Medical field: Interview with neurologist Nicole Sestito, Ph.D.

A few decades ago in the 1960’s, female neurologist Marian Diamond, Ph.D. (1926-2017) was conducting revolutionary research on the brain. Her findings were published in an article she co-wrote, yet her male colleague, when listing the contributors to the article, buried her name last and confined it to parentheses. In her career, Dr. Diamond not only proved the theory that brains physically change in response to environment, she was Cornell University’s first female science instructor in 1955, and she also famously studied Einstein’s physical brain. Nevertheless, she had to explain to a male colleague that her name should be given the same treatment as a man’s name for authorship credit.

Today, most doctors over age 65 are men. According to the U.S. Census Bureau, however, the number of women in the healthcare industry doubled from 2000 to 2019, and currently women hold over 76% of all healthcare positions in the U.S. Some careers, such as veterinarians and pharmacists, are now dominated by women. Fifty years ago when patients visited their pediatrician or gynecologist, they were almost certainly going to meet with a male. Today, women comprise the majority of practitioners in these fields, and they work alongside men in top healthcare positions in every area of medicine.

Fifty years after Dr. Diamond began her research career, Pennsylvania practicing neuropsychologist, Nicole Sestito, Ph.D., remembers her experiences as an intern and resident, where most of the students tended to be men. Because the field of neurology is male dominated, throughout her training she mostly interacted with male doctors. Although her gender clearly had much less of an impact on her career path trajectory than for women who entered the field years before, she still recalls personal experiences in which it was a disadvantage to be a woman. “I’ve had people be dismissive of what I do in ways that I don’t think they would be with a male colleague.”

She said, “I wasn’t always putting together that my being a woman was influencing the way people saw me or interactions I was having with other people, but things started to come together, and it makes you see everything in a different light.” Sestito said that she believes that she did not notice every microaggression as it was happening.

Sestito is happy to be with her current Pennsylvania group medical practice, which includes three female and three male neuropsychologists, but it took years to reach a place where she felt she was treated as an equal by male associates. She recalls asking a previous employer for a certain level of compensation to see patients. After the institution refused and she began a new job, she learned that the employer hired a male with lesser credentials at a salary greater than the amount she had asked for.

Having received her doctorate at Drexel, Sestito recalls that while a majority of the psychology students were female, most professors at the time were male and that males filled the vast majority of the leadership positions. Sestito also recalls that during her training in residency, male psychologists would on occasion put their hands on her shoulders in a condescending way. She said, “Especially as a trainee, it is especially hard to call people out on that sort of thing.”

In addition to having to deal with problematic behavior from colleagues, she also has experienced what she believes is disparate treatment from patients. Speaking on behalf of herself and her female colleagues, Sestito said that she and her female colleagues all have stories about middle aged and older patients being aggressive and making demands toward them. Explaining why this occurs, she said, “I think that it’s just this feeling that you can get away with acting towards a woman in a way that a male doctor would not tolerate.”

Sestito sees a large generation gap not only in the way older patients view female doctors, but in the way older doctors themselves view female colleagues. She said, “I think a lot of the doctors themselves, especially those of the older generation see us as less capable.” Several of Sestito’s female acquaintances have stated that the reason they have had successful past meetings with their bosses is because they tried to act like men.

Although the medical field has made obvious strides towards equalizing the treatment of women and men, clearly there is much more progress to be made. Sestito advises that women “go into the field with the awareness that [unequal treatment of women] is still implicit, and people don’t always mean to do it, but you’re probably going to face it.” She acknowledges that minority women face double discrimination. She recommends that women set their own boundaries and sometimes say no even if it goes against their nature to be people pleasers. Even seemingly innocuous tasks such as collecting money for a baby shower or cleaning the office kitchen accumulate over time and impact how individuals are viewed.

She also counsels women to recognize when they have imposter syndrome, in which an individual does not think she is good enough for her own position and that she will inevitably fail. “At one point I thought if I don’t start standing up for myself, no one else will do it for me,” she said.

While Sestito would like to see more women enter the healthcare field, she feels it is equally important for the men who are in the field to work as equal partners with their female colleagues. She said, “The goal is not just to fill every position with a woman, but to be able to work together, and for men to really understand these issues and change the behavior of their predecessors.”