By Michele Bohlmann
One of the things about being a medical student is people love to ask you what kind of doctor you’re going to be. This is a tricky question because there are so many options out there, so many factors that go into that choice, and so little time to experience it all. When that question comes my way, my answer is fluid at best: “Well,” I say, “probably family medicine…or emergency medicine…or…” and so on. There’s one piece that stays the same though: “Anything but surgery.”
I used to want to be a surgeon, back when I was 12 and I thought medicine looked just like Grey’s Anatomy. A lot of things changed my mind over the years: the five years of residency, the grueling hours, and the idea of sticking my hand into someone’s abdomen. The more I learned about the field, the more reality shifted me away from it. However, what really pushed me away was that surgical fields represent something that has historically been a part of the culture of medicine: “the boys club.”
In 1849, Dr. Elizabeth Blackwell became the first female physician in the United States, graduating top in her class at Geneva Medical College. She endured quite a lot to get to that point. Her applications were rejected by almost all the leading colleges (Encyclopaedia Britannica, 2019). Eventually, the faculty at Geneva Medical College held a vote to decide if she would be allowed to be admitted, assuming the vote would not pass. When presented with the vote, the all-male student body thought it was a joke, and decided to admit her. Reluctantly, the college had no choice but to accept Elizabeth Blackwell. (Cfmedicine.nlm.nih.gov, 2019). Unsurprisingly, her trials did not stop there. She was harassed by students and townspeople alike, and even barred from class demonstrations. In spite of this, she went on to achieve many great things: she founded an infirmary, a women’s medical college, and became a professor of gynecology at the London School of Medicine for Women (Encyclopaedia Britannica, 2019). Dr. Blackwell was the first to break through the doors of the boys club, and helped pave the way for future female physicians like myself. Yet, her work as a remains unfinished.
Despite the pioneering efforts of those like Dr. Elizabeth Blackwell, medicine still has a deep rooted problem with misogyny. Women are forced to navigate challenging hurdles their male counterparts do not encounter, including sexual harassment, and this often leads to gender inequity among specialties (Freedman-Weiss, et.al, 2019). Surgical fields in particular are overwhelmingly dominated by men, 59% in general surgery and up to 85% in specialties like orthopedics (Murphy, 2019; Vassar, 2019). In a 2015 AMA article, one physician noted that she doesn’t think women are “particularly motivated to deal with” the boy’s club. Additionally, this male domination leads to a lack of female mentors for incoming female surgical residents, and the cycle repeats.
The solution seems to lie with more women in these fields, but it is a lot to ask of someone to enter the boys club. The system is not yet changed. To commit to a male-dominated field as a woman is to commit to more burnout, unequal wages, struggles with family planning, and a veritable desert of reflective leadership. So I, like many of my colleagues, face this feminist catch-22. Do I willingly subject myself to more difficulties in an already grueling career for the sake of female leadership? Or do I resign myself from engaging in a heavily patriarchal culture, possibly at the detriment of the women to come after me? The answer is different for everyone.
This conundrum is not without hope, however. “TIME’S UP Healthcare,” a branch of the famous “TIME’S UP” movement, is one of many organizations that seeks to create a platform for the women of healthcare to share their stories of inequity and unite to enact change. Additionally, groups like the American Medical Women’s Association are present in many colleges to help unite female physicians and students through mentorship and give them opportunities for success. Data even show that female physicians have better outcomes than their male counterparts, solidifying the right of women to be heard and accepted in medicine(Tsugawa et. al, 2017). Being a pioneer is a tough job, and not everyone can be on the front lines. However, these organizations are platforms where my peers and I can take action in our own ways. Although we may not be prepared to join these mostly male specialties, we can arm ourselves with education, compassion, and resilience and work towards change together.
The world is a fast moving place, and progress is inevitable. Now more than ever, I am inspired by the great work women are doing to promote advancement and equality. I am excited to learn from more and more female mentors, and even become one myself. The “boys club” might still be lingering now, but I hope that it will soon become a memory and tomorrow’s women of medicine will be limitless.
- Cfmedicine.nlm.nih.gov. (2019). Changing the Face of Medicine | ElizabethBlackwell. [online] Available at: https://cfmedicine.nlm.nih.gov/physicians/biography_35.html [Accessed 3 Jul. 2019].
- Murphy, B. (2019). These medical specialties have the biggest gender imbalances. [online] American Medical Association. Available at: https://www.ama-assn.org/residents-students/specialty-profiles/these-medical-specialties-have-biggest-gender-imbalances [Accessed 3 Jul. 2019].
- Encyclopaedia Britannica (2019). Elizabeth Blackwell. [online] Encyclopaedia Britannica, inc. Available at: https://www.britannica.com/biography/Elizabeth-Blackwell [Accessed 21 Jul. 2019]
- Vassar, L. (2015). How medical specialties vary by gender. [online] American Medical Association. Available at: https://www.ama-assn.org/residents-students/specialty-profiles/how-medical-specialties-vary-gender [Accessed 21 Jul. 2019].
- Girod S, Fassiotto M, Grewal D, et al. Reducing implicit gender leadership bias in academic medicine with an educational intervention. Acad Med. 2016;91:1143–1150
- Freedman-Weiss, M. R., Chiu, A. S., Heller, D. R., Cutler, A. S., Longo, W. E., Ahuja, N., & Yoo, P. S. (2019). Understanding the Barriers to Reporting Sexual Harassment in Surgical Training [Abstract]. Annals of Surgery. doi:10.1097/SLA.0000000000003295
Tsugawa Y, Jena AB, Figueroa JF, Orav EJ, Blumenthal DM, Jha AK. Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians. JAMA Intern Med.2017;177(2):206–213. doi:10.1001/jamainternmed.2016.7875
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