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Shreeya R. Joshee

ACP Council of Student Members

— MEDICAL SCHOOL —
University of Nevada School of Medicine, Reno

— GRADUATING CLASS —
2024
 

Medicine has involved women since its inception, but, until recently, female physicians have not been given proper recognition for their contributions. Known as the first woman to complete a medical degree, Elizabeth Blackwell, who obtained her MD in 1849, is widely recognized as the “mother” of women in medicine, although there is debate surrounding this honor. James Barry—a graduate of the University of Edinburgh Medical School in 1812—also known as Margaret Ann Bulkley, is credited by some as the first person born female to have completed a medical degree, almost 37 years earlier than Dr. Blackwell. Dr. Barry later carried out the first recorded cesarean section by a European in Africa in which both mother and child survived the operation, and became known as the first surgeon to do so (1). Following the storied legacies of Dr. Blackwell and Dr. Barry were Dr. Mary Edwards Walker, who—in 1861—became the first female surgeon, and Dr. Rebecca Lee Crumpler, who—in 1864—became the first Black woman MD (2).

In January of 1870, with a one-sentence resolution, the University of Michigan became the first major medical school to formally allow the admission of women (3). Classes for women and men would remain separate for another four years before the school allowed the integration of genders. In 2019, over 200 years since the first record of female physicians, the AAMC recognized another historic milestone. For the first time in history, the majority of US medical students were women (4).

I matriculated into medical school in the fall of 2020. That year, women made up 53.8% of the entering class at US MD schools and 54.1% of matriculants at US DO schools (5, 6). Despite the increased numbers of women in medical school cohorts, the legacy of its predominantly male origins continues to perpetuate harmful stereotypes and creates limitations and inequalities for female medical students, residents, and attending physicians. For me, a medical student, these include being inaccurately referred to as a student in a female-dominated field such as nursing, medical assistance, or social work. In contrast, my male student counterparts are called “doctors.” The female residents/students I have worked with are constantly barraged with questions from other physician colleagues and patients about balancing marriage, family, and future motherhood obligations far more often than male students/trainees. This questioning is even more intense for women in dual-physician relationships who get additional questions about whose career will be prioritized and who will have to compromise. As the partner of a physician myself, when I disclose that my partner is also a doctor, I feel that it is automatically assumed by those around me that I will be the one eventually going part-time to raise our family.

There are many benefits to being a woman in medicine, despite the microaggressions and biases we face in this field. The mentorship between women at different training levels is the frontline to ensuring the success of women in medicine. The female mentors in medicine I have been lucky enough to work under model the success I hope to achieve in my future career and embody hope despite the struggles that come with being a woman in medicine. Through their actions, they also have displayed that the privilege of caring for patients and their families makes the journey worthwhile. I decided to pursue medicine after being inspired by the female physicians I knew growing up. I continue to be inspired by the female faculty and administrators at my school, the female attendings/residents I work with, and the female medical student leaders on this journey with me. Male allies in the form of students, doctors, and patients are equally as crucial in women's journey in medicine, especially those actively advocating to include women in leadership and policy decisions. Some of my most vocal allies have been physicians like my partner and my male attendings/medical students. They use their positions to ensure their female counterparts are recognized and respected for their contributions to the field at all levels of training.

On a macro level, organizations such as the American Medical Women's Association (founded in 1915) and the Association of Women Surgeons (founded in 1981) advocate for women's professional and personal welfare at all levels of medical training through systemic policy changes. ACP also has a longstanding commitment to “promoting gender equity and eliminating the inequities in compensation and career advancement that physicians can face” (7).

There is no doubt that things have changed a lot for women in the 170+ years since Dr. Blackwell earned her medical degree. However, there is still room for improvement in the following categories: improving the recruitment of underrepresented women of color and queer-identifying women, encouraging women to enter male-dominated specialties (currently, orthopedic surgery is only 5.8% female, thoracic surgery is 8.0%, and interventional cardiology is 8.0%), and reducing the number of women transitioning to part-time work compared to their male counterparts after graduation (women are 7.83 times more likely to make this transition) (8, 9). My generation of female physicians has benefitted from the women who came before us, so we must use our privilege to advocate for those who will come after us.

Our predecessors earned us a seat at the table. Now it is up to us to demand systemic change in all associated subspecialties within medicine that will increase physician diversity and truly allow the physician population to represent the patients they serve.

Acknowledgment: I would like to thank Taylor J. Morgan and Kendra B. Isable for their invaluable assistance in editing this article.

References

1. Dronfield J, Preez M. Dr James Barry: A Woman Ahead of Her Time. Oneworld Publications; 2016.
2. Merritt Hawkins. Women in medicine: a timeline of 15 pioneers and innovators. 10 March 2021. Accessed at on 2 August 2022.
3. University of Michigan Health. Leaders and Best: Milestones in the history of women in medicine at U-M. 9 March 2020. Accessed at on 2 August 2022.
4. Boyle P. More women than men are enrolled in medical school. Association of American Medical Colleges. 9 December 2019. Accessed at on 2 August 2022.
5. Association of American Medical Colleges. 2020 Fall Applicant, Matriculant, and Enrollment Data Tables. December 2020. Accessed at on August 2022.
6. American Association of Colleges of Osteopathic Medicine. 2020 AACOMAS Profile Applicant and Matriculant Report. 2021. Accessed at on 2 August 2022.
7. �ܼ�����ˮ��̳. Where We Stand: Women in Medicine. Accessed at www.acponline.org/advocacy/where-we-stand/women-in-medicine on 2 August 2022.
8. Association of American Medical Colleges. Active Physicians by Sex and Specialty, 2019. December 2019. Accessed at on 2 August 2022.
9. Frank E, Zhao Z, Sen S, et al. Gender disparities in work and parental status among early career physicians. JAMA Netw Open. 2019;2:e198340. [PMID: 31373646] doi:10.1001/jamanetworkopen.2019.8340

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