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Empowering Women in Medicine

What's Wrong with this Picture?

On the surface, women appear to be making rapid gains as physicians. Today, they are entering medical school in greater numbers than ever before. In 1930, women comprised only 4.4% of all medical students. In 1989-90, that number was over 36%.

Scratch below the surface, though, and a bleaker picture emerges: Students are the only level at which women are making gains. At every other level of medical power and authority, women are not present in large numbers and are not making the same gains.

For women of color, discrimination is even worse. Even the medical school increases are mostly white women. Women of color, who were 3.8% of all first-year medical students in 1980, were only 5.2% of all first-year medical students ten years later.

Medical School Faculty: No Parity for Women

Looking at faculty, one finds that in 1990 only 20.7% of all medical school professors were women. This represents only a 7% increase from 1967. At this rate, women will not reach parity on medical school faculties until the year 2077. What's more, this 20.7% is predominantly white women, as only 4.7% of all medical school faculty members are women of color.

When looking at rank, one finds that women are clustered primarily in the lower faculty ranks. Eighty-nine percent of all white women and 93.5% of all women of color faculty are below the rank of professor, compared to only 69% of white men and 78.3% of men of color.

When women enter the field of medicine to teach, they are promoted much more slowly than their male colleagues. On average, men are promoted twice as fast as women to the rank of assistant or associate professor. Thus, even though women are entering the academic pipeline, they are being blocked from moving up the ranks.

At the highest levels of medical academia, women are even more rare. Only 2% of all department chairs are women. In 1990 only 2 of the 127 medical schools in the United States were headed by women deans. Today, one year later, not a single medical school in the country is headed by a woman dean.

Sex Segregation: The Rule in Health Care

The health care profession, to this date, is essentially sex-segregated, as 84% of physicians are male and 97% of nurses are female.

Among practicing physicians, women are clustered in the four lowest-paid specialties: general family practice, pediatrics, psychiatry, and internal medicine. Together, these specialties account for 70% of all women physicians. In addition, a 1986 study showed that while women are more likely to go into these specialties, women of color are even more so. Surgery and its various specialties, which not only command the highest incomes but also the highest public confidence, are comprised of only 8% women.

The nursing profession, still essentially a female domain, has historically been undervalued, underpaid, and denied power within the medical hierarchy. This is despite the fact that nurses represent the largest group of health care professionals. While this report focuses on women physicians, we recognize that the problems of sex segregation, wage discrimination, and male domination of the health care industry also adversely affect women in the field of nursing.

Medical Women Face Wage Gap

Even within medical specialties, women physicians are not treated equally. A huge income gap between men and women exists. In 1985, the median income of women surgeons was 61% of male surgeons. By 1988, female doctors earned 62.8 cents for every dollar their male counterparts earned. What's worse, this figure is down from the 1982 figure of 63.2 cents for every dollar.

Medical Organizations Are Imbalanced

Women in national organizations fare no better. The American College of Obstetricians and Gynecologists (ACOG), whose sole mission is to provide health care to women, has never had more than two women in its top 17 offices at any one time in its 41-year history

And the biggest medical bastion of them all, the American Medical Association (AMA), which claims to speak for all doctors, has never had a woman executive officer in its 144-year history. In fact, the AMA never even had a woman on its board until 1989.

When women's lives hang in the very balance, we can't stand by and wait as women are relegated to the bottom ranks of medicine. Time alone does not achieve equality. Women, especially women in medicine, must act now if we are to safeguard the health of generations to come.