Emily Carter • 2021 Science Communication Series Cohort
Source: Emily Carter, Canva
Despite the equality of opportunity and representation that the United States stands for, representation of women in male-dominated fields, such as medicine, remains a challenge. As a result, 2017 marks the first year that more women than men were admitted to medical school in the United States, and it is not by much: 50.7% [1]. This small achievement, however, does not address the full problem. Although the future of medical school admissions appears promising in maintaining equal admittance rates, graduate medical education (post-medical school training in medical specialties) still experiences massive challenges to achieving equal representation of women in a variety of medical specialties.
Many factors contribute to the gender disparities experienced by women in several medical specialties. Some factors indicate situational events during a medical student’s training that influence specialty choice. For example, medical students’ exposure to sex discrimination influences women’s career choices and pursuits more than men’s [2]. Further factors include gender roles and the lack of representative female mentors in high leadership positions of their specialty. Gender disparities are prominent across academic ranks, as women are less likely to be full (tenured and/or including administrative roles) professors [3]. These factors often lead female physicians to choose their specialty based on the number of other female physicians represented in that specialty, and overall, to increase their likelihood of success in matching into the particular specialty.
Graduate medical education programs present a wide variety of specialties young physicians can choose from, everything from family medicine to ophthalmology (eye health and eye care), even infectious disease to neurosurgery. Among the graduate medical education training programs, surgical fields present some of the greatest gaps in the equal representation of women. In terms of sub-surgical specialty practices, women are least represented in orthopedic surgery (5.8% female), thoracic surgery (8.0% female), and neurological surgery (9.3% female) [4]. However, the gender gap extends beyond surgical fields influenced by a male-dominated culture.
The male-dominated culture in several medical specialties presents an environment where female physicians are less likely to pursue and excel in academic medicine [5]. Sexism in a female medical student’s training and a female physician’s specialty amplifies the lack of representation women experience in several medical fields. To mitigate this amplified impact, important steps taken to eliminate these perceived barriers that contribute to female physician’s medical specialty choice must be addressed and eliminated.
Only 45.6% of active graduate medical education trainees in the United States are women [6]. Medical schools have just achieved equal representation of women in admittance, but the lag for graduate medical education programs to do the same continues to exist. Will it take another century to achieve equal representation of women across all medical specialties?
The current boundaries in a variety of medical specialties that limit female medical students from choosing any graduate medical education program and specialty of their choice must be cured of these systemic impurities. We must provide women with equal opportunities to pursue any medical specialty of their choice and assure equal representation of women by addressing the male-dominated climate that plagues academic medicine.
References:
[1] Heiser S. more women than men enrolled in U.S. medical schools in 2017. Association of American Medical Colleges. https://www.aamc.org/news-insights/press-releases/more-women-men-enrolled-us-medical-schools-2017#:~:text=Females%20represented%2050.7%25%20of%20the,male%20matriculants%20declined%20by%200.3%25. Published December 17, 2017. Accessed April 21, 2021.
[2] Vassie C, Smith S, Leedham-Green K. Factors impacting on retention, success and equitable participation in clinical academic careers: a scoping review and meta-thematic synthesis. BMJ Open. 2020;10(3):e033480. doi:10.1136/bmjopen-2019-033480
[3] Jena AB, Khullar D, Ho O, Olenski AR, Blumenthal DM. Sex differences in academic rank in US medical schools in 2014. JAMA. 2015;314(11):1149-1158. doi:10.1001/jama.2015.10680
[4] Association of American Medical Colleges. Active Physicians by Sex and Specialty, 2019. https://www.aamc.org/data-reports/workforce/interactive-data/active-physicians-sex-and-specialty-2019. Published 2019. Accessed April 21, 2021.
[5] Kowalski A. The Impacts of Gender Disparity in Residency Matching. JAMA Netw Open. 2020;3(11):e2028161. doi:10.1001/jamanetworkopen.2020.28161
[6] Murphy B. These medical specialties have the biggest gender imbalances. American Medical Association.https://www.ama-assn.org/residents-students/specialty-profiles/these-medical-specialties-have-biggest-gender-imbalances. Published October 1, 2019. Accessed April 21, 2021.