Marjorie A. Bowman

History of Women in Medicine

Women have been in medicine for a long time. In ancient Egypt there were many women students and women professors in the medical schools and both Moses and his wife were students of medicine about 1500 B.C.1 There has also been a long history of discrimination, which was recorded at least as early as 1421 when a petition was presented to King Henry V to prevent women from practicing medicine.2 Supposedly the first formal medical degree awarded to a woman was to Constanza Collendain 1431.3

Enjoying a Marriage or Partnership

Cross-sectional statistics indicate that 75% of female physicians are married, 11% were previously married, and 14% have not married (AMA 1991). Fewer are married than men physicians: 89% of men physicians are married, 7% were previously married, and 5% have not married. More women physicians get divorced: in one study, 37% compared to 28% (Rollman et al 1997). About 90% of the women physicians who marry have a professional spouse, and about half marry another physician (Sobecks 1999). This is quite a switch from the turn of twentieth century, when most women physicians were single and the expectation was that a professional woman would remain single.

Dual-Career Couples

Current statistics indicate that female physicians marry at a rate of about 85%.1 About 85% of these will marry another professional, and about 50% will marry other physicians. According to Parker and Jones,2 a female physician who marries another professional will judge her professional existence more satisfactory than if she were married to a nonprofessional. Thus about 70% of female physicians will be faced with the situation of dual-career marriage. About half will have the added stresses that exist in a dual-doctor marriage.

Women Physicians as Healers

Women and men are different. Sociologic literature provides much evidence of difference. Women think differently (Belenky et al 1986; Gilligan 1982), have different bodies, conduct their lives differently, and have fewer leadership roles in organizations. Differences between individual men and women may vary, but the groups as a whole show some characteristic differences.

The Stress of Our Profession

Stress reactions are probably genetically ingrained from our early ancestry. The “fight or flight” response served our ancestors well. When a saber-toothed tiger approached, the sympathetic nervous system reacted automatically. The heart rate increased along with blood pressure. Breathing became shallow, and muscles tensed for action. Blood flow to the extremities decreased and fingers and feet became colder. In modern society these automatic responses have lost their evolutionary advantage. Although there are no longer saber-toothed tigers, the prehistoric stress response remains. It is estimated that approximately

Having and Raising Children

75 billion a year is lost on illness and absenteeism related to stress in the United States (Walis 1983).

Women in Medical School and Academia

It is generally accepted and expected that most people and most physicians (men and women) will have children. There is some converse acceptance for women, particularly professional women, to have no children. A woman physician makes a decision whether to have children. Does she want them? If so, when? What will be the sacrifices, the problems? How will she and her family manage?

Specialty Choices of Women in Medicine

“A medical school in the United States is an inhospitable world for a woman.” (Bowers) This quote from a 1968 article raises the following types of questions. If medical school is so inhospitable, why have so many women chosen this option, particularly in recent years? What happens to the women who so venture forth? Is discrimination so overwhelming?

Women Physicians as Minorities

Why certain physicians choose particular specialties and others choose different specialties is somewhat of a mystery. “Even the most sophisticated work has failed to account for the specialty of a majority of the sample.”1 When senior medical students were asked why they chose the specialty of their upcoming first year of residency, both men and women gave similar reasons.2 Opportunities for self-fulfillment topped the list, positive clinical experiences was next followed by the intellectual challenge of the subject matter of the specialty and the type of patient. The two factors with the greatest difference between men and women were financial advantage, which was slightly more important to men, and type of patient, which was slightly more important to women. Thus, men and women give similar reasons for choosing specialties, yet they choose different ones.

Women in Medicine: Career and Life Management

When Carole Lopate’s book Women in Medicine was first published in 1969,1 a male physician reviewer made several negative comments: “unless the girl agrees to take vows of celibacy on entering medical school, it is reasonable to conclude that she should be factored out,”2 i.e., the woman physician who was married and/or a mother would not work. He also believed that there was unlikely to be any demand for female physicians since women patients would find it less threatening to their ego to reveal their bodily imperfections to a male than a female. Further, he insinuated that the female’s ’well-known proclivity to gossip’ would be detrimental to patient confidentiality. His prejudices are quite evident to us today.