This month and every month, American University of the Caribbean School of Medicine (AUC) celebrates the progress women have made and continue to make in medicine, while also highlighting opportunities to increase gender equality in the field. National Women Physicians Day is held annually on February 3, a date chosen to honor the birthday of Dr. Elizabeth Blackwell, who in 1849 became the first woman to receive a medical degree in the United States.
To see the progress, let’s go back to 1975, when the percentage of women Doctor of Medicine (MD) graduates climbed above 10% for the first time in the United States. About five years later, the percentage of women faculty members in medical schools also passed the 10% mark. Since then, those numbers have slowly risen as opportunities increase, hiring and selection processes evolve, and more women pursue medicine as a career. In recent years, women graduates of MD programs have outnumbered men as percentages roughly follow the overall male-female population ratio in the United States, fluctuating around the 50% mark.
As for doctors themselves, who often push retirement back until their late 60s or 70s, the most recent U.S. Physician Workforce report from the Association of American Medical Colleges shows that 37.6% of all U.S. doctors are women. The numbers from another report, however, point toward better gains: a slight majority of physicians under the age of 35 are women. There is also a growing number of women among medical school faculty (41.4%).
Pediatric cardiologist and AUC alumna Anne A. Tedga, MD ’11, addressed additional statistics for women of color: “While the overall numbers of women physicians are uplifting, one is faced with persistently low numbers representing minority groups such as black and brown female physicians. As of 2018, Black women made up just 2.8% of the physician workforce, a number that has not changed much over the last century. There are even fewer Black women in academic leadership roles. There is still work to do.”
At AUC, where we have graduated more than 7,500 MDs since our founding in 1978, our students reflect the changing demographics, as well as general U.S. population lines (nearly 80% of our students come from the United States). In order to address sociodemographic disparities in the physician workforce, AUC strives to recruit a diverse student body inclusive of minorities. For the 2021-2022 academic year, 54% of our students were women.
Dr. Tedga recalled, “When I attended AUC, I felt that my class had a healthy gender distribution. We were relatively well represented in the student governing body as well. Post-AUC, we have done extremely well as a collective. A majority of my female counterparts gravitated toward primary healthcare. However, some went into such subspecialties as surgery, anesthesia, and cardiology.”
Two other former AUC students, Nikole Czapp, MD ’17, and Izabella Shuvayev, MD ’13, talked about their time as students, as well as the role of women in medicine in this AUC interview session. (Try not to be distracted by the palm trees of Sint Maarten — or the sleepy canine, “Doctor Rav.”)
Navigating Challenges
While the medical field is diversifying, women physicians continue to grapple with work-family conflict, gender and pay bias, and other factors that pose challenges to the advancement of their careers. Work and home can be tricky for any parent to balance, but physicians who are new mothers are especially impacted by varying levels of institutional support for aspects of parenthood that intersect with time spent at work — consider, for example, breastfeeding or finding opportunities to pump milk.
Dr. Tedga: “There are multiple institutional and cultural factors that discourage women physicians in these endeavors. I was fortunate to have a supportive residency program that designated breastfeeding areas in my workplace. In my recent fellowship, however, that wasn’t the case. I shared an office with my three co-fellows, two of whom were males. I invested in a hands-free breast pump and tried to coordinate my breastfeeding sessions during low-traffic periods in order to have some privacy. It’s hard to believe this was still a physician’s reality in 2023.”
Dr. Tedga elaborated on other challenges specific to women physicians: “We are often caught off guard by the persistence of stereotypes and misperceptions in the workplace — both from colleagues and patients. As a trainee, I experienced subtle and direct microaggressions, pertaining to my motherhood, believe it or not, from some of my faculty members. I believe that I was under unwarranted hyper scrutiny, which intensified after my return from maternity leave.
“The reality was that I felt inadequate as a mother leaving my newborn baby behind. Added to that, I equally felt inadequate as a trainee in spite of being a chief. This had a negative impact on my mental state as a mom already navigating postpartum nuances in a high-traffic environment. Thankfully, I received a lot of support from attending physicians, some of whom were career moms themselves. It’s important to note that there may be a stark contrast in other trainees’ experiences and that different programs have tools in place to address such disparities.”
Another common scenario women physicians describe is being mistaken for a nurse even after introducing themselves as the doctor, an experience that former AUC Provost Dr. Heidi Chumley described in her 2016 article “The Importance of Female Role Models in Medicine.”
“Whether intentional or not, this type of formative experience — being mistaken for a nurse because you are a woman — can greatly impact one’s self-worth and confidence as a new medical professional,” Dr. Chumley wrote.
AUC Associate Clinical Dean Dr. Erika Regalado recalled a similar experience: “Despite being the supervisor of a team, there have been several instances where patients have mistaken me for a resident and the male resident as the attending. I believe this continues to highlight the gender biases that continue in medicine.”
These and other factors have the potential to affect women physicians’ professional advancement and career longevity. According to one study, 22.6% of women physicians were not working full time within six years of completing training, compared to 3.6% of male physicians. This has implications not only for women physicians, but also for their communities and the patients they serve.
“In my experience, environments that are inclusive of women are often the ones that have success enhancing inclusion along multiple lines of diversity,” Dr. Chumley wrote. “And this is a very important point for our medical schools, particularly as we prepare students to care for a patient population that is increasingly diverse.” Dr. Tedga added, “Because female physicians bring different perspectives from their unique lenses (of femininity, marginalization, and motherhood), this is more reason to invite them to the table.”
Dr. Regalado stressed the importance of representation in the medical field, particularly for underrepresented minorities and patients of all genders. She believes that seeing physicians who look like them and share their backgrounds can inspire individuals to pursue similar paths and provide a sense of connection and trust in the healthcare system. “Having more women representation in medicine is important for girls. It’s important for them to have role models, to see women grow in roles of administration and become a voice to make a difference in not just women's care, but in the care of all patients.”
Regalado, who practices pediatrics, recently saw a young female patient who shared that she wanted to be a doctor when she grows up. “There is fulfillment in knowing that my presence has made a positive impact on my patients and reinforces the significance of representation in medicine.”
Paving The Way
What can we do to build on the progress already made and continue the advancement of women in medicine? It’s important to recognize bumps in the road while keeping the momentum. “Pursuing a career in medicine isn’t easy,” said Dr. Regalado. “There are increasing challenges for women from both the internalized and societal expectations of them. Juggling work and home and the increased mental load is challenging. However, it’s important for girls and young women to know that even though it’s challenging, becoming a physician is worth it — it’s very rewarding.” Many workplace challenges stem from systems and cultures that are slower to adapt, but there are plenty of ways we can all support and champion women in the medical field — and that starts on an individual level. “Being confident and proud of your position helps break down barriers,” said Dr. Czapp.
For women medical students and physicians charting a path to leadership positions, AUC offers this advice:
1. Seek out flexible workplace cultures. Flexibility and compromise are keys to success. For example, you may be willing to answer consultation emails at midnight if it means you can go to your kids’ soccer game earlier in the day.
2. Find mentors (and become a mentor). Seek mentors to help you grow in different aspects of your career. Not only does this expand your network and help you gain exposure to diverse perspectives, it also diffuses the demand on others’ time. Dr. Tedga recalled: “One of my mentors helped me negotiate my salary as a first-time attending physician. Another helped me navigate my role as a mother in a demanding fellowship. I carved out a niche that nurtured and celebrated the evolving multifaceted woman that I am. These wins built my confidence and equipped me to mentor others in return.” She added: “Just remember that successful leaders are approached by lots of students, and they may not have time for everyone. Be mindful of that, but don’t be shy: Build your network of male and female mentors. And then pay it forward to others.”
3. Don’t limit yourself. Approach your career with the assumption that no doors are closed to you. Go into it with your eyes open, but don’t let expectations limit you. If women start out their careers under the assumption that being a woman physician comes with insurmountable obstacles, it can be self-fulfilling. And remember that you don’t have to choose between a high-powered career and raising a family — you can do both.
4. Stay grounded. Dr. Tedga took the lead on this one: “To be grounded means you have the ability to remain unruffled and connect to your core identity in the face of adversity. More than ever before, it is important to protect your mental and emotional space from surrounding antagonism. Personally, I have found great refuge in my relationship with God, and would not have traversed multiple obstacles without it. Figure out what keeps you going when things fall apart, and then stick to that.”