Bouncing up: women in academic medicine

By | September 15, 2016

women doctorsDelivering the Olga M. Jonasson Lecture at the 101st Annual Clinical Congress of the American College of Surgeons in Chicago, IL in October 2015, Dr. Julie Ann Freischlag noted how difficult it is for women to break down barriers in many fields, especially in academic medicine.

But Dr. Freischlag is no ordinary woman.

Throughout her career, she was the “lone woman in a sea of suits.” In medical school, although she intended to be a pediatrician, during one hospital rotation she “fell in love with surgery,” a very demanding specialty. While interviewing at UCLA for residency, she suddenly became aware of being “the only woman in a crowd of 40 to 50 men in black suits.” She matched at UCLA, but not UCSF — because Dr. Paul Ebert, the then Chairman of the Department of Surgery at UCSF would not accept women into his program.

She was the sixth woman to finish the general surgery program at UCLA and the second female vascular surgery fellow. Upon graduation from her fellowship in 1987, she became the first woman surgery faculty member at UC San Diego. There, she had a memorable discussion with the supply man in charge of the operating room. He would not order size 5½ gloves for her, which she needed because of her small hands. She told him there was no way she could make her hands bigger. He finally backed down and ordered the 5½ size gloves that both she and many female nurses also wanted.

In 1989, she was recruited back to UCLA as the first woman surgery faculty member and chief of vascular surgery at Wadsworth VA medical center. In 1992, she was recruited by the Medical College of Wisconsin, where she became the first woman surgeon to be an associate and full professor there. She returned to UCLA in 1998 to become the first woman division chief. In 1993, she became the chair of surgery at Johns Hopkins, the first woman to hold that title there and also 1 of only 5 female chairs of surgery until that point. (There are now 10 women serving as chairs of surgery in the US.) After 11 years at Hopkins, she became Vice Chancellor of Human Health Sciences and Dean of the School of Medicine at the University of California, Davis.

Dr. Olga Jonasson was also an outsider. She did her residency in surgery at the University of Illinois Research and Education Hospital and a fellowship in transplantation immunobiology at the Massachusetts General Hospital of Harvard Medical School. For two decades, from 1967 to 1987, she developed one of the first clinical transplantation services in Illinois. In 1987, she became the first woman in the United States to chair the department of surgery at The Ohio State University.

Gender disparities pervade the healthcare workforce. According to the Rock Health Report, women make up 78% of the healthcare labor force; they comprise 48% of medical school graduates, 70% of medical & health services managers, and 19% of hospital CEOs. They lead a mere 4% of healthcare organizations and none among the Fortune 500 healthcare companies.

Dr. Freischlag suggested that in the presence of persistent conscious or unconscious bias and of stereotype bias, we should push back by being resilient. Resilience is the ability to “bounce back” from any sort of undesirable life disruption or change—be it a loss of job or a loved one. The Latin phrase per ardua surgo expresses it well: “I rise through adversity.”

Resilience is also a leadership trait. No one thought Dr. Freischlag would last long as Chair of the department of Surgery at Johns Hopkins. A few months after she took office there, the previous Chair gathered many of the division chiefs at his secluded home in Martha’s Vineyard to scheme on how to make her fail. Janice Clemens, the Vice Dean for Faculty — to whom she reported she did not fit in — turned out to be her savior. Dr. Clemens told Dr. Freischlag that she had been hired to be different and to not fit in, but to lead.

Dr. Freischlag thus drew deep, deciding to stay the course of leadership at Johns Hopkins and ended up lasting 11 long years. The experience changed her, and she in turn changed the culture of Johns Hopkins to make it more inclusive and fair. A new culture of transparency and teamwork, of kindness toward each other and toward patients, was created.

Resilience can also be built by taking chances. Dr. Freischlag suggests that women need to be encouraged to take on leadership roles and give each other a shot. “Giving chances to others and taking our own chances help us all bounce up. Giving chances demonstrates our humanity, and taking chances enhances our resilience and improves our ability to achieve our dreams,” she wrote.

By promoting diversity and inclusion, we enable all people to reach their full potentials. Hopefully through inclusion and diversity, we can improve our healthcare system, the care of patients, and by the same token, our society.

Nghia Vo

Nghia M. Vo, MD was trained as a surgeon in Hartford, Connecticut. He then completed a fellowship in Critical Care at New York Medical College. He now works as a Scientific Review Officer at the Agency for Healthcare Research and Quality (AHRQ). His previous research interests include portal hemodynamics and endothelial-seeded vascular grafts. His present focus is on healthcare research. Disclaimer: The views expressed are those of the author and do not necessarily reflect those of the Agency for Healthcare Research and Quality.

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About Nghia Vo

Nghia M. Vo, MD was trained as a surgeon in Hartford, Connecticut. He then completed a fellowship in Critical Care at New York Medical College. He now works as a Scientific Review Officer at the Agency for Healthcare Research and Quality (AHRQ). His previous research interests include portal hemodynamics and endothelial-seeded vascular grafts. His present focus is on healthcare research. Disclaimer: The views expressed are those of the author and do not necessarily reflect those of the Agency for Healthcare Research and Quality.