Learning from the lived experiences of medical women working and studying at the national hospital in Fiji: A mixed methods study.

Abstract

Objective: Our study aimed to explore the experience of attaining higher education among women in medicine at the largest national hospital in Fiji, focusing on barriers and enablers to completing training, and to explore women's perception of gender-based discrimination in the world of medicine. Findings subsequently informed evidence-based recommendations on enablers and barriers at the hospital and medical university to improve experiences of women in medicine.

Methods: We conducted a mixed-method study, emphasising the phenomenological qualitative component. All women doctors working at the national hospital were invited to complete a survey, and those with past or present engagement in postgraduate specialty medical training participated in semi-structured interviews. Survey data were analysed using descriptive statistics. Interviews were transcribed, coded then organised using thematic analysis. Reflexivity and triangulation were employed at all levels of the research to ensure rigour.

Results: Four distinct themes were found to illuminate women's enablers and barriers. Participants described work-life stress, absence of advocacy, coercion-control-power and inflexible systems as barriers. For enablers, they described inner strength, social circles, work culture and mentors/role models/advocates. Participants had mixed perspectives on gender-based discrimination in the workplace, with unanimity in calling for protected maternity leave entitlements.

Conclusions: Challenges only become true barriers when enablers are eclipsed by them. Institutional support helps mitigate these barriers especially for those women who lack social support. Gender based discrimination continues in the Pacific, commonly covertly, especially in terms of policy gaps regarding maternity leave during training.