Perhaps some would say I am hardly the person to discuss women in medicine.  But that would only be the case if I didn’t work for UMHS, a  Caribbean medical school that prides itself on its diversity and its support of women medical students.  Also it might be the case if I didn’t have as many women in my family and as friends who just happen to be medical professionals.  My mother and sister, both RNs, friends and extended family who are physicians, friends who are hospital administrators, therapists, dentists, and the like.  All of these, women who, against many odds, valiantly pressed their way into a field historically sealed (save for perhaps nursing, some administrative roles and therapy) as a measure to retain its good ‘ole boy club image. I also spent many years working in the area of women’s work and and corporate development, including a stint in healthcare where I had the opportunity to work with some pretty powerful women doctors and administrators.  Let’s consider this then,  an homage to the women who taught me a thing or two in my becoming a man.

As I recall growing up, my mother would proudly sign the letters R-N at the end of her name.  She felt she’d earned it.  She had.  Raising five kids on her own while going to nursing school was tough, I am sure.  My sister was the next to consider medicine.  She began as a medical student but later decided she’d rather go the same route as my mother. Her husband, too, became a nurse (although that is a subject for another article). Thus we have more nurses in my family than can usually be found on a hospital floor after a patient pushes the call light.

I once asked my sister why she didn’t keep going.  Why did she decide medicine wasn’t for her?  med stock 1

Her reply was simple, “It was just harder to do back then. It wasn’t the right time.”

Back then? Well that wasn’t really that long ago.  It was the late 70’s, early 80’s when she left for school, and by then certainly there were more than a few women in the field of medicine, right?  Or at least it seems it should have been.

However, statistics point to a pretty dismal percentage of women in medicine at the time my sister decided to go to medical school.  In the early 80’s a mere 12% of doctors in the US were women.  Though a far better number, perhaps, than in 1849 when Elizabeth Blackwell became the first woman  to graduate from a US medical school, still, 12% was not enough to provide encouragement for my sister.

Oh but if we could have turned forward the hands of time, she would have seen a world changed in just a few short years.  It is estimated that from 1981 to 2011, the percentage  of women doctors increased by more than 400%.  As societal prohibitions relaxed, and women became certainly more resistant to identification with limitations and career restrictions, more women stepped forward to enter and conquer a field that had for so long been all but closed to them.

In a brilliant traveling exhibit a few years back, The American Medical Women’s Association took a look at the changing face of medicine from the perspective of women medical pioneers and contemporary Sheroes. The exhibit sought to “honor the lives and achievements of women in medicine,”  many of whom “have reemphasized the art of healing and the roles of culture and spirituality in medicine.”  The exhibit now holds a permanent place on the AMWA website.  Having seen the exhibit personally, I was moved by what was a struggle for equality and relevance where instead, acceptance should have been a given.

I recall my sister and mother commenting that women doctors were so rare, that they would often do double takes when Dr. So and So would appear on their floor, hair tied back in a bun, no five o’clock shadow, and prepared to do rounds.  My sister said she often felt a little embarrassed by her assumption that a doctor was  a man.  She asked me to be honest with her.  Would I or would I not assume that a doctor whom I had never met was a man, even if just out of habit?  The shocking answer was, yes.

I couldn’t quite figure out why that was until I realized that I couldn’t recall having met a woman doctor until well into adulthood.

My sister had a little more to say about it.  A mother of 3, she recalls wondering how any resident would be able to carry her load, and be a mom.  She said she thought it impossible until she worked with an amazing young surgical resident who was a few months pregnant, with her second child!

Even my dear friend Rona, a brilliant and provocative woman and internist, said she would have been hard pressed to believe a woman could be a surgeon and a mother without sacrificing something somewhere.  “Of course that is just my lack of experience talking,” she said. “I mean, it’s not like women are immune to stereotyping other women.”.

In a recent Boston Globe article, reporting on gender discrimination in medicine, Dr. Dana Fugelso, a surgeon, says she believes subtle bias continues. After going on maternity leave, Dr. Fugelso says her operating room and secretary were taken and not given back.  The hospital’s surigical chief denied those allegations, saying his policy on operating room time applied equally to men and women

“If someone today thinks sex discrimination is a thing of the past, they are just not looking,’’ Fugelso said.

Dr. Eliza Lo Chin, a regular contributor to Mom-MD, and author of This Side of Doctoring: Reflections from Women in Medicine,writes:

The early 20th century, however, saw a decline in the women’s medical movement, largely the result of multiple influences – – medical education reform, closing of all but one of the women’s medical colleges, the rise of allied health fields such as nursing, public health and social work, and the changing face of medicine itself, becoming more scientific and less humanistic. Furthermore, society in the 1950’s glorified domesticity, placing a women’s primary role as that of homemaker. So in 1949, just 100 years after Elizabeth Blackwell, still only 5.5% of entering students were women. It wasn’t until after the revival of feminism in the 1960’s and the passage of Title IX of the Higher Education Act (preventing federal funded educational institutions from discriminating on the basis of gender) that these numbers began to increase significantly. In 1974, 22.4% of new medical school entrants were women; today, that figure has increased to 45.6%.

What that tells me, is that despite the odds, women are entering the field of medicine at even greater rates than ever.  Undaunted by inequity and unrestrained by circumstance, women continue to answer the call of service.  And given the extreme shortage of physicians in the US alone, we really need them now more than ever.

According to the Boston.com article, the issue of women doctors having children and needing to reduce time at work to see after their families is usually front and center in the conversation around gender and medicine.  Yet as more and more women enter the medical work force, some believe structures will have to change to adapt to women who choose to be both mom and doctor.  Rather than establishing the balance on the side of work, hospitals and healthcare systems are now having to consider a different and perhaps radical paradigm of what it means to be a working physician. And given that more and more men are taking an active role in early childhood parenting, and asking for paternity leave, it would appear these doctor-fathers will benefit from more than a century and a half of women fighting the good fight.

My sister called me up the other day and told me she’d read over the UMHS website and blog and was intrigued by the concept of older non-traditional students, entering into medicine as a second career.  I asked her what she was thinking.  Was she thinking about UMHS or interested in Caribbean medical schools in general?

She said she didn’t really know, except that she signed her name on something recently and wondered what her name might look like with the letters M-D after it. She asked what I thought of it.

I flashed back on our mother’s signature, one she’d earned the right to use after going back to school in her forties. She’d earned her degree while raising 5 kids on her own.

I told my sister, who is happily married and the mother of 3, “I’d think it was about time.”

About UMHS:

Built in the tradition of the best US universities, the University of Medicine and Health Sciences focuses on individualized student attention, small class sizes and recruiting high quality faculty. For these reasons, UMHS is quickly becoming the school of choice among Caribbean medical schools.

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