Women in medicine

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Historically and in many parts of the world, women's participation in the profession of medicine (as physicians, for instance) has been significantly restricted, although women's practice of medicine, informally, in the role of caregivers, or in the allied health professions, has been widespread. Most countries of the world now guarantee equal access by women to medical education, although not all ensure equal employment opportunities[1] and gender parity has yet to be achieved within the medical specialties and around the world.

Contents

Modern medicine

Women's participation in the medical professions was limited by law and practice during the decades while medicine was professionalizing.[2] However, women kept practicing medicine in the allied health fields (nursing, midwifery, etc.), and throughout the nineteenth and twentieth centuries, women made significant gains in access to medical education and medical work through much of the world. These gains were sometimes tempered by setbacks; for instance, Mary Roth Walsh documented a decline in women physicians in the US in the first half of the twentieth century, such that there were fewer women physicians in 1950 than there were in 1900.[3] However, through the latter half of the twentieth century, women had gains generally across the board. In the United States, for instance, women were 9% of total US medical school enrollment in 1969; this had increased to 20% in 1976.[3] By 1985, women comprised 14% of practicing US physicians.[4]

At the beginning of the twenty-first century in industrialized nations, women have made significant gains, but have yet to achieve parity throughout the medical profession. Women have achieved parity in medical school in some industrialized countries, since 2003 forming the majority of the United States medical student body.[5] In 2007-2008, women accounted for 49% of medical school applicants and 48.3% of those accepted.[6] According to the American Association of Medical Colleges (AAMC) 48.3% (16,838) of medical degrees awarded in the US in 2009-10 were earned by women, an increase from 26.8% in 1982-3.[7]

However, the practice of medicine remains disproportionately male overall. In industrialized nations, the recent parity in gender of medical students has not yet trickled into parity in practice. In many developing nations, neither medical school nor practice approach gender parity.

Moreover, there are skews within the medical profession: some medical specialties, such as surgery, are significantly male-dominated,[8] while other specialties are significantly female-dominated, or are becoming so. In the United States, female physicians outnumber male physicians in pediatrics and female residents outnumber male residents in family medicine, obstetrics and gynecology, pathology, and psychiatry.[9][10]

Women continue to dominate in nursing. In 2000, 94.6% of registered nurses in the United States were women.[11]

Biomedical research and academic medical professions—i.e., faculty at medical schools—are also disproportionately male. Research on this issue, called the "leaky pipeline" by the National Institutes of Health and other researchers, shows that while women have achieved parity with men in entering graduate school, a variety of discrimination causes them to drop out at each stage in the academic pipeline: graduate school, postdoc, faculty positions, achieving tenure; and, ultimately, in receiving recognition for groundbreaking work.[12][13][14][15] (See women in science for a broader discussion.)

History of women in medicine

Ancient medicine

The involvement of women in the field of medicine has been recorded in several early civilizations. An Egyptian, Merit Ptah (2700 BC), described in an inscription as "chief physician", is the earliest woman named in the history of science. Agamede was cited by Homer as a healer in Greece before the Trojan War. Agnodike was the first female physician to practice legally in 4th century BC Athens.

Medieval Europe

During the medieval period, convents were an important place of education for women, and some of these communities provided opportunities for women to contribute to scholarly research. An example is the German abbess Hildegard of Bingen, whose prolific writings include treatments of various scientific subjects, including medicine, botany and natural history (c.1151-58).[16] She is considered Germany's first female physician.[17]

The 11th century saw the emergence of the first universities. Women were, for the most part, excluded from university education.[18] However, there were some exceptions. The Italian University of Bologna, for example, allowed women to attend lectures from its inception, in 1088.[19]

Within the Islamic empire, between the 800s and 1300s, women generally treated other women, and were trained privately. Practitioners were well respected, with support from government, and many kept their fees low so that any good student could join them.

The attitude to educating women in medical fields in Italy appears to have been more liberal than in other places. The physician, Trotula di Ruggiero, is supposed to have held a chair at the Medical School of Salerno in the 11th century, where she taught many noble Italian women, a group sometimes referred to as the "ladies of Salerno".[20] Several influential texts on women's medicine, dealing with obstetrics and gynecology, among other topics, are also often attributed to Trotula.

Dorotea Bucca was another distinguished Italian physician. She held a chair of philosophy and medicine at the University of Bologna for over forty years from 1390.[19][21][22][23] Other Italian women whose contributions in medicine have been recorded include Abella, Jacobina Félicie, Alessandra Giliani, Rebecca de Guarna, Margarita, Mercuriade (14th century), Constance Calenda, Calrice di Durisio (15th century), Constanza, Maria Incarnata and Thomasia de Mattio.[21][24]

Early modern era

Historic women's medical schools

When women were routinely forbidden from medical school, they sought to form their own medical schools.

Historic hospitals with significant female involvement

Pioneering women in medicine

Women's history and women's health movement

Scholars have been examining the history and sociology of medicine for decades. Biographies of pioneering women physicians were common throughout this time, but the study of women in medicine took particular root with the advent of the women's movement in the 1960s, and in conjunction with the women's health movement. Two publications in 1973 were critical in establishing the women's health movement and scholarship about women in medicine: First, the publication of Our Bodies, Ourselves in 1973 by the Boston Women's Health Collective,[33] and second, "Witches, Midwives, and Nurses: A History of Female Healers", a short paper by Barbara Ehrenreich and Deirdre English also in 1973.[2] The Ehrenreich/English paper examined the history of women in medicine as the professionalization of the field excluded women, particularly midwives, from the practice. Ehrenreich and English later expanded the work into a full-length book, For Her Own Good, which connected the exclusion of women from the practice of medicine to sexist medical practices; this text and Our Bodies, Ourselves became key texts in the women's health movement.

The English/Ehrenreich text laid out some early insights about the professionalization of medicine and the exclusion of women from the profession, and numerous scholars have greatly built upon and expanded this work. These scholars include:

Breast cancer awareness campaigns are an outgrowth of the women's health movement.

See also

Bibliography

Significant biographies

References

  1. ^ See generally, "Women's Human Rights", 1998, Human Rights Watch (available online).
  2. ^ a b See generally Barbara Ehrenreich & Deirdre English, Witches, Midwives, and Nurses (1973).
  3. ^ a b Walsh, 1977.
  4. ^ Morantz-Sanchez, Preface.
  5. ^ "Applicants to U.S. Medical Schools Increase; Women the Majority for the First Time", Association of American Medical Colleges, Nov. 3, 2003, press release ("Women made up the majority of medical school applicants for the first time ever").
  6. ^ http://www.aamc.org/data/facts/charts1982to2007.pdf
  7. ^ https://www.aamc.org/download/153708/data/charts1982to2011.pdf
  8. ^ Dixie Mills, "Women in Surgery - Past, Present, and Future" (2003 presentation, Association of Women Surgeons; available at AWS website.
  9. ^ AMA (WPC) Table 16 - Physician Specialties by Gender- 2006
  10. ^ AMA (WPC) Table 4 - Women Residents by Specialty - 2005
  11. ^ RNSS
  12. ^ The term was coined by S.E. Berryman in "Who Will Do Science?", 1983; see Louise Luckenbill-Edds, "2000 WICB / Career Strategy Columns (Archive)", Nov. 1, 2000, WICB Newsletter, American Society for Cell Biology.
  13. ^ A. N. Pell, "Fixing the Leaky Pipeline: Women Scientists in Academia", Journal of Animal Science, v.74, pp. 2843-2848 (1996), available online at Journal of Animal Science, FASS.org.
  14. ^ Jacob Clark Blickenstaff, "Women and Science Careers: Leaky Pipeline or Gender Filter?", Gender and Education, v.17, n.4, pp. 369-386 (Oct. 2005).
  15. ^ National Academy of Sciences, Beyond Bias and Barriers: Fulfilling the Potential of Women in Academic Science and Engineering.
  16. ^ Hildegard von Bingen (Sabina Flanagan)
  17. ^ a b Gertrud Jaron Lewis (2006). "Hildegard von Bingen". In Richard K. Emmerson. Key Figures in Medieval Europe - An Encyclopedia. Routledge. pp. 229–30. ISBN 978-0-415-97385-4. 
  18. ^ [Whaley, Leigh Ann. Women's History as Scientists. Santa Barbara, California: ABC-CLIO, INC, 2003.]
  19. ^ a b JS Edwards (2002). "A Woman Is Wise: The Influence of Civic and Christian Humanism on the Education of Women in Northern Italy and England during the Renaissance". Ex Post Facto: Journal of the History Students at San Francisco State University XI. http://userwww.sfsu.edu/~epf/2002/edwards.html. 
  20. ^ a b Feminist approaches to technology: Reframing the question
  21. ^ a b Howard S. The Hidden Giants, p. 35, (Lulu.com; 2006) (accessed 22 August 2007)
  22. ^ Brooklyn Museum: Elizabeth A. Sackler Center for Feminist Art: The Dinner Party: Heritage Floor: Dorotea Bucca (accessed 22 August 2007)
  23. ^ Jex-Blake S (1873) 'The medical education of women', republished in The Education Papers: Women's Quest for Equality, 1850–1912 (Spender D, ed) p. 270 (accessed 22 August 2007)
  24. ^ Walsh JJ. 'Medieval Women Physicians' in Old Time Makers of Medicine: The Story of the Students and Teachers of the Sciences Related to Medicine During the Middle Ages, ch. 8, (Fordham University Press; 1911)
  25. ^ Michael Reiskind, "Hospital Founded by Women for Women", Jamaica Plain Historical Society (1995).
  26. ^ Scotland: Just the Medicine that the Doctor Ordered, Aug. 2005.
  27. ^ http://www.bium.univ-paris5.fr/histmed/medica/femmesmed.htm
  28. ^ http://muse.jhu.edu/journals/bulletin_of_the_history_of_medicine/v075/75.4zhuk.html
  29. ^ http://cat.inist.fr/?aModele=afficheN&cpsidt=12482437
  30. ^ http://jech.bmj.com/content/61/Suppl_2/ii3.full
  31. ^ Edwards, Muriel, M.D., "Emma K. Willits," Journal of the American Medical Women's Association, 5/1 (January 1950): 42-43.
  32. ^ "Dr. Marie Diana Equi", NLM Changing the Face of Medicine.
  33. ^ Our Bodies, Ourselves (1973).
  34. ^ "NLM Exhibit Honors Outstanding Women", NIH Record, Nov. 11, 2003.