Agnessa Gadeliya’s idealism drew her to medicine, along with the mental stimulation she derives from diagnosing diseases.
Gadeliya also sees a practical benefit to becoming a physician: It has increasingly become an attractive career for someone who wants to balance home and family life.
“If I ever have kids, of course I’ll work part time,” said Gadeliya, a third-year medical student at the University of Colorado School of Medicine.
In 2003, the medical profession turned a corner. The Washington, D.C.-based Association of American Medical Colleges reported that for the first time more women than men applied for admission to U.S. medical schools.
The following year, the percent of female applicants held steady at 50.4 percent. At the University of Colorado, female applicants outnumbered males in 2000 and 2001 but fell slightly below half in 2002, 2003 and 2004.
Women make up 20 percent to 30 percent of all doctors. Their presence has influenced the practice of medicine, the structure of work and salaries.
“It’s a wonderful career for women because there is so much diversity in what you can do,” said Maureen Garrity, the CU School of Medicine’s associate dean for medical student admissions. That opinion defies traditional notions of medicine as an all-consuming calling.
“Women are starting to figure out you can do it and still have families and a personal life.”
Women surgeons scarce
J.J. Stroh grew up as the daughter of a Colorado Springs veterinarian and views her future job in family medicine in the tradition of lifelong relationships.
“You’re taking care of the entire family, from birth to old age,” said the 30-year-old family medicine resident.
Stroh is typical of female physicians. According to the Association of American Medical Colleges, females outnumber or equal male residents in less procedure-oriented, more nurturing primary care specialties such as pediatrics, psychiatry and family medicine.
Women also are drawn toward dermatology and emergency medicine because set hours in those specialties allow for a personal life. Obstetrics and gynecology also are popular with women because many patients demand a female doctor. But women remain scarce in other surgical fields.
Danielle Haakinson, 28, a first-year medical student, plans on a career in emergency medicine “because it is sort of shift work,” she said.
In 2004, 68 percent of pediatric residents were female. Women made up 51 percent of family medicine residents and 41 percent of internal medicine residents. Just 12 percent of neurosurgery residents and 5 percent of interventional cardiology residents were women.
Experts say resident work hours and a lack of mentors influence the gender trend. Surgical residencies demand a grueling 80-hour workweek and are timed just as female residents may want to start families.
“(Surgical specialties) have been slow to change their style and expectations of members around work hours and scheduling,” said Dr. Colleen Conry, vice chair of the family medicine department at CU. “It still is more of an old-boy culture.”
Conry is grateful the early days of women in medicine are over. When she started her studies 25 years ago, a Kansas City taxi cab driver refused to take her to medical school.
“He said, ‘You want the school of nursing,’ ” she recalls. “I said, ‘No, I want the school of medicine.’ He dropped me off at the school of nursing.”
Today, the medical industry has come to value what traditionally are regarded as female qualities of empathy and good listening, experts say.
Research shows female doctors spend more time with patients, ask more personal questions and do a better job getting patients to agree to treatment.
No studies exist, but malpractice experts believe women get sued less as a result.
“We think that communication has something to do with your likelihood of having a lawsuit in the event of a bad outcome,” said Dr. Richard Quinn, a physician risk manager with COPIC Insurance Co. “It’s sort of self-evident. The nature of the female in dealing with traumatic events is more of a nurturing type of approach, and we certainly recommend it.”
Part-time trend causes alarm
A shift in medicine over the last few decades from private to group practice, including health maintenance organizations, has aided women in medicine. Group practice enables doctors to share responsibilities and have more opportunities to work part time or to otherwise arrange family-friendly schedules.
Kaiser Permanente employs 267 female doctors, and 61 percent work part time. Of Kaiser’s 440 male physician employees, 18 percent work part time.
“We totally support the life-work balance,” said Jacque Murphy Montgomery, a Kaiser spokeswoman. “It’s actually a recruiting strategy.”
Yet the popularity of part-time work is causing some alarm. Various studies have pointed to a physician shortage developing over the next 20 years, with the growth of part-time workers as one cause.
“Apples aren’t replacing apples as doctors are retiring,” said Kurt Mosley, a vice president of business development for the Irving, Texas-based MHA Group, a health care staffing company. “We have to have 11/2 or maybe two females to replace one retiring physician.”
Nonetheless, the physician shortage allows doctors to enjoy plenty of job opportunities.
While medicine isn’t the path to wealth that it once was, it remains a lucrative field.
According to an annual survey by the American Medical Group Association, in 2004 emergency medicine doctors earned $227,000 a year; family practice doctors, $166,000; and radiologists, $412,000.
Younger doctors seem less concerned about pay than previous generations did.
“I’m really not doing it for the money,” said Stroh, the family practice resident. “If I was, I would have picked another speciality.”
Despite advances in medical school applications, women continue to lag on medical school faculties.
According to the medical colleges association, only 15 percent of medical school faculty at the rank of full professor and 10 percent of deans are women.
A study at the University of Arizona found that female faculty members consistently earn about 11 percent less than their male counterparts, even after clinical productivity and research hours are factored in.
At the University of Colorado, just two out of 24 department chairs are women, and just 13 division and section heads – out of 56 divisions and sections – are women.
It takes 14 years to become a full professor, and some experts say women are just catching up.
“I still think the number of women in leadership positions is lower than what you would expect, given the denominator,” said Dr. Jean Kutner, division head of internal medicine at the University of Colorado, whose department includes more than 100 doctors who report to her.
“Because there are few women in leadership positions, there are few role models. There’re not many people out there where you’d say, ‘Yep, that’s the person I want to be when I grow up.’ “
Outside of academic medicine, the last bastion of resistance to young female doctors may be patients.
Stroh, doing a residency in Greeley, recalls more than once outlining a care plan to her patients.
“That’s fine,” patients would say, “but when is the real doctor coming in?”
“That would be me,” she replies.
INFOBOX
Medical specialties by pay and gender
Highest-paid specialties Pay Percent female
Neurosurgery $421,000 5 percent
Cardiac, thoracic surgery $417,000 3 percent
Diagnostic radiology $412,000 21 percent
Orthopedic surgery $354,000 4 percent Lowest-paid specialties Pay Percent female
Internal medicine $172,000 30 percent
Pediatrics $172,000 51 percent
Family practice $166,000 32 percent
Sources: American Medical Group Association; The American Medical Association
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