Women often are stereotyped as being motherly and having maternal tendencies to those who are not their own, which leaves people thinking women would make good caretakers. Yet, they have struggled to find their place in medicine, one of the most important areas of “care.” Historically, it was not an accepted idea for women to do anything other than get married, have babies, care for those babies, cook, clean, and cater to her husband’s every waking need. The world was full of strong women who wanted out of their daily routine, and the chance to put their abilities to use. However, there must always be someone to start the charge and lead the pack. Rosa Parks led the idea that African Americans should not have to sit in the back of the bus, Hillary Clinton wanted to be the first female president, and Sally Ride was the first American woman to fly in space. These women represent the idea that women can do anything they set their mind to, and should be viewed as equals to men. They stood for beliefs and desires, and put them into action.
Elizabeth Blackwell had her own desires to become a surgeon. She led the charge for all women who had the idea that they wanted to obtain an education and lead a practice in healthcare. Women like Krista Donaldson, Jennifer Dounda, and Cheryl L. William are just a few who have found success in the medical field today because of the barriers Blackwell broke. However, it still is not easy. There are many young women that have the same dreams ahead of them, including myself, but our journey will probably look a little different.
What obstacles did women, like Blackwell, face when pursuing their dream of becoming medical doctors, nurses, or researchers, and what difficulties should we expect today? In the 19th century, the presence of women in medicine was slim to none. Women sometimes worked as nurses, midwives, or distributors of folk medicine, but never as physicians. Even basic education was not common for women. It was not until the second half of the 19th century that women started to get degrees in medicine. Even with degrees, some did not get to lead their own practice, but only assist as aides. The early stages of a feminist movement began to appear. Women wanted to be given equal opportunity, namely in education and career opportunities. Some accepted the thought of women entering the medical field and some did not. But nevertheless, the women fought on.
Elizabeth Blackwell is a name associated in the quest for equal opportunity. She is well-known in the history of female discrimination, specifically in the field of medicine. She broke many barriers, including being the first woman to successfully attend and graduate medical school and founding the New York Infirmary for Women and Children. In early February 1821, Elizabeth was born to Samuel Blackwell and Hannah Lane. Elizabeth and her family’s beliefs were heavily influenced by her father. Laura Windsor reports in Women in Medicine: An Encyclopedia that, “[h]e supported women’s rights, was against slavery, and encouraged all his children to be active in society. He was also very religious, and Elizabeth participated in Bible study and daily prayers” (28). The family atmosphere was the perfect place for Blackwell to grow her dream of entering the medical field, and develop her beliefs, mirroring those of her father. Her family moved to the United States in 1832, when business fell through and they needed a new start (28). After her father died, Blackwell became a teacher in order to support her family. However, that was not what she wanted or was destined to do. When a friend suggested she would make a good physician, “[s]he decided to apply to medical school. She was turned down by twenty-eight colleges and was finally accepted by Geneva College in New York” (28). That is where her tough journey began.
Blackwell had successfully been accepted into a school, but the hard part was just getting started. Windsor suggests, “[t]he faculty there had put the matter to the male students; they decided to allow her entrance, although many agreed as a joke, feeling that a female would alleviate any boredom” (28). Right off the bat, she experienced discrimination when all the male students looked at her as an object of entertainment. People would stand and stare at the new student, new girl to be exact, but Elizabeth kept minding her own business, and eventually things settled down. She had her sights set on being a surgeon. “She graduated in 1849 with outstanding grades and became the first female physician in the United States” (Windsor 29). With a degree under her belt, she needed some practical experience. Finding someone who would teach a woman was even more difficult than obtaining the actual education. “She was able to study at clinics in England and eventually in Paris at La Maternité. She was not accepted as a physician, however, but only as an aide” (Windsor 29). She worked and learned where she could and put in an unhealthy number of hours, but she was driven to get to where she wanted. Despite her hard work, her dreams of being a surgeon were cut short. It is reported by Windsor that, “[o]n November 4, 1849, she contracted ophthalmia from a baby she had helped operate on that morning. After losing sight in her left eye, she tried several cures. Eventually, however, an infection set in and she had the left eye removed and a glass eye inserted” (29). It seemed like all her efforts to overcome the barriers of society were going to be for nothing because of an unlikely event.
Elizabeth Blackwell was not about to give up on healthcare just because she had lost an eye. She decided to change directions and not only open a hospital, but be an educator and public speaker. Blackwell found two other women to help support and carry out the idea of starting up a healthcare facility. One was her sister, Emily Blackwell, and the other was Marie Zakrzewska, a woman who was told to seek out Dr. Blackwell if she wished to get a medical degree. “On May 12, 1857…the New York Infirmary for Women and Children officially opened with Dr. Marie as the resident physician, Dr. Emily as the surgeon, and Dr. Elizabeth as the director. Within a month the beds were filled with patients from all backgrounds and speaking many different languages” (Windsor 30). The success was evident to Elizabeth, but the hard times were not over. People were not just going to accept care from female doctors, and were not scared to consider them unfit when a patient’s condition did not improve, or when death prevailed. Windsor confirms the unfair response, “[a] patient died of puerperal fever, and the relatives formed a mob outside, threatening the physicians and claiming the death was their fault. A similar incident occurred when a patient died from a ruptured appendix” (30). Blackwell and her colleagues kept on even with the threats and accusations, and eventually they began to gain the trust of their community.
Blackwell also took pride in public speaking. She most often spoke about hygiene in areas where diseases seemed more prone to occur. Along with lectures, she focused on opening up new facilities for other women to receive clinical experience. She continued this work until she began to have some health problems. Windsor writes about her last years, “Blackwell returned to England, knowing she would probably never see her friends or family in the United States again. In 1907, she fell down some stairs and became an invalid shortly after…She died on May 31, 1910, in Hastings”(33). Elizabeth Blackwell did not solve the issues that faced all women who desired to pursue a dream, but she carved a path and made it possible for the future.
Along with Elizabeth Blackwell, other women were taking a stand for what they wanted. Because women were rarely accepted into medical colleges with men, multiple all-women colleges were opened. Ann Preston was the Dean of the Women’s Medical College of Pennsylvania. She had set up a visit on a Saturday morning for some female students to receive practical experience, which was not a common occurrence. Despite their excitement, many of the women left that day with horrible memories. Sanchez shares the account of one woman’s thoughts in Sympathy and Science, “Dr. Eliza Wood carefully preserved the Philadelphia Evening Bulletin’s detailed description of the incident:”
The students of the male colleges, knowing that the ladies would be present,
turned out several hundred strong, with the design of expressing their
disapproval of the action of the managers of the hospital particularly,
and of the admission of women to the medical profession generally.
Ranging themselves in line, these gallant gentlemen assailed the young ladies,
as they passed out, with insolent and offensive language, and then followed
them into the street, where the whole gang, with the fluency of long practice,
joined in insulting them…
During the last hour missiles of paper, tinfoil, tobacco-quids, etc., were
thrown upon the ladies, while some of these men defiled the dresses of
the ladies near them with tobacco juice. (9)
As horrible as this was, the incident may have been a bridge for women. They gained some sympathy from the public and other physicians. This sympathy actually helped boost women’s confidence, and started to spark the feeling that this movement was making progress.
Dr. John Ware was a General Practitioner in Boston, who had an opposing opinion on females in medicine. Sanchez points out that, “[h]e was also concerned to divert women’s attention from the idea of studying medicine” (24). He had the belief that women were only supposed to be midwives. Ware also voiced that women were too tender and sensitive to handle the things that came with medicine. “Ware cautioned that midwives, ignorant as they were of general physiology, could not even detect, much less cope with, placenta previa, shock, convulsions, or puerperal fever” (25-26). This opinion was quickly argued with the thought of, “Then why do we not educate women with medicine?” Ware covered his tracks with a different argument. “He admitted quite simply that his objections to women becoming doctors were ‘founded rather upon the nature of their moral qualities, than of the powers of their minds…'” (26). Ware published his opinion in a pamphlet in 1820, before Elizabeth Blackwell and Eliza Wood made their marks. These views were public before many tried their hand at breaking the barrier. It was not only Ware that held these beliefs. According to Sanchez, it was a common opinion of the era that, “women were distinguished from men by their inability to restrain their ‘natural tendency to sympathy’ as men could and as physicians must” (26). Once again, the opinion of a man did not stop those women for one second.
After these stories of success for women, one might say a change was coming. However, it was not about to occur without more challenge and controversy. The 1950s, 60s, and 70s were a very crucial time for women’s involvement. Ann Boulis declares in The Changing Face of Medicine, “[t]he increasing representation of women among medical students during the 1970s resulted from the confluence of three largely independent trends: the removal of barriers to women’s entry into medical education, the sharp expansion in the capacity of medical schools, and the end of the military draft for young men” (16). Despite the improvements, the inequality was not over, but it did start to look different. The enrollment issue was still prominent, but became smaller. The bigger problems include discrepancies within medical specialties, opportunities for advancement and senior positions, and the pay gap between men and women.
“Since the 1970s the face of students at American medical schools has changed markedly, with women rapidly approaching 50 percent of entering medical students” (Boulis 9). Some sources claim that the reasoning for these changes is the decline of men’s interests in pursuing medicine. While a change in interests might have been popular in the 70s, that does not explain everything. Boulis disputes this point with fact, “[t]he number of male physicians more than doubled between 1970 and 2004, increasing from 300,000 to nearly 650,000, even as the number of female physicians rose from 25,401 to 235,627” (19). This proves that the number of females practicing medicine did not only improve because men lost interest. A piece of legislature that helped women’s standing was the passing of Title IX of the Higher Education Act in 1972. Boulis claims the Act “banned discriminatory policies in admissions and salaries in any school receiving federal funds” (25). Title IX, worked against Title XII which allowed schools to discriminate in admissions. These statistics show that the status of women enrolling in medical school and actively practicing medicine improved starting in the 1970s.
The percentage of female and male physicians in each medical specialty is also a controversial topic. It can be debated whether the discrepancy is due to interest, or to discrimination. Boulis draws attention to the controversy,
In 2005 women were markedly underrepresented in ten of thirty-even
specialty fields. In 1975 women were markedly under-represented in the
same ten specialties, plus general surgery and occupational medicine…the
fields with persistent under-representation of women include all surgical
specialties except obstetrics and gynecology and several procedure
-intensive medical fields…Thus the specialties that were male dominated
in the 1970s have remained so… (67-68)
While these statistics are only a few of the many calculations to be done, the trend is still that male representation dominates female representation. According to the American Medical Association, in 2014 data shows that women make up a larger percentage of family medicine (58%), psychiatry (57%), pediatrics (75%), and obstetrics/gynecology (85%). However, men make up a larger percentage of surgery (59%), emergency medicine (62%), anesthesiology (63%), radiology (73%), and internal medicine (54%) (Vassar).
The idea that men also prevail in receiving promotions and senior positions has also been proven. Women are beginning to make strides in the right direction regarding leadership positions, but not as quickly as hoped. Karen O’Connor emphasizes in Gender and Women’s Leadership: A Reference Handbook that, “[a]lthough women constituted 25.6% of the membership of the American Medical Association (AMA) in 2006, they constituted only 18.4% of the delegates that serve in its governing body” (5). Some say that this is still a source of discrimination, however, “nevertheless this level of participation by women in the AMA House of Delegates in 2006 far exceeds the 1.5% observed in 1983, the 8.7% in 1996, or the 15% in 2001” (5). That set of statistics from the AMA shows a growing improvement in women holding senior positions. An explanation comes from O’Connor, that some believe the slow change in female frequency, is referred to as a “slow pipeline phenomenon.” This means that people cannot expect women to currently hold the positions that take years to graduate to. Many of those positions are held by men that worked for many years before graduating to positions of higher authority. Therefore, it would make sense that men would outnumber the women in this regard because perhaps the number of women in that stage of life is far less, due to the society that was present when they started their education. (6)
One of the most largely disputed topics regarding the differences between men and women in the work force is the pay difference, and obviously it shows up in the medical fields as well. Boulis notes, “[i]n fact, an analysis of the 2000 census suggests that the gender gap in medicine is larger than it is for any other profession: female physicians earn on average 63 percent of what their male colleagues earn” (79). The pay difference is quite evident when broken down by specialties, and this is keeping in mind it is based on physicians that have the same level of education, have the same responsibilities, put in the same number of hours, and have the same number of years of experience. According to CTS, in 2004, the average income for men working in internal medicine was $158,146, and for women, $116,056. In the same study, men working in family practice earned $157,388, while women earned $110,795. Men in pediatrics earned $168,596, and women earned $111,625. Lastly, in surgical specialties, men earned $243,135, while women earned $187,793 (Boulis 81). The discrepancy is too evident to ignore and pretend it is not happening. Research and data may show the pay gap is decreasing, however, it is by too small of an amount to immediately notice. Over 10 years, the gap closed by about 5%, which is not enough to make the gap noticeably different anywhere in the near future. Despite the continued discrepancies, many women hold a very successful career.
While women of modern medicine do not have the historic stories of success in medicine, there are some cases that show that women have suppressed stereotypes of being inferior to men. A woman who has made herself known is Dr. Krista Donaldson. Donaldson received a Ph.D. in mechanical engineering from Stanford and works as the CEO of a non-profit company called D-Rev. D-Rev engineers and provides essential medical equipment to people who live on less than $4 per day. She has also been a speaker on TED Talks, to share her research and success. MomMD reports, “[u]nder her leadership, Design Revolution has led to the emergence of affordable treatment options to people in developing and third world countries, from helping babies with jaundice to providing custom fit high-performance prosthetic knee joints for thousands of amputees worldwide.”
Another woman, Dr. Jennifer Dounda received a Ph.D. in biochemistry from Harvard and now works as a professor at the University of California, Berkeley. MomMD notes her success, “Dr. Doudna has devoted her career to understanding the function of catalytic and other non-protein-coding RNAs, laying the foundation for understanding the evolution of RNAs and their relationship to the molecules that play a role in early human development.” Her research is based on the goal to one day be able to remove and replace genes in DNA, to remove certain diseases and genetic disorders.
Dr. Cheryl William is a Professor of Pathology and Internal Medicine at the University of New Mexico, where she conducts cancer research. It is suggested by MomMD that, “[h]er work focuses on next generation gene sequencing to identify new genomic abnormalities for improved diagnosis, risk classification, and therapy.” Her department is at the top of all cancer research facilities, and Dr. William is widely known for her research on leukemia.
These three women hold a superior position in society and have the top education in their fields. They are evidence that women have moved, and continue to move up in the ranks of society and medicine. They are role models and instill confidence that women are as capable as men, and are proof that the view of women in medicine is changing as a whole.
For all the women looking to enter the medical field, the opportunities look more promising compared to 50 years ago. Elizabeth Blackwell and her colleagues started the push by challenging opinions and actions that tried to prevent them from getting what they wanted and receiving what they deserved. Men, like Dr. John Ware, shared the idea that women are too sensitive and get too emotionally involved to do what men can. In history, women faced the challenge of even being able to receive the education and practical experience to practice medicine, the biggest obstacle of all. Today, the obstacles look different. Women can obtain the education needed and practical experience, but the challenge is making ourselves known and equally appreciated. Equality within specialties, equal opportunities for advancement, and equal pay are the challenges in modern medicine that women face. However, Krista Donaldson, Jennifer Dounda, and Cheryl William are women who have found successes and reached desired goals. For the next generation of women, the outlook looks relatively positive. The journey always comes with challenges, but has greatly improved from a century ago.
Works Cited
Boulis, Ann K., and Jerry A. Jacobs. The Changing Face of Medicine. London:
Cornell University Press, 2008. Print.
Morantz-Sanchez, Regina Markell. Sympathy and Science. New York: Oxford
University Press, 1985. Print.
O’Connor, Karen. Gender and Women’s Leadership: A Reference Handbook. SAGE
Publications, Inc., 2010. Web.
Top 10 Most Influential Women in Modern Medicine. MomMD. 2017. Web. 17
September 2017.
Vassar, Lyndra. How Medical Specialties Vary by Gender. AMA Wire. American
Medical Association, 2015. Web. 17 September 2017.
Windsor, Laura Lynn. Women in Medicine: An Encyclopedia. California: ABC-CLIO,
Inc., 2002. Print.