seniors to juniors. I recall a woman medical student sneering at the profile of a surgical intern, also a woman, suggesting that her earned position was “probably not due to competence.” I remember wondering how many others shared such views but chose not to voice them aloud.
While the challenges faced by women are now a prominent topic in medical education — addressed through lectures, articles, and research papers that highlight bias, discrimination, and systemic barriers in the male-dominated field of surgery — discussions about conflict among women remain relatively superficial. These conversations often focus on hierarchical tensions between senior and junior women, attributing such dynamics to competition for limited opportunities or the pressure to adopt traditionally masculine traits to secure their place in the field, while treating junior women colleagues more critically (also known as queen bee syndrome, a term first introduced in 1973).
Nonetheless, it seems that while many women encounter challenging dynamics with their female peers, discussing these experiences remains somewhat taboo. Raising these concerns in larger group settings or public forums carries the risk of being perceived as perpetuating sexism. For instance, addressing counterproductive communication patterns observed in predominantly female spaces is frequently dismissed as a manifestation of internalized misogyny, rather than an opportunity for constructive dialogue and growth.
Reflecting on these experiences brought to my mind the simple yet fascinating concept of social identity theory and salience of social identity: Individuals derive part of their self-concept from membership in social groups. When someone is in a setting where their group identity is distinct, that identity becomes more salient, potentially leading to in-group policing. In the context of women in surgery or women interested in this field, our gender identity often feels heightened, and we may subconsciously view other women as representatives of this shared identity. As a result, the perceived flaws of another woman might feel like reflections of our group as a whole, leading to defensiveness against any form of imperfection — a phenomenon that could help explain some of the tension we experience.
Going back to the negative comment a student made about the newly matched intern, women have historically faced unfounded accusations of leveraging social skills or personal charm to advance their careers, rather than being recognized for their competence, qualifications, and merit. If a woman were to be found guilty of those accusations, some may argue that it would negatively reflect on all women in the field, so the suspicion engenders implicit bias and defensiveness against any woman who has this potential “weapon” of above-average appearance, social skills, charm, and charisma. I think this is frequently dismissed as jealousy, as evidenced by comments under a video recently gone viral in which a female resident laments, “God help you if you’re decent-looking with a nice personality. You will have a target on your back [by other women].” Envy definitely exists, but in my opinion, animosity between female colleagues is more complicated than that. Intragroup tensions, while equally present in both male and female-dominated spaces, were found to have a more significant negative impact on women, per a study on intragroup conflicts in women-dominated occupations (teaching, nursing, and social work). Further sociological research could provide valuable insights, offering alternative frameworks to analyze these dynamics beyond the narrative of adopting masculine traits.
Women can be each other’s strongest advocates, which makes me believe there is significant hope for progress on this issue. The first step toward fostering more supportive dynamics among women, like any other challenge, is to address it openly, encouraging honest conversations, constructive feedback, and accountability. Another critical step is to reframe how we see one another; not as representatives of a fragile group identity, but as individuals fully capable of thriving without the need to prove our worth through perfection or toughness.
What has been your experience with other women in surgery? Share in the comments.
Helia is a third-year medical student at Yale School of Medicine. When not learning medicine, she can be found sketching, collecting rare books, and bouldering. She is a 2024–2025 Doximity Op-Med Fellow.
Illustration by Jennifer Bogartz
