Introduction

“Each time a woman stands up for herself, she stands up for all women.” —Maya Angelou 

On any given day, a doctor wakes up with the intention of furthering education and saving lives. Americans frequently rank “physician” as one of the most grueling and demanding jobs in America [1]. Doctors are under constant pressure to provide the best solutions and protection to the patients under their care. Our doctors keep us alive. On average, doctors work about 1.5 times more hours per week than other Americans [2]. Such a mentally and physically exhausting job has a wide range of challenges and takes a special person to be up for it. However, there is one big challenge in the world of medicine that affects a large subset of doctors and is rarely talked about. It has nothing to do with the type of work being done. That is the challenge of being a woman in the medical field. 

The first recognized physician emerged in the third millennium BCE in ancient Egypt. His name was Imhotep. In 1849, nearly five thousand years later, Elizabeth Blackwell became the first woman to earn a medical degree in the United States. By definition, Blackwell was a pioneer, blazing a bright trail for future female medical doctors. A strong advocate for women in medicine, Blackwell campaigned tirelessly for women’s rights and established several institutions dedicated to educating female medical students. 

As extraordinary as her success in the medical field was, it certainly was not easy for Blackwell to obtain the education she so desperately wanted. She was rejected from multiple medical schools, leaving Geneva Medical College (now Hobart and William Smith Colleges) as her only option. Her acceptance was put to vote among the 150 male students; if even one had voted “no,” she would not have been accepted. After a unanimous vote, Elizabeth Blackwell was permitted to enroll. Her perseverance paid off. She successfully stood up for her right to an education. 

Since Blackwell’s challenging breakthrough into the medical world, millions of women have followed in her footsteps to achieve medical licenses. In 2019, women comprised 50.5% of all students enrolled in medical school [3]. Success in numbers, however, does not overshadow the bias that women fight against daily in the workplace. Though female physicians go to work each day and treat patients, the same way that a male doctor would, they must overcome the obstacle of discrimination. Gender discrimination in the medical field rears its ugly head in many different ways. 

Motherhood 

As Dr.Katherine Chretien, author of the book Mothers in Medicine, pointed out in an interview, “Female doctors are forced to recognize the barriers for women to progress and promotion.”Arguably the biggest barrier is how female doctors pay the price for having a family. The professionalism of female doctors is put into question when women choose to become mothers. They are looked at as less productive and there is a heavy bias against those who might not be able to attend after-hours meetings because they have kids to take care of. Having other responsibilities is severely looked down upon. It is not difficult to see the differences in the ways that men and women discuss their promotions, their family roles, and their work in general. 

There is no doubt that motherhood and maternity leave will affect a woman’s career given the necessary time off, shifting priorities, and additional responsibilities. Motherhood may inspire some female physicians to reconsider their priorities in terms of personal and career goals [4]. Maternity leave is extremely stressful for new mothers in the medical field. Depending on where they work, their career might suffer greatly from the extended time off. Many women, especially if they are single, can’t afford to take the leave due to the economic impact that comes with taking an extended leave from work. The stressful situation, paired with pressure and judgment from colleagues, employers, and patients contributes to why female physicians often feel disadvantaged in the workplace. According to Dr. Koo, “when women become pregnant and take leave, everyone has an opinion about it — whether they say it or not.” 

Upon having children, many women find that the expectations they had for themselves are heightened and they begin to feel burdened with chasing an unrealistic standard. As a result, female doctors often find it difficult to balance maternal responsibilities and work, which prompts them to feel guilty, question their mothering, and even look into part-time work. Though a great number of women practice medicine full-time, according to a JAMA survey, a majority eventually want to shorten their hours or switch to part-time work [5]. The JAMA survey found that only 4% of male doctors worked part-time compared to 23% of female doctors. “Among doctors with children, 31% of females and 5% of males worked part-time. [Further], 64% of full-time female doctors have considered moving to part-time status, while only 21% of full-time male doctors have weighed the same option.” As the survey shows, many female doctors chose to work part-time hours to balance work and familial obligations [5]. 

These issues extend beyond the medical profession. Many professional women feel torn between work and home life, feeling as if they can’t effectively engage fully in either one. Indeed, “about half of working mothers say they’ve needed to reduce their work hours… or that they felt like they couldn’t give 100% at work” [6]. Unsurprisingly, in fields that have long been male-dominated, it would be difficult for male co-workers and employers to entirely appreciate the struggle of being a working mother. 

In addition to the career costs that come with being a mother, female doctors confront several stigmas after they have children. The “motherhood penalty” is a term that refers to the disadvantages that mothers face in the workplace. Research from the Women and Public Policy Program at the Harvard Kennedy School concludes that “mothers suffer a penalty relative to non-mothers and men in the form of lower perceived competence and commitment” [7]. They also deal with soaring expectations, lower chances of hiring and promotion, and decreased yearly pay. On top of that, 50% of employed mothers, compared with 39% of employed fathers say that being a working parent makes it more difficult for them to advance in their careers [6]. Women in the medical field feel discouraged from becoming parents. 

As Dr. Qaali Hussein, an accomplished trauma surgeon and mother of six, recounted in a Twitter thread, “With each pregnancy, I was told to pursue more ‘family-friendly fields’ since my ‘priorities had changed.’” [8]. In addition to the unfair assumption about what is important to female physicians entering motherhood, people often stereotype their emotions. Spiked hormones are a well-known side effect of pregnancy and motherhood in general. However, these emotions are too often used against female doctors to convince them they are too emotional to tend to patients. Although emotions may occasionally run high, it would be unjustified to assume that every mother’s emotions would get in the way of her effectively doing her job. It is also a common mistake to assume that after childbirth, a woman has gone soft and will no longer be able to devote enough time and energy to being a doctor.

In addition to stereotypes regarding emotions, many presume that doctors who are also mothers are distracted by their children and unable to focus completely on their work. They are criticized for not giving 100% of their attention to either area and “female doctors are more likely than their male peers to shift to part-time work or stop working a few years after completing their medical training.” [9]. These assumptions about mothers in the medical field are harmful and often hold women back; “69% of working Americans say working moms are more likely to be passed up for a new job than other employees” [10]. Even more telling, “mothers were six times less likely than childless women and 3.35 times less likely than childless men to be recommended for hire” [7]. 

However, not having children doesn’t always eliminate gender-based discrimination since many married (and even unmarried) women are seen as a risk to employers. Even with no plans to have children, female doctors are often viewed in light of their potential to become mothers. Essentially, you’re damned if you do, and you’re damned if you don’t. Just as damaging as stereotypes about female doctors in the workplace are the stigmas regarding their home lives. Rather than condemning female doctors and surgeons for their flagging work ethic after childbirth, some proactively offer an opinion as to how female doctors are performing as parents. 

Many people disapprove of working mothers in general for not giving 100% of their time and attention to their children. Being a doctor is a demanding job and those who don’t take part-time work are often extremely busy and have to make difficult choices concerning how and where they spend their time. Ann Boulis and Jerry Jacobs, who reported on the evolution of women in the medical field, stated that women have entered a profession designed for the “male bread-winner and the stay-at-home spouse” [11]. Female doctors and mothers are accused of working so much to avoid household chores or because they don’t want to take care of their children, whereas male doctors who are fathers are seen as providers and good dads for working so hard to support their children. 

This double standard is frustrating to those who work hard to support their families and yet are seen as bad mothers. Female doctors who are new parents begin to doubt their abilities to successfully care for children as well as excel in their field. This doubt can cause female doctors to hold themselves back and even stop engaging because they begin to question their capabilities in both areas of life. Female doctors are seen as unreliable because on average, they see fewer patients, don’t work as many hours, and are more likely to leave medicine sooner. Consequently, they earn less money than their male counterparts [11]. 

Promotions

A significant example of the inequality between male and female physicians presents itself in the pay gap. In addition to female doctors acknowledging that they have to argue for the pay they deserve, a 2019 study showed that male primary care physicians earned 25% more than their female counterparts. This means that “the average male doctor made $258,000 per year, while the average female physician earned $207,000.” In England, a BBC survey revealed that of the top 100 highest-paid doctors, only five were women. Between specialists, the gap is much larger but has since decreased “from 36% in 2018 to 22% in 2019. The average male specialist’s salary is now $372,000 compared to female specialists’ $280,000 [12].  Out of the most popular specialty choices for female residents, dermatology is the only one ranking in the top 10 highest-paying specialties [13]. 

When it comes time to choose specialties in the medical world, women are usually drawn to a few specific areas for several reasons and factors. The most frequently chosen specialties among women are obstetrics and gynecology (83.4%), pediatrics (72.1%), and dermatology (60.8%), while men tend to lean toward orthopedic surgery (84.6%), neurological surgery (82.5%), and radiology (73.2%) [13]. Women with children generally often prefer OB-GYN or pediatrics because they offer more flexibility with hours and doctors can have more say in their schedules. Women often stress about the balance they would have to maintain between their medical careers and their families, which is why it’s unsurprising that a female doctor with children would choose a specialty in which she has a say in her schedule and could work part-time [11]. 

OB-GYN is a field that is more flexible and allows women to take leave and shorter hours when necessary. Women in the medical field are often criticized for a perceived lack of professionalism after having children; female doctors are told they are too soft or not serious enough to be doctors. In these specific specialties, “the inherent characteristics that a woman brings to the medical career, such as compassion, empathy, warm communication, and amiability” are potentially very helpful and even encouraged [11]. 

Women in the medical field constantly have to prove themselves to everyone around them. Most new mothers may start to look into specific areas of medicine they feel comfortable managing, rather than pushing themselves to tackle more demanding specialties. Could being pushed into certain “less-stress” specialties have harmful effects on a female doctor’s career? Female physicians can’t ignore that “women do not achieve promotions or advancement to leadership positions at the same rate as their male peers,” they’re less likely to procure individual grants and leadership positions and in academic medicine, women encounter more difficulty finding mentors and sponsors than men do [14]. 

Sources list family as the main reason why “almost 40% of women physicians scale back their medical practice, or leave the profession altogether, early in their careers” [15]. Though there are men and female physicians alike who have families, the data indicates that more women than men are scaling back their careers. Being a doctor is a hard enough job without the added strain of having to endure opportunity-limiting gender-based discrimination. 

Stereotypes 

Many myths uphold the pretense that women do not deserve to be paid as much as men. According to a survey, 76% of female physicians feel that unconscious employer discrimination is the reason for their male counterparts earning more money than they do [16]. These harmful stereotypes often have a domino effect, limiting female physicians in many ways. If a woman believes she is too emotional or not dedicated enough to her work, it might make her less likely to ask for a raise or sufficient pay. Since most employer discrimination is unconscious, there would be no way to close this gap if women didn’t feel that they could advocate for equal pay. The double standards that exist in this profession are astounding. 

These baseless assumptions regarding the inherent limitations of female physicians not only confine women’s opportunities in the medical field but also their capacity for growth and confidence in their skills and talents as doctors. Ultimately, this could be damaging to the patients under their care, who require a doctor with self-confidence in their capabilities. “In recent years, most medical graduates have been women” [17]. 

Given all they’ve traditionally endured and the challenges they continue to face, don’t they deserve to be paid at least as much as their male counterparts? Additionally, many defend the wage gap because women don’t work as many hours as men. However, a study conducted by Malgorzata Skaznik-Wikiel, a reproductive endocrinologist, found that even though it’s more likely for women to practice fewer than five days per week, the differences in the number of hours they spend working are not significant [18].  

Another myth that purportedly explains this wage gap is that women don’t need larger salaries because they have men in their lives who earn more and can take care of them. This is false, as researchers at The University of Texas at Austin estimated that “more than 75% of American mothers will find themselves the sole or principal financial support for their households at some point during their first 18 years of motherhood” [19]. Another argument against equal pay is that women don’t work as hard, long, or efficiently as men do. Again, this couldn’t be more inaccurate, especially in the medical field. Male and female doctors alike have to lift heavy patients, be exposed to toxic radiation and chemicals, and be in close contact with communicable diseases. 

It’s also highly likely that this pay gap directly results from how long it took for women to break their way into the medical field. It’s the deep-rooted prejudice that not only inspires others to view women as incompetent but causes women to doubt themselves and buy into the myth that they aren’t capable of excelling in their jobs. A female physician who participated in a wage-gap survey remarked that “the culture is changing but there is still an old boy’s club mentality in medicine that is occasionally difficult to break into” [16].  Discrimination like this is dangerous because it could push women to resent the job and dislike going to work every day. Research suggests that female doctors provide an unparalleled level of care to patients and make them feel comfortable.

“One study of over 1.5 million Medicare patients found that those who were treated by a female physician were less likely to die or be readmitted to the hospital within 30 days than those patients treated by a male physician” [20]. This is most likely attributable to the fact that female physicians tend to bring additional perspectives on how to approach problems and focus more on preventive care, being proactive rather than reactive. Practices like these provide a better chance of survival for their patients, making a female perspective crucial in a field where lives are often at stake. 

However, nobody wants to work in a hostile work environment or feel disrespected in their profession. The blatant discrimination against female doctors at work could be a driving force in a woman’s decision not to pursue medicine or stay in a job where she is devalued. Most female doctors have reported incidents of obvious discrimination, sexist behavior, insubordination, retaliation, and even sexual harassment. “Only 12% of women reported having never dealt with some form of sexual harassment versus 38% of men” [21]. With this mistreatment, it’s no wonder that female physicians feel unsafe or averse to staying at their jobs.

Given the abundant evidence suggesting that female physicians provide patient care that is at least as good as that provided by male doctors, why are people so reluctant to bet on female doctors? Historical beliefs of inferiority are most likely the reason that women in the medical field are not taken as seriously nor as valued as they deserve to be. Again, it is also the double standard applied to female and male behavior. Specifically, a female physician in charge of others may be seen as pushy or bossy when they take authority, whereas male physicians with higher roles are more respected. 

Conclusion

“If society will not admit of woman’s free development, then society must be remodeled.” ―Elizabeth Blackwell

Without some necessary steps toward gender equality, the medical field may lose more and more valuable perspectives. Stereotypes and long-outdated expectations of women’s role in society are holding female physicians back and causing them to doubt their abilities. Gender discrimination in a field where the focus should be on saving lives is diverting physicians’ attention away from their patients to prejudice in the workplace. Equality shouldn’t be seen as a threat, or as a form of increased competition, but as a goal to strive for to better the medical field as a whole. With equal opportunity, there will be a greater number of capable doctors who will be there for their patients. Many improvements are still needed to make gender equality in the medical field a reality. 

The inflexible and often hostile nature of the workplace for mothers and mothers-to-be makes many women feel as if they need to choose between their families and their careers. Many female doctors struggle with intense guilt over not being able to dedicate enough of themselves to either, leaving them stretched paper-thin and struggling to meet the demands of work life and home life. There is clear underrepresentation in certain specialties that have historically been less accommodating of families and approximately half of all female doctors shorten their work hours or leave medicine altogether within the first few years after residency [15]. Judgment, both internal and external, can be a driving force in this decision to leave work and focus on their families. Male physicians do not seem to have the same pressure to be caregivers. 

The wage gap, though it has narrowed in recent years, remains one of the most obvious signs of gender discrimination in the medical field. Women are illogically paid less than men for the same job and must fight harder for the equal salaries they deserve. Historically, society has supported the notion that a man should be the sole breadwinner for his family; however, today more working women than ever before provide for their families and depend on equal compensation. It shouldn’t be harder to get paid than it is to do your job. There needs to be a change. 

Workplace discrimination takes a number of shapes and forms, and they are all harmful. Whether it’s blatant harassment or more subtle, the effects of sexism in the medical field will always be disadvantageous to both the women affected and to the practice as a whole. Eventually, gender bias will cause too much strain and make the job seem not worth the trouble. Though it may seem harmless, prejudice in the medical field is more serious than many realize as excellent talent is lost. 

As evidenced by the many barriers female physicians have broken through, it’s clear that women are more than capable of achieving equal success in the field when compared to their male counterparts. There is power in diversity and the medical field would suffer greatly without a female perspective. Gender bias is draining and tough to deal with. This discrimination is dangerous because not only do female doctors begin to doubt themselves and buy into these sexist ideas, these antiquated notions continue to wield power. 

To realize full equality in the workplace, it’s time to stop closing doors for female physicians, to embrace their varied and valuable perspectives, and to give each one the support she deserves to realize her potential for greatness.