Women in Medicine

By Parmida Zolfaghari / Winter 2020

“What a thing to be a woman, setup to fail the moment you were born.” My mother always held this idea to be her truth. She gave birth to three daughters and it ached her heart thinking of this male dominated world they were born into. As much as she loved us, she would tell us how she wished were born male instead. Knowing her intentions behind her words did not make it any easier to hear them and living in a society that reflected her words was even harder to process. Did it really matter that much what gender assignment my sisters and I were given when we took our first breath? How could such a small concept dictate the rest of our lives? The sad truth of it all was that our mother was trying to warn us because as a woman that was her truth. It was something she wanted to protect us from but had no real control over. It felt like men were given a head start from the moment they left their mother’s wombs. Unfortunately, this underlying ideology holds true throughout most of the world and especially this country I call home. As a child I did not understand the depth of my mother’s words but as an adult I chose to look at them critically. I am choosing to see how I can be an active member of the society advocating for the ideology of the patriarchy to no longer be a reality. Disregarding the stigma that I was born into as a woman, I have always wanted to challenge it which is a small part of why I chose medicine as a future route. I have always thought to myself, what better career than one that gets to give back to, care for and make connections with people. However, I knew little of the mountain of challenges that were set forth before me as a woman, not only majoring in a STEM field but pursuing a career in medicine.

Democracy: A form of government in which the supreme power is vested in the people and exercised directly by the people; political or social equality (Dictionary.com).

Democracy can be practiced in many forms such as the practice of democratic medicine. In an article by The Hasting Centers, William Ventres explains the five born principles of democratic values that can be embodied by what we can call to be “democratic medicine.” The five principles include history, duty, community, citizenship, and unity. Ideally this is the type of medicine that should be practiced, one that highlights and values individuals and their backgrounds. However, can democratic medicine truly exist alongside the inequalities present within the journey of a career in medicine? Under the principles that William expanded on, what he had said about community stood out to me, “My work with patients extends beyond the confines of any examination room or hospital ward. It encompasses an awareness of the complexity of human relationships and a recognition of how nonbiomedical factors influence disease and illness.” I believe to be a well-rounded physician that can offer a truly equal and democratic practice of medicine, you need to be surrounded by physicians that have experienced different walks of life as well. By having an inequal workforce within the healthcare system, the ideologies of a democratic medicine cannot truly exist, meaning due to this exclusion it is not fully vested in the people.

In the medical field there exists many different types of gender inequality that are not only taking away from women’s rights in a professional manner but also women’s health care as a whole. Within medical education there exists a small number of female lead positions such as faculty, professors, and dean positions. In an article by Psychiatric Times, it mentions about 46% of medical residents are female, however, only about 38% of all faculty are female which then only 21% are full time professors and 16% are deans. When looking at the hierarchy, a clear gender imbalance is shown which has consequences that allow for the trend to continue. When female students enter medical schools, they are surrounded by male mentors and professors leaving no familiarity to exist at the beginning of their careers. I believe this sets up for the mindset that women do not belong in leadership roles and they should be oh so grateful to get an equal position as a male colleague. The leadership statistics that represent women should be increased drastically to support the ideologies of equal healthcare and democratic medicine. I believe the male physicians that hold these leadership positions must take action toward creating more opportunities for their female colleagues. The partnership between the two groups will allow for quicker progression within all of medicine and the actions of male physicians in leadership positions can go a long way towards decreasing the gender gap within the field.

Studies have shown that as female students continued through their residency, they ended up with lower grades and evaluations compared to their male classmates. People who assessed these studies suggested that it was because women were believed to be judged and evaluated with a higher difficulty than men. Looking at the research collected and multitudes of personal experiences, it seems to me that women have had to prove that they are deserving of their placement within the field where men automatically seem to belong. To prevent this imbalance within medical education and assessments, a formatting of nonbiased testing must be created where gender biases do not take place through the judgment process of the assessments. Furthermore, in some cases, I feel as though gender should be highlighted in a greater extend but differently. By highlighting the unique experiences different groups contribute to, a better and more effective way of assessment can be performed that is more catered to the individual and their contributions to the field. Like the anatomy of a human being, male and females although similar, have various differences. These differences also exist through social standings and perception of our world. By acknowledging that there is unique perspective and way of treating patients that is valuable provided by female physicians, we can create a more equal and stronger workforce in medicine.

The gender inequality challenges continue even through the picking of specialties as female physicians. According to a posting on October of 2019 by the American Medical Association, in higher paying specialties like neurological surgery, it was shown that about 82.5% of the specialty was male dominated. For the small ratio of women in such fields, there also exists great deals of backlash and discouragement. In the Psychiatric Times it was mentioned that when female interns were in the neurosurgery department, the operating room staff of both male and female had a bad outlook on this, “Neurosurgery is not a good field for women,” one surgical technician declared, while another told me that women in neurosurgery are unhappy and mean.” In the example from Psychiatric times, the stereotyping of all female neurosurgeons shown was present because of one female neurosurgeon they had encountered in the past. Due to the small population of women within these specialties, one female neurosurgeon counted as a reliable number to base opinions off of it seemed. Thinking back to this story, it makes me sad to see how easily within our current society this is an acceptable judgment to make. I felt as though for other physicians to have this type thought process it was negligent and detrimental towards progression of medicine. I believe if the goal of a physician is to practice medicine equally and to the best of their ability, it is their responsibility to create an inclusive and welcoming environment for their colleagues of different experiences, backgrounds and identities. Within medicine, there also exists various pressures in choosing your specialty as a woman. Many by the time they begin working in medical fields start also thinking about having a family which can create a great deal of conflict in a woman’s life. Some women choose quicker or less complicated routes and specialties (meaning potentially less income) to be able to have a family. The decision for women to have to make such sacrifices seems counterintuitive to me since men continue to grow within their fields and reach leadership positions and have a family as well. The misconception of one or the other only exists within a woman’s world.

The struggles of a woman in medicine become even more challenging as a woman of color. Not only is half the population faced with inequality, people of color fall under even greater inequality. In HuffPost it was mentioned that women of color were discouraged early on in their educational career to change their dreams and path of going into medicine. Not only were they told that they were not smart enough to continue this path but also were pressured into starting a family instead. They were set up very early on to fall into the system that only works against them, by not having proper STEM education available for them to begin with. Even once they have decided to pursue this path, there are further obstacles such as financial burdens. To take the MCAT alone, you need the proper test preparation materials, and beyond that it costs thousands of dollars each year to cover medical school fees which if you are coming from a lower income family, it becomes close to impossible to do so without gaining debt. In HuffPost it was said that “While these fees apply to applicants of all races, the racial wealth gap means they hit students of color harder: In the latest figures available, for every dollar of wealth a white family owns, the median Asian-American family has 68 cents, the median Latino family has 10 cents and the median black family has just 8 cents.” With even more pressures on women of color, there is a great imbalance of diversity that exists within the medical field. Having diversity within the healthcare system is quite important since there exists diversity within patients. Only 11.7% of active Physicians consist of women of color where their knowledge and practice hold valuable within our society.

In the hierarchy within medicine that consists of majority white males, it allows for not the best patient care existing within healthcare, or a democratic practice of medicine. There exists something special about understanding where an individual comes from and having that personal connection with them, the type of treatment that prioritizes the patient disregarding their gender or background. HuffPost continues to back this claim by mentioning “researchers at Johns Hopkins University found that “racial and ethnic minority respondents are more likely to perceive bias and lack of cultural competence when seeking treatment in the health care system overall than whites.” That, in turn, can lead to lower quality care.” Healthcare should be inclusive to all and not just for a specific race or gender. By creating more opportunities and taking away pressure off of women of all races in medicine, we’d be creating equality for all, both professionally and within patient care.

Work Cited

Aguilar, Orson. “We Need More Women Physicians Of Color.” HuffPost, HuffPost, 2 Nov. 2017.

Allen, Rebecca M. “Gender Inequality in Medicine: Too Much Evidence to Ignore.” Psychiatric Times, 3 May 2017.

“Democracy.” Dictionary.com, Dictionary.com.

“These Medical Specialties Have the Biggest Gender Imbalances.” American Medical Association, 1 Oct. 2019.

“Timeline of Women in Medicine.” American Medical Association, 25 Sept. 2018.

Ventres, William. “What I Practice: Democratic Medicine.” The Hastings Center, 11 Oct. 2018.