Progress for Women in Medicine Slow, but Significant

Dr. SiegfriedMy childhood was guided by Donna Reed and June Cleaver, but I came of age under the influence of Gloria Steinem and Betty Friedan, when women were clamoring for change. By the time I completed my training, almost half of my professional colleagues were female. So I am impatiently annoyed that in the year 2016 women have not been as equally represented among the leaders in our field.

But change is never easy or fast. From a historic perspective, it’s been only about a half-dozen generations since women were even allowed to train in medicine (initially at a segregated institution).  Opportunities for leadership have been even more recent. In 2016, 57% of college students are female but only 23% of all bachelor's and master's level institutions employ female presidents. That figure is higher for community colleges and Ivy League universities.¹ Women also continue to lag behind men as lead authors in top medical journals, although those numbers are improving.²

Next: Women in leadership: professional societies

Professional Organizations

The American Dermatological Association (ADA) is dermatology’s founding, and most enduring, specialty-specific organization. The ADA was established by 16 men in 1876, and membership has always been by peer-nomination. In 1925, a few years after Dr. Rose Hirschler became the first female US dermatologist,⁴ an ADA vote allowed women to attend their historical lectures and dinner. It was another quarter-century before Dr. Beatrice Kesten, who clearly deserved the recognition, became the first female ADA inductee.⁵

The American Board of Dermatology (ABD) was established in 1932 as a founding member of the American Board of Medical Specialties. Dr. Kesten became the first female director in 1953. The organization did not elect another woman until Barbara Gilchrest became a director in 1988. As of 2015, only ten of the 100 emeritus directors were women. However, the current ABD leadership includes eight women and 11 men.

The American Academy of Dermatology (AAD) was founded in 1937 by 17 “founding fathers.” The inaugural meeting was held November 1938 in my hometown, St. Louis, Mo., and was attended by approximately 40% of the nearly 600 members.⁶ The AAD now represents more than 19,000 fellows; almost half are women. As of 1970, only one woman served on the AAD Board of Directors (June Carol Shafer, 1956-1958). The second, Dr. Margaret Ann Storkan, was elected in 1971 and became vice president two years later, when less than 10% of the more than 4,000 AAD members were women. During the next two decades, women made few leaderships inroads, despite support from male colleagues like Dr. Walter Shelly, who reportedly nominated several women to committees, but was often declined.³

It was not until 1992 that Dr. Wilma Bergfeld took office as the first woman president, after serving on the Board of Directors for 10 years. Since then, the AAD has been led by additional female presidents, vice presidents, secretary/treasurers, and board directors. The AAD also honors outstanding members as well as non-dermatologists, including a small minority of women: one of the 10 Distinguished Service Award recipients, one of the first 10 Gold Medal honorees, five of the 30 Master Dermatologists and two of the 26 Marion Sulzberger winners.⁷

Men have dominated the political world in almost all cultures. In 2016, 89% of the countries in the world are led by men. The dermatology academic political microcosm is similar. Among those who chair academic departments of Dermatology, I counted 17 women among the 117 programs listed by the AAMC.⁸ Notably progressive locations are my “Show Me” state, where all three departments are chaired by women, and Massachusetts, with three of four programs being led by women. And two programs are chaired by a second generation female (Eastern Virginia and Boston University).

A forum held at the March 2016 annual AAD meeting focused on “Closing the Gender Gap in Academic Dermatology and Dermatology Leadership: Problems and Solutions.” It included all-women faculty presentations on work-life balance, navigating the two career household, negotiating skills, and mentoring. It did not tackle the delicate and complex topic of pay discrepancy, which is greater for professionals.

Is lack of female leadership the result of institutional sexism, or of women’s personal choice and skill set? Males and females have evolved over millennia to embrace different roles. Physical strength, a characteristically male trait, trumped all other leadership qualities until technological advances allowed appreciation of alternate leadership skills. So, as Dr. Walter Shelly noted,³ other female characteristics must be impacting our eligibility. One may be motivation to sit at the male-dominant table. I know of few women who aspire to climb to the top of an administrative bureaucracy or to build a large corporation. But technology has allowed growing interest and inquiry about the differences between male and female leadership, including advantageous feminine characteristics:  compassion, organization, honesty, collaboration, task focus, and interest in mentoring.

Change is slow, but steady. Many women have already achieved notable firsts: flying solo across the Atlantic, winning a Nobel Prize, and serving as mayors, senators and Prime Ministers. And one day a woman will be elected President of the United States.

Also by Dr. Siegfried: 

Weighing diagnosis with delivery

Next: References

References:

1. https://www.eab.com/daily-briefing/2015/03/19/one-quarter-of-presidents-are-women

2. http://www.pharmalive.com/women-lag-men-as-lead-authors-in-top-medical-journals/?utm_campaign=shareaholic&utm_medium=email_this&utm_source=email

3. http://www.the-dermatologist.com/article/3646

4. França K, Ledon J, Savas J, Nouri K. Women in medicine and dermatology: history and advances. An Bras Dermatol. 2014; 89(1):182-3

5. http://www.amer-derm-assn.org/about.html

6. Hubler WR. Organizing American dermatology and the founding of the American Academy of Dermatology. J Am Acad Dermatol. 1988;18(4 Pt 2):783-5.

7. https://www.aad.org/Forms/Policies/Uploads/GP/GP%20-%20Awards%20Policy.pdf

8. https://services.aamc.org/eras/erasstats/par/display8.cfm?NAV_ROW=PAR&SPEC_CD=080