Dr. Michelle Smith

In a 1995 report from the Council on Graduate Medical Education entitled Women in Medicine, gender bias was singled out as the greatest deterrent to women physicians achieving their full potential in every area of the medical profession and across all stages of medical careers. Ethnic minorities have had a double burden to bear.

Today average enrollment for women in medical schools is nearly 50 percent (in contrast to 10 percent of all medical students in 1970). Yet only 20 percent of practicing physicians and 24 percent of academic faculties are female. After several years of advancement toward gender equity, it is apparent that women remain behind their male colleagues when it comes to positions of leadership and influence in medicine.

A national symposium entitled Advancing Women’s Leadership in Medicine, Health Sciences, and Health Care, sponsored by the Women’s Leadership Institute of Mills College on January 12 and 13 of this year, was designed to address issues of gender inequity in health care and the health science fields. The prestigious list of speakers included Cora Tellez, ’72, CEO and President of Health Net; Marie Kuffner, MD, President of the California Medical Society; Echo Heron, RN, activist and published author; Deborah Campbell, RN, Director of the West Contra Costa County Hospital District Board; Catherine Gillis, Dean of the Yale School of Nursing; and Pamela Dyne, MD, Director of the UCLA Emergency Medicine Residency Program.

These remarkable women attempted to identify strategies to improve post-graduate education and advance the careers of women in health-related fields. President Janet L. Holmgren captured the essence of this dynamic group in her introductory comments. “Every woman’s path is unique. . . . We’ve shared many obstacles to advancement.”

The specialty areas and symposium topics were as varied as the women present. Challenges and opportunities for working in community health programs, undeserved areas, and nontraditional fields such as naturopathic medicine were among subjects of interest. Other topics included stress, chemical dependency, and depression among practitioners; coping with the dying patient; and leadership opportunities for nurses, nurse practitioners, and physician assistants. Discussions centered on the lack of role models and mentors; surviving and thriving in one’s career; integrating personal and professional life; and seizing opportunities for career advancement.

Cora Tellez reported that over 90 percent of workers in the health care industry are women. Yet in her position as CEO and President of Health Net, it is apparent that “very few women rise above middle management . . . and achieve high corporate positions.”

According to Dean Gillis, fewer women have enrolled in a basic nursing bachelor’s program during the last five to six years. Barriers in nursing careers that lead to dissatisfaction in the professional environment have contributed to the “graying” of nurses, whose average age is 47.

Among the concerns most frequently voiced at the conference were demands placed by family life on a woman’s pursuit of a career in medicine, and the need for balance. Barbara Staggers, MD, MPH, FAAP, Director of Adolescent Medicine and Multicultural Affairs at Children’s Hospital in Oakland, observed that women who take on leadership positions often feel undeserving of support in their personal and professional lives. Whereas most married male physicians have a spouse who is not employed full-time outside of the home, the opposite is true for their female counterparts. Professional women with families feel their lives are replete with responsibilities and find it difficult to incorporate leadership opportunities. It is not unusual to experience conflict around distribution of time between family and patients.

When Dr. Judith Leong Mates, delegate to the California Medical Association and newly elected chair of the Women’s Caucus of the American Medical Association, was planning a family during her medical training, she was careful to aim for a delivery date at the beginning of a scheduled four-week vacation. “I didn’t want my femaleness to be a detriment to fulfilling my obligation as a resident.”

In a study of faculty perceptions of gender discrimination in academic medicine, “Female faculty were 2.5 times more likely than male faculty to perceive” gender bias. The study concluded, “Despite substantial increases in the number of female faculty, reports of gender-based discrimination and sexual harassment remain common.” Dr. Kuffner poignantly summarized the experiences of many professional women when she said, “Let’s fact it: men are . . . easily threatened by bright women.”

Strategies to counteract assumptions that discourage young women from pursuing scientific and medical careers were discussed. Although lack of skills or credentials is not the major reason women are disproportionately represented in the upper academic ranks or other positions of leadership, many conferences and recommendations have focused primarily on developing these capabilities.

Progress in achieving gender equity in leadership positions in medicine and other health careers is occurring, albeit slowly. Suggestions for acceleration of progress were numerous at the conference. Much of the advice centered on taking initiative and building a strong support system. Emphasis was placed on willingness to take risks and seize opportunities, and women were encouraged to expand to areas outside of their comfort zone.

Women can benefit from the experiences of men by establishing self-confidence and learning to network early. Involvement with a national organization and political astuteness were recommended as useful measures to become familiar with the leadership community. Men should not be excluded from mentoring roles for young women, as they hold the majority of higher positions of authority.

The entire spectrum of health care providers including physicians, nurses and nurse practitioners, health care administrators, and hospital administrators should be encouraged to participate in the advancement of women. Community leaders and women’s organizations should also be encouraged to help. Increased representation of women in leadership roles will provide expanded opportunities for them to mentor students effectively and shape the future of women’s health care.

Mills has done much to encourage women to excel in medicine and science. The Post-Baccalaureate Premedical Program at Mills prepares students who were not science majors in college to go to medical school. About 80 percent of the students in the program are women. In addition, the Expanding Your Horizons in Science and Mathematics conference is held every year at Mills. The one-day program for 6th-12th grade girls and young women gives these students a rewarding experience with science and mathematics and encourages them to take more science and math courses.

The Women’s Leadership Institute has sponsored several other forums on women in science. On December 7, 2000, a panel of distinguished women talked about strategies and directions for women’s leadership in science and technology. The keynote speaker, Dr. Jaleh Daie, Director of Science Programs at the David and Lucile Packard Foundation, spoke on the importance of helping girls achieve in science, encouraging them to envision careers in science and technology. She emphasized that women are needed in these fields not only because of the shortage of professionally trained workers, but because of the unique contributions women can make through leadership in more holistic thinking, problem solving, and setting a different agenda in priorities for policy making.

Other speakers at the December 7 meeting included Dr. Kristie Boering, specialist in atmospheric chemistry at UC Berkeley; Dr. Jill Fabricant, ’71, former Director, NASA Technology Commercialization Center and currently Director of Medicine for Humanity; and Nancy Ramsey, author of Nuclear Weapons Decision Making and co-author of The Futures of Women: Scenarios for the 21st Century.

The January symposium emphasized a basic tenet: the need to nurture and integrate other passions. The key to balance is finding the courage to carve out a niche, and to participate in activities that regenerate energy. This principle was best exemplified by her concluding remarks when Cora Tellez emphatically queried, “If you can’t find passion in what you’re doing, what the heck are you doing it for? Life is too short!”