Women in Medicine

Why aren’t there more women in science and medicine? Just because we lack certain anatomical dangly bits, does that mean we’re less capable? Apparently Harvard’s president Lawrence H. Summers thought so. In a classic case of foot-in-mouth disease, he suggested that innate differences between men and women might be one reason fewer women succeed in science and math careers. His comments (in 2005) predictably set off a media feeding frenzy. I won’t even attempt to get into that nature/nurture controversy. Whatever the statistical generalities, the fact is that individual women can and do succeed in those careers. What really matters is whether qualified women today have a fair opportunity to choose their profession and rise in it.

Something very interesting is happening in medicine. It’s happening slowly, quietly, and steadily, with no help from affirmative action programs.

At the beginning of the 20th century about 5 percent of the doctors in the United States were women. In 1970, it was still only 7 percent. By 1998, 23 percent of all doctors were women, and today, women make up more than 50 percent of the medical student population. In 1968 only 1.2% of practicing dentists were women. By 2003, 17% of dentists were women, and 35% of dentists in new active private practice were female.

In the academic world, women are also making steady progress. By 2003, women held 30 percent of all medical faculty positions and 40% of the faculty positions in obstetrics and gynecology, pediatrics, and public health and preventive medicine. In 1990 there was only one female medical school dean; now 10% of deans are women. Most of the overt roadblocks have dissolved, but women still struggle with certain handicaps. There is still subtle prejudice in some quarters, especially in the older, higher echelons, the “old boy” networks. Women are less likely to have mentors to guide their careers, and women with children are less likely to rise to high positions and to express satisfaction with their jobs.

The status of women has generally improved throughout the world (with a few obvious exceptions). Attitudes have changed, and not only because of the Women’s Liberation movement. I suspect that the most important factor was the availability of reliable birth control. For the first time in human history, women are able to choose whether to have children and when to have them. And women no longer have to choose between career and family: they can have both, just like men always have.

The face of medicine is changing. Some have expressed hope that women will help bring balance to the profession. Doctors who can balance work, family and leisure might turn out to be more humane, understanding, better clinicians.

There is no job women can’t do. Even the military has gradually accepted them. The Air Force is now 20% women; the Army 14%. In 1976 the Air Force allowed the first women to enter pilot training; in 1995 in Kuwait, Martha McSally became the first woman pilot to fly a combat sortie in a fighter aircraft; she eventually logged 100 combat hours.

In 1991, physician and flight surgeon Rhonda Cornum was in a Blackhawk helicopter that was shot down in Iraq. She was captured by Saddam Hussein’s forces and was sexually molested by her jailers while she had two broken arms, a bullet in her back, and other injuries. She didn’t break down, feel sorry for herself, develop PTSD, or leave the Army. She went on to do a urology residency and is currently commander of the Army’s Landstuhl Regional Medical Center in Germany. She’s a shining example of how tough women can be.

A new book has been published that provides a personal glimpse into what it was like for a woman to be a medical student, doctor, and military officer during a critical period of transition in the 60s, 70s, and 80s. The title is Women Aren’t Supposed to Fly: The Memoirs of a Female Flight Surgeon. I’ll let you discover the author’s name for yourself. She’s no Rhonda Cornum, but she does have some stories to tell.

The book is described as “An irreverent romp through the worlds of medicine and the military: part autobiography, part social history, and part laugh-out-loud comedy.” When the author applied to medical school the admissions committee grilled her: “What if you decide to get married?” Her medical school only accepted 4 women each year.  As the second woman ever to do an Air Force internship, she had to fight for acceptance. Even a patient’s 3 year old daughter proclaimed, “Oh, Daddy! That’s not a doctor, that’s a lady!” She was routinely mistaken for a nurse, lab technician or volunteer. She was banished from the on-call room and forced to sleep on a cot in a treatment room where the lights couldn’t be turned off. She was refused a residency, paid less than her male counterparts, couldn’t live on base, and couldn’t claim her husband as a dependent because he wasn’t a wife. After six years as a general medical officer in Franco’s Spain, she became a board-certified family practice specialist and a flight surgeon, doing everything from delivering babies to flying a B-52. She earned her pilot’s license despite being told “Women aren’t supposed to fly” and eventually retired from the Air Force as a full colonel. She is witness to an era when society was beginning to accept women in traditionally male jobs but didn’t entirely like the idea yet. She found unconventional ways to cope. She once admitted a spider to the hospital, and she publicly corrected her commander’s terminology, saying, “When women fly, we don’t call it the cockpit, we call it the box office.” Her warped sense of humor sustained her and it spices the stories she tells about her experiences and the patients and colleagues she encountered.

My whole family enjoyed reading this book and giggled frequently. It might be of interest to some of you too.

Women may not have achieved true equality in science and medicine, but there are no longer any real impediments. Any woman who is capable and motivated can succeed. It’s instructive to look back at recent history and realize how much has changed in a short time. Things are easier for women today thanks in part to the women who persevered when things weren’t so easy.

This article was originally published in the Science-Based Medicine Blog.

Dr. Hall is a contributing editor to both Skeptic magazine and the Skeptical Inquirer. She is a weekly contributor to the Science-Based Medicine Blog and is one of its editors. She has also contributed to Quackwatch and to a number of other respected journals and publications. She is the author of Women Aren’t Supposed to Fly: The Memoirs of a Female Flight Surgeon and co-author of the textbook, Consumer Health: A Guide to Intelligent Decisions.

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