“Medicine is so broad and so closely interwoven with general interests, dealing as it does with all ages, sexes, and classes, and yet of so personal a character in its individual appreciations, that it must be regarded as one of those great departments of work in which the cooperation of men and women is needed to fulfill all its requirements.”
-Elizabeth Blackwell, First Female U.S. Physician, 1849
Women: Centuries of Care
Legend has it that the first female physician practiced medicine centuries ago. Her name was Metrodora and it’s estimated that she was a Greek doctor sometime between 200-400 CE. Not only did she blaze a trail as a practicing physician but she left another legacy: the oldest known medical book written by a woman, On the Diseases and Cures of Women.
Before Metrodora and since, women have been the caregivers of their families and their communities but, until astonishingly recent history, almost all have been blocked from practicing medicine professionally.
Elizabeth Blackwell: Pioneer
When Elizabeth Blackwell, the first female physician in the U.S., was admitted to medical school in 1847, it happened almost by accident. Every prestigious school she had applied to rejected her. The admissions officials at Geneva Medical College, a smaller, less-prestigious school on the Canadian border in NY, couldn’t quite reject her: she was too well-qualified. But they didn’t want to make the decision themselves, choosing to pass the responsibility off to their students. Believing the request for Blackwell’s admission to be a joke, the student body voted unanimously to admit her. And, so, she arrived.
But the small town that housed the medical school wasn’t ready for her. She describes being stared at “like a curious animal” as she walked through town to and from class, and the experience of being considered a “bad woman” or an “insane” woman for wanting to do “men’s work.”
Her experience in the classroom wasn’t much better. When her classmates prepared for a discussion on the male reproductive system, she was asked to leave the room so her “female sensibilities” wouldn’t be offended. As the audacious pioneer she was, she refused.
Women in Medicine in the 1960s
Today, albeit by the slightest margins, there are more women enrolled in medical school than men. But the climb to get here hasn’t been easy.
When our friend and retired movement disorder specialist Cindy Comella, MD, grew up in the 1960s, she had no real-life role models that reminded her: you, too, can be a doctor. In fact, she didn’t meet a woman physician until she attended medical school in the late 1970s and had a female professor.
Marilyn Hart, dressed in a nurse’s costume as a child.
Marilyn Hart, MD, a PMD Alliance ambassador and retired family medicine physician, affirmed Dr. Comella’s story. “When I was little in the early 1960s,” she said, “as a woman, I saw that you could only be a nurse or a teacher or a housewife. You weren’t a lawyer. You weren’t a business executive. And you weren’t a doctor.” She, too, didn’t meet her first female physician until she was in medical school.
For both these women, going to medical school meant stepping into a world dominated by men. When I asked Dr. Hart how many women were enrolled in medical school with her, she pulled out her black and blue yearbook titled “Clinic” and counted: 142 men and only 20 women.
Gender Gaps in Medicine
Dr. Comella is grateful: she went to Cincinnati Medical College, which was known for its diversity. She bonded with other women classmates, many of whom went on, she said, “to achieve incredible careers.” But respect and empowerment weren’t everywhere. “My parents raised me to think that I was as good as anyone else, man or woman,” she told me. “But as a young doctor, one thing I will always remember is the patients who would take one look at me and ask if ‘the doctor’ was coming in after I was done.”
What sticks out most in Dr. Hart’s memory is preferential treatment and the unexpected ways it showed up in a hospital’s culture. “At the time,” she said, “all the nurses were women and they wanted to marry doctors.” She remembers the nurses slipping their phone numbers into the pockets of her male colleagues or baking them brownies. “Nobody was making me brownies,” she laughed. It sounds funny now, but the social discrimination was pernicious.
She remembers how hard it was to find a residency that felt supportive and honoring. On one particularly “patronizing,” as she describes it, interview process, she learned that out of 700 residents, only three were women—and none of them even shared her specialty. “I would have never even seen them,” she said. She passed on the opportunity.
Juggling Kids and a Career
When Drs. Hart and Comella started their careers in the 1970s, women were still traditionally seen as their family’s caretakers, often unevenly responsible for the kids and household chores regardless of whether they worked or not. Dr. Comella explained, “The unequal expectations for women and men balancing work and family life have been pervasive my entire career…When my children were growing up, I was largely responsible for their care and their education. My career had to be secondary to their needs. I was responsible for the kids’ lunch boxes and dinners. Although,” she teased, “my kids would have preferred someone else do this particular chore. (I am a poor chef.)”
“But to me at the time,” she went on, “that was the way things were.” While Dr. Comella wouldn’t have wanted to give up her primary role in her children’s lives and she muses that women are “often more efficient at balancing their careers and families” (perhaps from centuries of practice), she admitted, “it can be exhausting.”
As for Dr. Hart, she said she’s lucky to have a very supportive and involved husband, but she, too, remembers barriers to having a full-time, high-powered career while raising her children. “Today, I would never do these things,” she said smiling. “But, at the time, I would sometimes bring my kids to work with me and pass the babies off to patients,” letting them spend time with whoever could hold them throughout the day.
Change is Possible: Women in Medicine Today
In the span of both their careers, Drs. Hart and Comella have noticed a shift. “I have volunteered at the local university,” Dr. Hart said, “and helped the first-year medical students.” She describes the booming number of female medical students as well as the rich diversity of their experiences, many of them having explored the world, or started a family, or tried out other jobs before choosing to get their medical degree.
Dr. Comella is hopeful about the support women have access to these days. “Through the various medical societies, there are now resources to address the challenges women face. In particular, there are leadership courses which include women or are designed specifically for women. These courses educate women in knowing they have a voice and how to use it in a productive way to further the cause of women in medicine.”
She admits there are improvements to be made: “We are still on the road to equality,” she insisted, “and there is a long way to go.” Women need “mentorship opportunities and an awareness of their shared issues.” They need chances to connect, feel heard, and use their voices together.
She believes it is possible. “I am impressed with my women colleagues,” she said proudly. “They started from behind, but are surging to the forefront.” When women do better, we all do better. Seeing the commitment of women in medicine and their allies, Dr. Comella radiates optimism: “We will all be on equal footing in the near future.”