with Dr. Kathyrn Hill
The average quota for women medical students between the years of 1918-1941 was five percent. Because of this five percent quota, 507 women sent 833 applications to medical schools in the United States in 1933. In 1941, however, 636 women filed 2,283 applications for admission to medical school.3 It was obvious by this time that women's entry into medical school was not hindered by their inability to meet the increasing admissions requirement, but was blocked by those who controlled the system of medical education. Thus, although a five percent quota was in effect, women encountered many barriers when trying to enter medical school.
If women were fortunate enough to gain entry into, and subsequently graduate from medical school, they then were presented with the additional obstacle of competing for the limited internship positions available to women. During the 1930’s, an average of 250 women medical graduates faced the arduous task of competing for 185 internships open to women. During this same period, 4,844 male medical graduates could choose from 6,154 internship opportunities available to them. In 1941, only 105 of 712 AMA-approved internship hospitals even accepted applications from women.4
An extraneous problem could, however, cause these barriers to be lowered. Problems such as war and/or man-power shortages were) in some respects, actually advantageous to women physicians. For example, the number of hospitals accepting women interns increased by 400% from 105 in 1941, to 463 at the end of 1942.5 The reason for this increase, in fact, can be explained by the dwindling number of male interns due to the patriotic cause of military duty.
Another effect the absence of men during the war produced upon women had to do with their entry into medical school. As barriers were grudgingly lowered, the number of women entering medical training steadily increased from 5.4% in 1941, to 8.0% in 1945.6 Therefore, World War II provided women with a new set of opportunities within the medical profession.
Women physicians also possessed the desire to be of professional service to our country during World War II. Public Law 252, enacted on September 22, 1941, "authorized the president to make temporary appointments of ‘qualified persons’ as officers
in the U.S. Army."7 Acting upon this law, members of the American Medical Women’s Association requested to be commissioned in either the U.S. Army or Navy. Their requests for appointments were promptly rejected. The women physicians were told that "when the words ‘person or persons’ were used in the law, only a man or men were intended."8 They were also informed that if, by chance, women physicians were needed, they would be employed on a contract basis. Thus, they would not receive commission with the rank of an officer, the privilege of wearing a military uniform, or the chance for promotion within the armed services. Along with the denial of numerous benefits, contracted women physicians would also receive a lower salary and a lower status than commissioned physicians. As a result, women physicians were eager to serve their country, yet unwilling to accept a lower status in relationship to their male counterparts.9
In an effort to gain commission into the service, the angered members of the American Medical Women’s Association launched a major campaign aimed at overturning the ruling pertaining to Public Law 252. Their persistence eventually was rewarded on April 16, 1943, when President Roosevelt signed into law the Sparkman-Johnson Bill which enabled women to enter the Army and Navy Medical Corps.10
Dr. Elizabeth H. Hewkins wrote in the New York Times after the war, "The girls who riveted and welded ... have returned to their peace-time-pursuits, but women doctors who took the place of men and worked long hours ... have come into their own. They have arrived, they are wanted, and their position is at last secure."11 In fact, however, women physicians’ position was less than secure.
As easily as the barriers were lowered during the war, they were once again raised after the war, if not to their original height, at least to a height great enough to remain an obstacle. For example, in 1945, women physicians were removed from hospital staffs to make room for the returning veterans. Thus, the medical establishment took swift action to reverse the gains women physicians in the medical profession had enjoyed during the war years. "By the fall of 1946, a full-page advertisement (complete) with protests from leading women doctors appeared in the New York Herald Tribune under the caption: ‘Doctors Wanted: No Women Need Apply.'"13
A similar trend is evident in the percentage of women medical students in the pre-war and post-war periods. Statistically speaking, "The peak year for women coincided with the year when the male student supply was at (its) lowest ebb. After the war, the downward trend continued so that by 1955 the low point had been reached, which was 5.3% in 1954."14
Regarding women’s careers in medicine, the period from 1949 to approximately 1960 has been called the "era of hostility."15 Women physicians faced several problems, such as hostility, downgrading, and isolation from their professional colleagues.16 The rationale behind the animosity expressed by their male medical colleagues can be explained by an examination of the traditional attitudes of men toward women physicians at this time. One complaint male physicians voiced was that women, after obtaining their advanced degree, would either not practice medicine, or would dropout while in medical school and/or during their professional career. In fact, however, most research revealed that between 84%
and 93% of the women practiced medicine after graduation.17
On the other hand, the drop-out rate of women medical students or those in active practice was actually slightly higher than their male counterparts. For instance, the withdraw rate for female medical students during 1950-1958, vacillated between 10.3% and 18.7%. The figures for male medical students were somewhat lower, 6.4% to 10.2% during this time period.18 Throughout their medical careers, women physicians careers, women physicians tended to drop-out of active practice an average of 4.8 years during the childbearing portion of their life, as compared to 2.l years for male physicians. The addition of other facts, however, serve as a justification for this gap between male and female physicians. Men tended to terminate their medical careers much sooner than women. While 84.6% of the male doctors retired by age sixty, only 50% of the women retired by this age. Since the female life cycle is longer than the males, women physicians were more apt to work longer towards the end of their life cycle. Thus, it may be argued that female doctors could have been more productive than male physicians over the course of their entire life span.19 Regardless of who works longer, the statistics indicate that "both the proportion of women who withdrew and the duration of their interruptions have decreased over the years."20
Of course, also during 1945-1960 the general attitude of the traditional male doctor was that a woman’s place was in the home, not in the career world, or more specifically the hospital. These attitudes were created by the existence of our patriarchal society and its accompanying expectations of the roles of women in marriage and family life.21 In order for a woman to have a career,
she was forced to find a workable plan that combined family duties and professional duties. Men’s general attitudes during this period were, "If she (a female physician) is married and childless she is frustrated, or if she raises a family, she is neglecting her practice."22 A 1957 questionnaire concerning the role of women in medicine that was answered by male physicians brought forth several responses such as, "'Women were created to be wives,'" and, "'(I’d) prefer a third-rate man to a first-rate woman doctor.'"23 Women physicians were also considered unrealiable workers by administrators, because in an emergency, family would invariable take priority over the job.24
Women physicians, not only during this particular time, but throughout history have had to cope with the difficulties associated with multiple role conflict. As Elizabeth Blackwell stated, "Managing a medical career and a home requires the ability to get organized and stay organized without becoming bogged down in detail. A woman must decide what is most important to each role, and then use her time and energy to accomplish these essentials."25 These thoughts were not exclusive to Dr. Blackwell’s time either. Women physicians from 1945-1960 also faced the dilemma of holding two jobs, one at work and another one at home. Commenting on the multiple role conflict they encountered, women doctors of this time angrily wrote, "Only when the institution of wifehood in its present form is either abolished or made available to doctors of both sexes will women physicians be able to do as much as their male colleagues."26
Although the period when professors addressed the classes
as gentlemen only had been transcended by 1945, numerous obstacles still remained to be met by women physicians until 1960.27 External barriers included, discrimination throughout their schooling, lack of financial, emotional, and psychological support, lack of female role models, and lack of patronage or sponsorship within the medical professi within the medical profession.28 Internal barriers, on the other hand, included the multiple role conflict a woman doctor experienced while trying to juggle her roles as wife, mother, and physician. Looking back over the endless obstacles women encountered in the medical profession from 1945-1960, it is no wonder only eight percent of the doctors in the United States today are women.29 Elizabeth Blackwell once stated, "The study of human nature by women as well as men commences that new and hopeful era of the intelligent co-operation of the sexes through which alone real progress can be attained and secured."30 We can only hope that one day Dr. Blackwell’s ideology will become a truism in the realm of medical reality.
ENDNOTES FOR BACKGROUND INFORMATION