Women in Medicine: Opportunities and Challenges

Women are now equally represented in medical school enrollment in the United States. The field of medicine offers some opportunities to women who want to be both doctors and mothers that are not available in other professions. These opportunities, which include flexibility and predictable schedule, are available in some medical specialties but not others. Emma Goldberg of the New York Times writes about the special challenges for women who have a passion to become surgeons. The field of surgery remains male dominated, with only 23 percent of practicing surgeons being women. What are some of the challenges women face who want to become surgeons? Goldberg notes the following:

  • 72 percent of female medical students reported verbal discouragement from going into surgery.
  • Surgical residencies can last up to seven years and require eighty-hour work weeks with little flexibility.
  • Students start training in their midtwenties and continue into their early thirties, which are prime childbearing years.
  • Parental leave policies for pregnancy are not uniform.
  • Flexible schedules are not allowed when returning from pregnancy leave, requiring twelve-hour shifts that don’t allow for breast-feeding or childcare.
  • Access to lactation spaces or breaks for pumping is limited or nonexistent.
  • Women don’t get childcare support.
  • Pregnant residents are subject to microaggressions from faculty and coresidents who feel a pregnant doctor is a burden.

While the obstacles are significant, many women want to be surgeons and bring important sensitivities to the doctor-patient relationship. Institutional changes can make the training of surgeons more inviting to both women and men who want to have families and help close the looming deficit of surgeons needed in the United States.

Some medical specialties offer more family-friendly options. Claire Cain Miller writes in the New York Times about the choices some women have made to go into specialties that are not always their first choice and sometimes are lower paid in order to practice medicine in a more family-friendly specialty, such as pediatrics, dermatology, geriatrics, and child psychiatry. In fact, women are the majority in these specialties, and they are less likely to stop working after childbirth than women in other professions. Here are some of the reasons women are drawn to these specialties:

  • This type of work offers flexible and predictable hours.
  • These professionals are part of a large group practice where more people are available to help cover the work. The majority of female doctors now work for large group practices as employees rather than as independent owners of a medical practice.
  • Women doctors who work reduced hours tend to be paid proportionately. For example, they receive 80 percent of pay for working 80 percent full time.

The more time-intensive specialties, such as surgery, are still male dominated and pay more. As young men going into medicine are beginning to demand more work-family balance, perhaps specialties such as surgery and oncology will reform their requirements for eighty-hour work weeks during training, thereby attracting more women. In the meantime, medicine, overall, has become a model that other professions could follow to create more equitable and family-friendly work environments. Policies and procedures in many medical specialties that work for women are

  • Lactation rooms and breaks for pumping
  • Flexible and predictable schedules
  • Part-time schedules with proportional pay
  • Childcare support
  • Support networks of “doctor moms” who share resources and encouragement and help each other out
  • Parental leave policies that include fathers and support part-time return after childbirth

These policies and practices are needed everywhere.


Photo by Artur Tumasjan on Unsplash

How Gender Bias in Medicine Affects Women’s Health: A Book Review

Doing Harm by Maya Dusenbery, a new book recently reviewed in the New York Times by Parul Sehgal, is a rich collection of studies and statistics that reveal sexism at every level of medicine. Sehgal notes that the core message of the author is that the ancient distrust of women to be reliable narrators of their own experiences or their bodily pain is linked to the current “believe women” moment we are in as more speak out in the “Me Too” movement. The author also points out that this suppression of women’s voices is linked to how frequently women get interrupted in meetings and how rarely women are quoted as experts. Women’s voices are ignored or belittled and, in addition to the other challenges we face, this dynamic impacts our ability to get good medical care. Dusenbery offers multiple examples to make her point:

  • Women with abdominal pain wait in emergency rooms for sixty-five minutes compared to forty-nine minutes for men.
  • Young women are seven times more likely to be sent home from the hospital while in the middle of a heart attack.
  • Doctors rarely communicate (or understand) how drugs from aspirin to antidepressants affect women and men differently.
  • Autoimmune disorders have been understudied because a majority of the patients are women.
  • Women are consistently undertreated for pain: male patients are given pain relief while women are given sedatives and told their pain is emotional.
  • For women of color, especially black women, the situation is worse. Black patients are twenty-two times less likely to get any kind of pain relief in emergency rooms.
Sehgal suggests that the solution is not more female doctors because female doctors can have implicit bias, too. The best action we can take is to speak out about sexist and paternalistic experiences we have with doctors. We must share our stories. We can also put pressure on medical professionals to study women’s health. And we have to insist on having our voices heard. I remember when my mother kept going to her doctor and complaining that she “didn’t feel right.” The doctor told her that older women often experience aches and pains and sent her home. But my mother knew something was wrong and she kept going back to the doctor and insisting on tests. Finally, they listened to her and she was, in fact, about to have a massive heart attack. She needed open-heart bypass surgery. She saved her own life by refusing to be ignored. We must not allow ourselves to be silenced.   Photo courtesy of Wellcome Images (CC BY 4.0)]]>

Women in Physics and Medicine: Closing the Gender Pay Gap, Increasing Respect, and Decreasing Burnout

New studies on women in physics and medicine find continuing disparities in pay and promotions. Audrey Williams June, writing for the Chronicle of Higher Education, reports the results of a new study by the Statistical Research Center at the American Institute of Physics showing a gender pay gap of 6 percent for female faculty members in physics. The study also found that men are overrepresented in senior faculty roles and that women receive fewer grants for research and lab space. For women in medicine, the issues can be severe. Dhruv Khullar of the New York Times reports that female physicians

  • are more than twice as likely to commit suicide as the general population;
  • earn significantly less than male colleagues
  • are less likely to advance to professorships; and
  • account for only one-sixth of medical school deans.
Khullar notes that gender bias begins to impact women physicians during medical residency training and continues throughout their careers. He points out that the structure of medical training and practice has not changed much since the 1960s, when almost all medical residents were men and only 7 percent of medical school graduates were women. Today women account for more than one-third of practicing physicians and one-half of physicians in residency training. Unchanged training structures that assume a stay-at-home spouse to support a trainee’s eighty-hour-work week create work-family conflicts for women. The combination of work-family conflicts and embedded gender discrimination in the profession takes a toll on women’s lives and careers in some of the following ways:
  • In households where both spouses are doctors, women with children work eleven hours less per week, while there is no difference in the hours worked by men with children. This statistic reflects the greater responsibility that women doctors carry for family care that their spouses do not share equitably.
  • Female physicians are more likely to divorce than male physicians.
  • For female physicians, getting patients and other doctors to show them respect by calling them “doctor” is a battle. Women physicians are assumed to be either physician assistants or nurses by both patients and other doctors and are often introduced by their first names in professional settings instead of by their professional title of “doctor.”
  • The gender pay gap for female physicians is significant and was detailed in an earlier article.
  • A recent study at Harvard found that gender bias affects referrals to female surgeons from other physicians.
What can be done to close the gender pay gap, increase respect, and decrease burnout for women in physics and medicine? Both June and Khullar suggest that having more women in leadership and mentorship roles could make a big difference. Khullar also notes that “disparities don’t close on their own. They close because we close them.” Let’s continue to put pressure on our institutions to be more equitable and inclusive. Do these disparities exist in your own profession? Please share with us what efforts your organization is making to close these gaps. Photo by Walt Stoneburner, CC BY 2.0.]]>