Maureen Strohm’s son was 4 when she read him the children’s book “You Can Be Anything.”
“One character is a doctor, and I said to him, `Devon, you can be a doctor too, like Mommy,’ ” said Strohm, who practices family medicine at the University of Southern California Hospital.
She laughed at the memory. “He said, `Mommy, I can’t be a doctor–only girls are doctors.’
“That’s when I realized that, in addition to his knowing me as a doctor, our family physician at the time was a woman and his dentist was a woman,” said Strohm, 42. “All of his contacts in the health-care field had been women–and so he drew his own conclusions.”
That medical students applaud when Strohm tells this story at seminars is a tribute to the changes in medicine over the last two decades.
In 1970, women made up fewer than 9 percent of medical students. When Strohm tells her story today, 40 to 50 percent of the students in the audience are women.
According to the American Medical Association, the number of women doctors in the United States has increased 300 percent since 1970, an infusion that helped alter the face of medicine. But with many first-year medical school classes now reaching a 50/50 male/female ratio for the first time, a new transformation is afoot.
“Currently, 19 percent of all doctors in the U.S. are women,” said Sherry Singer, spokeswoman for the AMA. The average female med-school enrollment was 40 percent in ’92, the latest year for which national statistics are available.
As women break barriers and branch into an increasing number of specialties, patients have more choices, experts say. Women also can bring a unique perspective that is changing how medicine is practiced.
“Invariably, women present a viewpoint that should be considered but isn’t when dealing with only males,” said Dr. Peter Katsufrakis, 37, associate dean for student affairs at USC Medical School.
For example: “They will bring up the issue of the effect of an illness on the patient’s family and will generally talk about how a disease or condition affects a woman differently from a man.”
Some patients cite reasons such as compassion, good listening skills and a willingness to search for answers as qualities that women tend to bring to the practice of medicine.
The revolution didn’t come easily. It took the women’s movement of the ’70s as well as federal legislation to alter the perception and reality of medicine as a man’s world.
“That’s when Title IX . . . was approved by Congress, saying it was illegal for schools receiving federal funds to discriminate against women,” said Janet Bickel, assistant vice president of the Association of American Medical Colleges. “Prior to that, there were no requirements concerning women, and our society had never looked into it.”
Between 1970 and 1980, female enrollment in medical schools increased almost fivefold and has slowed only a little this decade.
“Women’s sights were being raised from becoming second-grade teachers and nurses to bigger things,” Bickel said.
But even as women gained entry into medical schools, they learned that the struggle had just begun.
“In those early years, I would have to say it was, well, interesting being one of the few women in medicine,” said Dr. Charlotte Yeh, 42, an emergency-room physician who did her early training at Harbor-UCLA Hospital. She is now physician in chief in the emergency room of the teaching hospital at Tufts University, Boston.
She recalls having to sleep on the couch in the waiting room because overnight “on-call” rooms for residents were just for men. Hospitals did not provide separate facilities for female residents until several years later, she said.
Going through interviews for a residency in surgery invariably meant questions about whether Yeh was planning to have a baby, she recalled, as well as warnings that the tough conditions made women weep.
During her first high-level executive-committee meeting, the men in the room thought Yeh was the stenographer, there to take notes, she said. And each day brought new reminders that she had entered a male-dominated field.
“You’d be on rounds, and you’d be walking down the hall and talking about a case with the other doctors,” she said. “They would continue walking and talking right into the men’s room, and I would stand outside the door, wondering whether I should go in too.”
These days she no longer wonders.
“Now we continue the conversation into the ladies’ room,” she said and laughed.
Dr. Adelaide Randak, 54, of Woodland Hills, took another path into medicine. A self-described “tennis-playing housewife” at the time she decided to fulfill her longtime dream of becoming a doctor, she deliberately had a child first.
“I went into medical school when I was 32–I wasn’t the oldest, but I was the second-oldest,” she said. Not everyone was supportive, but she didn’t know it at the time.
“I have only discovered in very recent years what some people really said about me. Some of my female friends said things like, `She abandoned her kids and her family,’ ” Randak said. “But the truth is, I got so busy, I just never looked back.”
She recalls just one instance of blatant sexism during her training:
“There was a very famous–world-famous–surgeon at UCLA, and as far as he’s concerned, women should be at home having children and cooking,” she said. “I happened to get him for my surgery orals, and he told me I didn’t belong in medicine. He wanted to throw me out of school. I wasn’t prepared for that–it was crushing.”
Although this surgeon gave Randak a poor evaluation and recommended failure, the other examiner, also a man, gave her a high ranking. She passed.
Younger doctors tell a different story.
“My year was 25 percent women,” said Dr. Maria DiMeglio, a 33-year-old Van Nuys gynecologist in her first year of practice after attending the School of Medicine at the University of Southern California.
“There wasn’t any feeling that women don’t belong. It was more like, `Of course you’re supposed to be here.’ “
Female medical students say the way already has been paved for them.
“In general, at least here at ULCA, it seems like there is a lot more openness that sexism exists, and it’s being approached and recognized and is not as pervasive as it once was,” said Marla Abrolat, a third-year medical student at the University of California, Los Angeles.
“As a woman, I feel confident that if something happened, I could approach my administration and get help with the problem.”
So far, sexism hasn’t been part of her medical-school experience.
“My problem has not been with professors or residents, maybe because the best of the lot have been selected to teach us,” she said. “My problem has been with the patient who, when I walk into the room, calls out `Nurse!’–or sometimes the private-practice physician.
“I can see once we get out and we’re not as protected, it will become more of an issue.”
Lisa Cherubian, 23, another third-year student at UCLA, agrees. Her professional experiences with male classmates have been no better or worse than with men in other areas of her life, she said. Professors encourage female students to speak up in class, and she said that attitude carries over into the hospital.
Cherubian is reluctant to discuss the time a male superior “made a pass” at her. At the time, she talked it over with another woman and with her supervisor, who told the man to leave Cherubian alone.
“That was just one incident, and I don’t think it’s a common thing,” she said.
Classmate Deborah Grossman, 38, said she runs into difficulties not because she is female but because she is older than her classmates.
“I find that I’m not discriminated against because of gender, but I’ve gotten into situations where an instructor has ignored me when I need help because they seem to expect me to be more knowledgeable because of my age,” she said.
But in general, medical school is a gentler place than she expected.
“My expectations were based on popular culture, things like movies and television, which portray women really having to fight,” she said. “I thought it would be harder to get in and harder to be accepted. I didn’t realize that the ratio was going to be 50/50.”
Although women have earned themselves a space on the welcome mat, career advancement is another story.
“Harassment has been rampant and blatant all over the place. We’re only now getting a handle on how to deal with that,”said Dr. Nancy E. Warner, professor of pathology at the USC School of Medicine. “Younger men are more attuned to the idea that equality for women is a good thing. The younger generation is less likely to be blatantly harassing people.”
Warner began teaching when she was a resident at the University of Chicago from 1950 to 1953. The faces were all male. The mix changed gradually.
“I can’t say that I ever looked up and suddenly the room was full of women,” she said. “It just changed slowly over time.”
While women doctors may have gained acceptance among patients and colleagues, glass-ceiling issues such as equal salary and access to the career ladder seem to be alive and well in the medical field.
According to the AMA, fewer than 10 percent of women faculty reached the full professor level in 1993, compared with 31 percent of male faculty. The distribution is the same as in 1980. And women doctors earn 59 to 63 percent of what male colleagues earn, according to the AMA.
“I read a recent study that examined a group of women and men who graduated at the same time from medical school,” Warner said. “The women weren’t getting anywhere. The men were all doing much better.”
The male doctors earned more, received more grant money for research and advanced further in academic pursuits.
Warner noted that until medical schools factor in a woman’s right to take time off to have children, the academic deck always will be stacked in a man’s favor. Doctors who want to become professors have six years to get tenure, during which time they must find research money, conduct research and publish papers and books.
“This is often the time women choose to marry and have families,” Warner said. “In terms of tenure, women are out of luck. The solution–stop the tenure clock when a person gets pregnant. That’s now being done at some schools.”
In the meantime, there’s always comfort to be found in the outrageous stories about the way things used to be.
“There was a woman named Dr. Alice Hamilton, who was put on the faculty at Harvard, the first woman assistant professor there,” Warner said. “She was told, `You cannot ever sit on the platform at graduation, you cannot ever go into the faculty club,’ a whole list of restrictions.
“That’s the kind of baloney that there used to be.”
