The American Medical Association declares each September “Women in Medicine Month” with the goal of increasing the influence of women physicians and advocating for women’s health issues. Over history, women were restricted from the profession of medicine, although they have always been on the frontlines of the practice of healing as family caregivers, nurses and midwives. In 1849, Elizabeth Blackwell became the first woman to graduate from medical school in the U.S., and over the 19th and 20th centuries, women made significant gains in access to medical education and professional practice. In some cases, they started their own medical schools and hospitals when established medical institutions wouldn’t admit them. In 1969, 9% of U.S. medical students were women. In 1976, this number had grown to 20%, and in 1990, when I was in medical school, 35% of my class was women. Today, women make up 50-51% of medical school classes and approximately 27% of practicing physicians are women.
I’ve thought back on my decision to go to medical school. I was certainly influenced by my father, an MD and my mother, a nurse. As the oldest child, I was often called on to be a caregiver and helper, and medicine seemed a natural fit. I also appreciated that there was a well-defined path: take these classes, get really good grades, and do some hands-on work by volunteering or working in a healthcare setting. If you follow this recipe, mix in a bit of good luck, show up every day, and drink from the firehose of information and experiences blasted at you without drowning, you’ll find yourself eventually adding the letters MD behind your name.
Also, I thought I would be a pediatrician, but somehow along the way I was entranced by surgery. I did some sewing as a child, and exhibited a couple of fancy 4-H aprons at the Red River Valley Fair. I even bought patterns for making clothes at Northport’s Ben Franklin store, yet the end product disappointed me. I think it was because I didn’t look like the stylized drawings of the girls wearing the clothes on the pattern package. But surgery was a lot more than sewing, of course, and I liked having multiple ways of addressing problems. I ultimately chose my specialty because I get to work with both children and adults, and there were many issues that I could help solve: sinuses, allergies, sleep, hearing, and cancer. I also loved the artistry of facial cosmetic procedures and the self-esteem boost that they gave to patients.
I chose this despite the fact that it was very sexist. I went to medical school in Dallas, Texas. The men’s locker room was labeled “Doctors” and the women’s locker room was labeled “Nurses.” In order to go to the doctor’s lounge to discuss cases pre-op, I would have to go through the men’s locker room. I always knocked loudly. I did a great job in Orthopedics but was told that it was not a good specialty for women. The lone female Ortho resident was ridiculed because she fainted after a busy night on call and no time for breakfast.
Training through medical school and residency is tough on everyone, regardless of gender. It’s a long road with four years of school, and three to seven years of residency depending on which specialty you choose. But, I think there are some extra challenges as a woman in medicine that I didn’t think about before I entered. Medical training is happening during peak times for developing long-term romantic partnerships and having families. It is not impossible—but not easy—to date, marry and have kids during training. I’m in a group of 16 women MDs this year called Whole Health Medicine Institute. Our ages range from late thirties to early fifties. Half are childless, a few by choice, some by circumstance. Of those who do have kids, infertility and premature birth was an issue for some. I married late, had 2 miscarriages, and feel blessed that I was able to adopt my child.
On the home front, balancing the roles of doctor, mom, wife, friend and community participant is tricky. Some of us still have the mentality of “I can do it all,” to the detriment of our health and sanity. Some women physicians have worked out a part-time schedule that suits their professional practice and family life. Others have spouses who assume the “household management” role. My life has been blessed with wonderful nannies who have helped with Grant and the house, and a flexible husband, except during planting and harvest.
In academic medicine, the hallowed halls that train new doctors and do research, few women make it through the ranks. Of those who do, 50% report discrimination and harassment. Studies also show that their salaries are 25% less, even when controlled for variables such as patient mix and insurance payers. It would be interesting to study these issues in the context of Sheryl Sandberg’s book Lean In. Women are known to be less aggressive in negotiating pay and asking for raises. Or are we subtly sabotaging ourselves in this arena?
My hope is that more women in medicine will challenge the system and the culture, in training and in practice. Dr. Linda Pololi of Brandeis University conducted a survey that showed both men and women felt strains in medicine. She’s quoted in the Huffington Post, “We have this dehumanizing organizational culture in academic medicine that doesn’t allow people to realize their potential or be as vital and productive as they can be. It’s hard to ignore the far-reaching consequences of a work environment that has trouble modeling compassion and care.”
Perhaps when we realize that a more humane and human culture will benefit us all—men, women and patients—we will be less hesitant to work for change and solutions.