Women in medicine

Historically and presently, in many parts of the world, women's participation in the profession of medicine (as physicians or surgeons for instance) has been significantly discouraged. On the other hand, women's informal practice of medicine in roles such as caregivers, or as allied health professionals, has been widespread.

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Women in society

Most countries of the world now provide women with equal access to medical education. However, not all countries ensure equal employment opportunities,[1] and gender equality has yet to be achieved within medical specialties and around the world,[2] despite studies suggesting that female doctors may be providing higher-quality care than male doctors.[3][4]

Modern medicine
Wafaa El-Sadr is an Egyptian epidemiologist and MacArthur Fellow, who directs two programmes at Columbia University Mailman School of Public Health.
Monique Frize (centre) is a Canadian academic and biomedical engineer known for her expertise in medical instrumentation and decision support systems (DSS).
Awa Marie Coll-Seck is Senegal's former Minister of Health and an international public health expert, Executive Director of the Joint United Nations Programme on HIV/AIDS and the Roll Back Malaria Partnership.

In 1540, Henry VIII of England granted the charter for the Company of Barber-Surgeons;[5] while this led to the specialization of healthcare professions (i.e. surgeons and barbers), women were barred from professional practice.[6] Women did, however, continue to practice during this time. They continued to practice without formal training or recognition in England and eventually North America for the next several centuries.[6] Women's participation in the medical professions was generally limited by legal and social practices during the decades while medicine was professionalizing.[7] However, women openly practiced medicine in the allied health professions (nursing, midwifery, etc.), and throughout the nineteenth and twentieth centuries, women made significant gains in access to medical education and medical work through much of the world. These gains were sometimes tempered by setbacks; for instance, Mary Roth Walsh documented a decline in women physicians in the US in the first half of the twentieth century, such that there were fewer women physicians in 1950 than there were in 1900.[8] However, through the latter half of the twentieth century, women made gains generally across the board. In the United States, for instance, women were 9% of total US medical school enrollment in 1969; this had increased to 20% in 1976.[8] By 1985, women constituted 16% of practicing US physicians.[9]

At the beginning of the twenty-first century in industrialized nations, women have made significant gains, but have yet to achieve parity throughout the medical profession. Women have achieved parity in medical school in some industrialized countries, since 2003 forming the majority of the United States medical student body.[10] In 2007-2008, women accounted for 49% of medical school applicants and 48.3% of those accepted.[11] According to the Association of American Medical Colleges (AAMC) 48.3% (16,838) of medical degrees awarded in the US in 2009-10 were earned by women, an increase from 26.8% in 1982-3.[11] While more women are taking part in the medical field, a 2013-2014 study reported that there are significantly fewer women in leadership positions within the academic realm of medicine. This study found that women accounted for 16% of deans, 21% of the professors, and 38% of faculty, as compared to their male counterparts.[12]

However, the practice of medicine remains disproportionately male overall. In industrialized nations, the recent parity in gender of medical students has not yet trickled into parity in practice. In many developing nations, neither medical school nor practice approach gender parity.

Moreover, there are skews within the medical profession: some medical specialties, such as surgery, are significantly male-dominated,[13] while other specialties are significantly female-dominated, or are becoming so. In the United States, female physicians outnumber male physicians in pediatrics and female residents outnumber male residents in family medicine, obstetrics and gynecology, pathology, and psychiatry.[14][15]

Women continue to dominate in nursing. In 2000, 94.6% of registered nurses in the United States were women.[16] In health care professions as a whole in the US, women numbered approximately 14.8 million, as of 2011.[17]

Biomedical research and academic medical professions—i.e., faculty at medical schools—are also disproportionately male. Research on this issue, called the "leaky pipeline" by the National Institutes of Health and other researchers, shows that while women have achieved parity with men in entering graduate school, a variety of discrimination causes them to drop out at each stage in the academic pipeline: graduate school, postdoc, faculty positions, achieving tenure; and, ultimately, in receiving recognition for groundbreaking work.[18][19][20][21] (See women in science for a broader discussion.)

Glass ceiling

The glass ceiling is used as a metaphor to convey the undefined obstacles that women and minorities face in the workplace.

Female physicians of the late nineteenth century faced discrimination in many forms due to the prevailing Victorian Era attitude that the ideal woman be demure, display a gentle demeanor, act submissively, and enjoy a perceived form of power that should be exercised over and from within the home. The predominant, conservative viewpoint was that a woman's primary duty was to be a steward of a moral world by shaping the character of her children and being a dutiful wife. This meant that few women chose to work outside of a few specific professions, if they worked outside of the home at all, and even fewer ventured into jobs outside of teaching and nursing, especially as doctors. Female physicians were still expected to defer to the expertise of their male colleagues and were often simply tolerated at best but more so scorned and ridiculed. Medical degrees were extremely difficult for women to earn, and once practicing, discrimination from landlords for medical offices, left female physicians to set up their practices on "Scab Row" or "bachelor's apartments."[22]

One study surveyed physician mothers and their physician daughters in order to analyze the effect that discrimination and harassment have on the individual and their career. This study included 84% of physician mothers that graduated medical school prior to 1970, with the majority of these physicians graduating in the 1950s and 1960s. The authors of this study stated that discrimination in the medical field persisted after the title VII discrimination legislation was passed in 1965.[23]

According to this study, one third of physician daughters reported experiencing a form of gender discrimination in medical school, field training, and the work environment. This study also stated that both generations equally experienced gender discrimination within their work environments.

This article provided an overview on the history of gender discrimination, claiming that gender initiated the systematic exclusion of women from medical schools. This was the case until 1970, when the National Organization for Women (NOW) filed a class action lawsuit against all medical schools in the United States.  More specifically, this lawsuit was successful in forcing medical schools to comply to the civil rights legislation. This success was seen by 1975 when the number of women in medicine had nearly tripled, and continued to grow as the years progressed. By 2005, over 25% of physicians and around 50% of medical school students were women. The increase of women in medicine also came with an increase of women identifying as a racial/ethnic minority, yet this population is still largely underrepresented in comparison to the general population of the medical field.[23]    Within this specific study, 22% of physician mothers and 24% of physician daughters identified themselves as being an ethnic minority. These women reported experiencing instances of exclusion from career opportunities as a result of their race and gender. 

In an article titled "I'm too used to it”: A longitudinal qualitative study of third year female medical students' experiences of gendered encounters in medical education," the author described how confidence in ability varies based upon gender. According to this article, females tend to have lessened confidence in their abilities as a doctor, yet their performance is equivalent to that of their male counterparts. This study also commented on the impact of power dynamics within medical school, which is established as a hierarchy that ultimately shapes the educational experience.[24]

Specifically, this article described how power dynamics led to the formation of a “hidden curriculum” in medical school, which revolves around understanding the contribution of gender roles in regards to being a female doctor. According to this article, this position holds females more accountable for their actions as a result of unrealistic expectations set forth by these gender roles, which expects female doctors to take on a nurturing and matronly persona when dealing with patients. The hidden curriculum, according to this article, is an integral aspect of a female's medical education that must be learned in order to tolerate instances of gender discrimination.

On the topic of power dynamics, another study commented on the nature of sexual harassment, stating that it was most commonly perpetrated within career training stages, by people in positions of power. According to this article, instances of sexual harassment attribute to the high attrition rates of females in the STEM fields.[25]

Another study describes sexual harassment as a growing problem due to the fact that it goes widely underreported, which is said to be caused by the transient nature of career training, alongside weak policies and the perpetrators holding positions of power over the victim.[24]

A 2019 study of Israeli female physicians in senior positions in the health system sought to understand the factors contributing to, or impeding, their success.  Some interviewees described themselves as "goal-oriented" and had either set themselves a target, or had adopted an active approach to achieve their positions.  Others said that they had progressed naturally from one position to another until they had arrived at their current place.  The interviewees acknowledged barriers and obstacles such as management of the work-home conflict, a lack of mentoring, a male workplace culture, lower salaries than the men received in comparable positions, and the difficulty of integrating academic activity into their work—but said that these did not interfere with their advancement.   They also identified positive factors that contributed to their success, including emotional and practical support at home, striving towards excellence at work, a position of command during military service, and the filling of organization-wide positions, which facilitated professional networking.   Working in academic or service delivery environments abroad and developing specific professional niches were also cited as factors contributing to their attainment of their leading positions.  Interviewees told stories of how they or their colleagues had experienced discrimination, yet they did not attribute great importance to these incidents or had not allowed them to stop them.  Finally, the interviewees were split on the question of affirmative action.  Some supported it, while others had reservations about it.  The latter group indicated a belief that changes in the balance of female representation in the system would come about naturally, given the increase in the rate of women among physicians.[26]

Women's contributions to medicine in the United States

American women have successfully provided the world with medical information not previously known. A few women who provided such knowledge were:

Helen Brooke Taussig: The First Female President of the American Heart Association

Helen Brooke Taussig was born on May 24, 1898, in Cambridge, Massachusetts. She is most commonly known as the first female president of the American Heart Association[27] Taussig was diagnosed with Dyslexia when she was young. Around the same time, her mother, Edith Guild Taussig (1861-1909) died.[27] Her father, Frank William Taussig (1859-1940), was an economist and educator in the United States. He was also known for creating the "Foundation of Modern Trade Theory". Taussig earned a A.B from University of California, Berkeley in 1921. In 1922 she applied at Harvard University's Medical School, and was denied. The University was not accepting women at the time. Instead she graduated from Johns Hopkins University School of Medicine in 1927. In her 30s, Taussig grew deaf.[28] In 1930, Taussig was appointed the Head of he Children's Hear Clinic at the Harriet Lane home, which was part of Johns Hopkins University. Due to her inability to hear, Taussig found an alternative method to studying the heartbeat in children by feeling the beat with her hands. This method lead her to discover "Blue Baby Syndrome",[29] which was termed so due to the cyanotic hue resembling babies who were thought to be ill. In 1947, a surgeon named Alfred Blalock teamed up with Taussig and wrote an article called "Congenital Malformations of the Heart," which explored their creation and alternative approach for a stunt-"Blalock-Taussig Shunt"- that would help circulate blood from the lungs to the heart. In the article it states, "The operation here reported and the studies leading thereto were undertaken with the conviction that even though the structure of the heart was grossly abnormal, in many instances it might be possible to alter the course of the circulation in such a manner as to lessen the 'cyanosis' and the resultant disability." (Read before the Johns Hopkins Medical Society, March 12, 1945.) Taussig received multiple awards after 1950. In 1954, Taussig received the Albert Lasker award, which is awarded for outstanding contributions to medicine. In 1959, Taussig was acknowledged for being one of the first women who received full professorship to Johns Hopkins University. In 1964, Taussig was awarded the medal of freedom from President Lyndon B. Johnson. Finally, in 1965, Taussig was known as the first women of the American Heart Association, for which she is so prominently known for. To further her interest in pediatrics, nearly a decade and a half later in the 1960s, Taussig remained to advocate for children's[30] health. She was "responsible for investigating the epidemic of serious congenital limb malformations". This investigation focused on European children and Taussig had a theory that the malformations were caused by the use of Thalidomide. She resolved this ongoing issue by persuading the Food and Drug Administration to discontinue the use and sale of Thalidomide in the U.S

Helen Flanders Dunbar: The "Mother" of Holistic Medicine

Helen Flanders Dunbar was born in Chicago on May 14, 1902, and Dunbar was the oldest child. Dunbar's mother, Edith Vaughn Flanders (1871-1963), was an Episcopalian clergyman's daughter as well as a professional Genealogist. Dunbar's father, Francis William Dunbar (1868-1939), was very much established as well due to his standing as an electrical engineer, as well as a patent attorney. In her early life, Dunbar's education was strictly limited to tutors and attending private schools. She graduated from Brearley School, which was located in New York City, in 1919, which lead to her enrollment in Bryn Mawr College. At this particular point in her life her interest in theology, philosophy, and medicine. Dunbar met James Henry Leuba at Bryn Mawr College, which sparked her interest due to his standing as a psychologist of religion at the college. In the summer of 1929, after successfully receiving a bachelor's degree in mathematics and psychology from Bryn Mawr, Dunbar continued her education by spending five weeks in Worcester, Massachusetts receiving clinical training. In 1927, Dunbar received a bachelor's degree as "Magna Cum Laude" from Union Theological Seminar. This achievement was awarded primarily due to her thesis, "Methods Training in the Devotional Life Emphasized in the American Churches".[30] Dunbar also won a travelling Fellowship due to this particular piece of writing. From 1931 until 1936, Dunbar held the position as director of Joint Committee of the New York City Religion and Health of the Federal Council and Churches of the Academy of Medicine. From 1943 until the year before she died, Dunbar wrote an assortment of books including: "Psychosomatic Diagnosis" in 1943, "Mind, Body: Psychosomatic Medicine"[30] in 1947, "Your Child's Mind and Body; A practical guide for parents" in 1949, and "Illness: the realization of an infant's fantasy with special reference to testing methods" in 1951. During the year of her death, Dunbar wrote "Accidents of Life Experience", "Basic aspects and applications of the psychology of safety", and "Psychiatry in medicine specialties".[30] Helen Flanders Dunbar died in 1959. She was found face down in her swimming pool.[31]

Midwifery in 18th century America

As per the documentary “A Midwife’s Tale”, historian of 18th century America, Laurel Thatcher Ulrich, follows the diary of Martha Ballard, which proves to be a telling source of women's roles as medical practitioners. Out of the different occupations women took on around this time, midwifery was the best paid of them all.[32] In the 18th century, households tended to have an abundance of children largely in part to have a helping hand in responsibilities and to combat high mortality rates.[33] Despite the high chance of complications in labor, Martha Ballard, specifically, had high success rates in delivering healthy babies to healthy mothers.[32]

Competition between midwifery and obstetrics

A shift from women midwifery to male obstetrics occurs in the growth of medical practices such as the founding of the American Medical Association.[34] Instead of assisting labor in the basis of an emergency, there were doctors such as Dr. Benjamin Page who wanted to take over the delivery of babies completely; putting midwifery second.[32] This is an example of the growing sense of competition between male physicians and female midwives as a rise in obstetrics took hold. The education of women on the basis of midwifery was stunted by both physicians and public-health reformers, driving midwifery to be seen as out of practice.[35] Societal roles also played a fact in the downfall of the practice in midwifery because women were unable to obtain the education needed for licensing and once married, women were to embrace a domestic lifestyle.[34]

History
Hildegard of Bingen, a Medieval German abbess who wrote Causae et Curae, a medical text.
Russian Empress Alexandra Feodorovna with Vera Gedroitz, 1915
Elizabeth Blackwell, MD, the first woman to graduate from medical school in the United States (1849).
Woman's Medical College of Pennsylvania in 1886: Anandibai Joshi, a Marathi Hindu from India (left) with Kei Okami, a Christian from Japan (center) and Sabat Islambooly, a Jewish woman from Syria (right). All three completed their medical studies and each of them was the first woman from their respective countries to obtain a degree in Western medicine.

Ancient medicine

The involvement of women in the field of medicine has been recorded in several early civilizations. An Egyptian of the Early Dynastic Period or Old Kingdom of Egypt, Merit-Ptah, described in an inscription as "chief physician", is the earliest woman named in the history of science. Agamede was cited by Homer as a healer in ancient Greece before the Trojan War. Agnodice was the first female physician to practice legally in 4th century BC Athens. Metrodora was a physician and generally regarded as the first medical writer. Her book, On the Diseases and Cures of Women, was the oldest medical book written by a female and was often referenced by many other female physicians. She credited much of her writings to the ideologies of Hippocrates.[36]

Pioneering women in ancient medicine
  • Peseshet (2500 BC), earliest cited female physician
  • Agamede, pre-Trojan War healer
  • Agnodike was the first female physician to practice legally in 4th century BC Athens.

Medieval Europe

During the Middle Ages, convents were an important place of education for women, and some of these communities provided opportunities for women to contribute to scholarly research. An example is the German abbess Hildegard of Bingen, whose prolific writings include treatments of various scientific subjects, including medicine, botany and natural history (c.1151-58).[37] She is considered Germany's first female physician.[38]

Women in the Middle Ages participated in many healing techniques and capacities. According to historical documents, small numbers of women occupied almost all ranks of medical personnel during the period.[39] They worked as herbalists, midwives, surgeons, barber-surgeons, nurses, and traditional empirics.[40] Women treated everyone, not only women as historians once thought. The names of 24 women described as surgeons in Naples between 1273 and 1410 are known, and references have been found to 15 women practitioners, most of them Jewish and none described as midwives, in Frankfurt between 1387 and 1497.[41] Women also engaged in midwifery and healing arts without leaving any trace of their activities in written records, and practiced in rural areas or where there was little access to medical care. Society in the Middle Ages limited women's role as physician. Once universities established faculties of medicine during the thirteenth century, women were excluded from advanced medical education.[39] Licensure began to require clerical vows for which women were ineligible, and healing as a profession became male dominated.[40] In many occasions, women had to fight against accusation of illegal practice done by males, putting into question their real motives. If they were not accused of malpractice, then women were considered "witches" by both clerical and civil authorities.[42] Because surgeons and barber-surgeons were often organized into guilds, they could hold out longer against the pressures of licensure. Like other guilds, a number of the barber-surgeon guilds allowed the daughters and wives of their members to take up membership in the guild, generally after the man's death. According to documents, Katherine la surgiene of London, daughter of Thomas the surgeon and sister of William the Surgeon belonged to a guild in 1286.[43] Documentation of female members in the guilds of Lincoln, Norwich, Dublin and York continue until late in the period. Midwives, those who assisted pregnant women through childbirth and some aftercare, included only women. Midwives constituted roughly one third of female medical practitioners.[40] Men did not involve themselves in women's medical care, likewise, women did not involve themselves in men's health care.[44] The southern Italian coastal town of Salerno was an important center of medical learning and practice in the 12th century. There, the physician Trota of Salerno gathered a number of her medical practices in several written collections. One work on women's medicine that was associated with her, the De curis mulierum ("On Treatments for Women") formed the core of what came to be known as the Trotula ensemble, a compendium of three texts that circulated throughout medieval Europe. Trota herself gained a reputation that spread as far as France and England. There are also references in the writings of other Salernitan physicians to the mulieres Salernitane ("Salernitan women"), which give some idea of local empirical practices.[45]

Dorotea Bucca was another distinguished Italian physician. She held a chair of philosophy and medicine at the University of Bologna for over forty years from 1390.[46][47][48][49] Other Italian women whose contributions in medicine have been recorded include Abella, Jacqueline Felice de Almania, Alessandra Giliani, Rebecca de Guarna, Margarita, Mercuriade (14th century), Constance Calenda, Clarice di Durisio (15th century), Constanza, Maria Incarnata and Thomasia de Mattio.[47][50]

Pioneering Women in Medieval Europe
  • Trota of Salerno 12th century physician who collected many of her empirical practices in writing. Part of her work was incorporated into the so-called Trotula compendium of writings on women's medicine and cosmetics.
  • Hildegard of Bingen (1098–1179) is considered Germany's first female physician. She conducted and published comprehensive studies of medicine and natural science.[38]

Medieval Islamic world

For the medieval Islamic world, little specific information is known about female medical practitioners although it is likely that women were regularly involved in medical practice in some capacity. Male medical writers refer to the presence of female practitioners (singular, ṭabība) in describing certain procedures or situations. For example, the late 10th/early 11th century Andalusi physician and surgeon al-Zahrawi, in explaining how to excise bladder stones, notes that the procedure is difficult for male doctors practicing on female patients: because of the need to touch the genitalia, the male practitioner must either find a female doctor who can perform the procedure, or a eunuch physician, or a midwife who takes instruction from the male surgeon. In other words, even though direct evidence for female practitioners is rare, their existence can be inferred.[51] As al-Zahrawi's example also suggests, midwives played an important role in the delivery of women's healthcare. For these practitioners, there is more detailed information, both in terms of the prestige of their craft (ibn Khaldun calls it a noble craft, "something necessary in civilization") and in terms of biographical information on historic women.[52][53] To date, no known medical treatise written by a woman in the medieval Islamic world has been identified.

Pioneering women in medieval Islamic world
  • Rufaida Al-Aslamia (7th century AD) Islamic medical and social worker recognized as the first female Muslim nurse

Western medicine in China

Traditional Chinese medicine based on the use of herbal medicine, acupuncture, massage and other forms of therapy has been practiced in China for thousands of years. However, Western Medicine was introduced to China in the 19th Century, mainly by medical missionaries sent from various Christian mission organizations, such as the London Missionary Society (Britain), the Methodist Church (Britain) and the Presbyterian Church (US). Benjamin Hobson (1816-1873), a medical missionary sent by the London Missionary Society in 1839, set up a highly successful Wai Ai Clinic (惠愛醫館) [54][55] in Guangzhou, China. The Hong Kong College of Medicine for Chinese (香港華人西醫書院) was founded in 1887 by the London Missionary Society, with its first graduate (in 1892) being Sun Yat-sen (孫中山). Sun later led the 1911 Xinhai Revolution, which changed China from an empire to a republic. The Hong Kong College of Medicine for Chinese was the forerunner of the School of Medicine of the University of Hong Kong, which started in 1911.

Due to the social custom that men and women should not be near to one another, women of China were reluctant to be treated by Western male doctors. This resulted in a tremendous need for female doctors. One of these was Sigourney Trask of the Methodist Episcopal Church, who set-up a hospital in Fuzhou during the mid-19th century. Trask also arranged for a local girl, Hü King Eng, to study medicine at Ohio Wesleyan Female College, with the intention that Hü would return to practise western medicine in Fuzhou. After graduation, Hü became the resident physician at Fuzhou's Woolston Memorial Hospital in 1899 and trained several female physicians.[56] Another female medical missionary Dr. Mary H. Fulton (1854-1927) [57] was sent by the Foreign Missions Board of the Presbyterian Church (USA) to found the first medical college for women in China. Known as the Hackett Medical College for Women (夏葛女子醫學院),[58][59][60][61] this College was located in Guangzhou, China, and was enabled by a large donation from Mr. Edward A. K. Hackett (1851-1916) of Indiana, US. The College was dedicated in 1902 and offered a four-year curriculum. By 1915, there were more than 60 students, mostly in residence. Most students became Christians, due to the influence of Dr. Fulton. The College was officially recognized, with its diplomas marked with the official stamp of the Guangdong provincial government. The College was aimed at the spreading of Christianity and modern medicine and the elevation of Chinese women's social status. The David Gregg Hospital for Women and Children (also known as Yuji Hospital 柔濟醫院) [62][63] was affiliated with this College. The graduates of this College included CHAU Lee-sun (周理信, 1890-1979) and WONG Yuen-hing (黃婉卿), both of whom graduated in the late 1910s and then practiced medicine in the hospitals in Guangdong province.

Early modern era

In the early modern era, following the Middle Ages, accuracy in documentation of women present in the health field increased. This increase in documentation gave a clear representation of women engaged in the healthcare of London residents.[64]

Historical women's medical schools

When women were routinely forbidden from medical school, they sought to form their own medical schools.

  • New England Female Medical College, Boston, founded in 1848.
  • Woman's Medical College of Pennsylvania (founded 1850 as Female Medical College of Pennsylvania)
  • London School of Medicine for Women (founded 1874 by Sophia Jex-Blake)
  • Edinburgh School of Medicine for Women (founded 1886 by Sophia Jex-Blake)
  • First Pavlov State Medical University of St. Petersburg (founded 1897 as Female Medical University)
  • Tokyo Women's Medical University (founded 1900 by Yoshioka Yayoi)
  • Hackett Medical College for Women, Guangzhou, China, founded in 1902 by Presbyterian Church (USA).

Historical hospitals with significant female involvement
  • Woman's Hospital of Philadelphia, founded in 1861, provided clinical experience for Woman's Medical College of Pennsylvania students
  • New England Hospital for Women and Children (now called Dimock Community Health Center), founded in 1862 by women doctors "for the exclusive use of women and children"[65]
  • New Hospital for Women (founded in the 1870s by Elizabeth Garrett Anderson and run largely by women, for women)
  • South London Hospital for Women and Children (founded 1912 by Eleanor Davies-Colley and Maud Chadburn; closed 1984; employed an all-woman staff)

Pioneering women in early modern medicine
18th century
  • Dorothea Erxleben (1715–1762), the first female doctor granted a M.D. in Germany.
19th century
  • Jennie Kidd Trout (April 21, 1841 – November 10, 1921) was the first woman in Canada to become a licensed medical doctor, in March 1875.
  • Lilian Welsh (1858–1938), first woman full professor at Goucher College.
  • Matilde Montoya (1859-1939), first female physician in Mexico, in 1887.[66]
  • Dolors Aleu i Riera (1857–1913), first female medical doctor from Spain, 1879.[67]
  • Annie Lowrie Alexander (1864–1929), first licensed female physician in the Southern United States[68]
  • Elizabeth Garrett Anderson (1836–1917), pioneering female doctor and feminist in Britain; co-founder of London School of Medicine for Women.
  • Lovisa Årberg (1801–1881), first female doctor and surgeon in Sweden.
  • Amalia Assur (1803–1889), first female dentist in Sweden and possibly Europe.
  • Alice Mary Barry (1880-1955), doctor and first women nominated fellow of the RCPI
  • Elizabeth Blackwell (1821–1910), first woman to graduate from medical school in the US; MD 1849, Geneva College, New York.
  • Madeleine Brès (1839–1925), the first French female MD [69]
  • Milica Šviglin Čavov (b. unknown, circa 1870s), the first Croatian female doctor.[70][71][72] She graduated from the Medical School in Zürich in 1893, but was not allowed to work in Croatia.[70]
  • Margaret Cleaves (1848–1917), pioneering doctor in the brachytherapy; M.D. 1873.
  • Irene Condachi (1899-1970), M.D. 1927, one of only two practicing female doctors in Malta during World War II.[73]
  • Rebecca Lee Crumpler, (8 February 1831 – 9 March 1895), first African American female physician in the United States, awarded her M.D. in 1864 by New England Female Medical College in Boston.
  • Jane Cummins (1899), DMRE, DTM&H and officer in the WRAF
  • Maria Cuțarida-Crătunescu (1857–1919) the first female doctor in Romania
Maria Cuțarida-Crătunescu, the first female doctor in Romania, 1857-1919. Stamp of Romania, 2007.
  • Bertha De Vriese (1877–1958), the first Belgian woman to obtain a medical degree from Ghent University.[74]
  • Eloísa Díaz (1866-1950), the first Chilean woman to graduate from Medicine in the Universidad de Chile. She graduated on December 27, 1886 and obtained her degree on January 3, 1887.
  • Marie Durocher (1809–1893), Brazilian obstetrician, midwife and physician. First female doctor in Americas.
  • Marie Equi (1872–1952), American doctor and activist for women's access to birth control and abortion.[75]
  • Anne Walter Fearn (1865-1938) Doctor in Shanghai, China, for almost 40 years.
  • Selma Feldbach (May 5, 1878 - April 2, 1924) was the first Estonian woman to become a medical doctor.[76][77][78]
  • Kadambini Ganguly (1861–1923), the first Indian woman to obtain a medical degree in India having graduated from the Calcutta Medical College in 1886.
  • Vera Gedroitz (1870–1932), the first professorix of surgery in the world
  • Ogino Ginko (1851-1913), first licensed and practicing female physician of western medicine in Japan.
  • Anastasia Golovina, also known as Anastassya Nikolau Berladsky-Golovina, and Atanasya Golovina (1850-1933), the first Bulgarian female doctor.[79][80]
  • Alice Hamilton (February 27, 1869 – September 22, 1970) was an American physician, research scientist, and author who is best known as a leading expert in the field of occupational health and a pioneer in the field of industrial toxicology. She was also the first woman appointed to the faculty of Harvard University. 
  • Mary Josephine Hannan (1865-1935), first Irishwoman to graduate LRCPI & SI and LM
  • Mary Hearn (1891-1969), gynaecologist and first women fellow of the RCPI
  • Rosina Heikel (1842 - 1929), the first female physician in Finland (1878), as well as the first in the Nordic countries, MD and feminist.
  • Matilde Hidalgo (1889–1974), the first Ecuadorian woman to have obtained a medical degree.
  • Frances Hoggan (1843–1927), first British woman to receive a doctorate in medicine (1870).
  • Johanna Hellman (1889 - 1982), was a German physician who specialized in surgery, and the first female to be a member of the German Society for Surgery.[81]
  • Marie Spångberg Holth (1865-1942), the first woman to graduate in medicine in Norway, which occurred in 1893, when she graduated from the Royal Frederiks University of Christiania.[82][83][84]
  • Ana Galvis Hotz (1855-1934), first Colombian woman, and from Latin America, to obtain a medical degree.
  • Elsie Inglis (1864–1917) Pioneering Scottish doctor and suffragist, born in India. MD Edinburgh School of Medicine for Women, worked at Rotunda Hospital, Dublin
  • Aletta Jacobs (1854-1929), first woman to complete a university course in the Netherlands, and the first Dutch female MD.
  • Ana Janer (b. unknown), one of the first four women from Puerto Rico to earn a medical degree; the other three were María Elisa Rivera Díaz in 1909, Palmira Gatell in 1910, and Dolores Piñero in 1913.[85][86][87] Ana Janer and María Elisa Rivera Díaz graduated in the same medical school class in 1909 and thus could both be considered the first female Puerto Rican physician.[88]
  • Sophia Jex-Blake (1840-1912), English physician, feminist and teacher.
  • Anandi Gopal Joshi (1865-1887), the first Indian woman to obtain a medical degree having graduated from the Woman's Medical College of Pennsylvania in 1886.
  • Eva Jellett (1868-1958), first women to graduate from Trinity College Dublin with a medical degree in 1905.
  • Bohuslava Kecková (1854-1911), first Bohemian (Czech) woman to obtain a medical degree in 1880 from University of Zurich.[89]
  • Sun Chau Lee (周理信, 1890-1979), one of the first female Chinese doctors of Western Medicine in China.[90]
  • Hope Bridges Adams Lehmann (1855-1916), first female general practitioner and gynecologist in Munich, Germany.
  • Draga Ljočić-Milošević (1855-1926), a feminist activist and the first female Serbian physician, a graduate of Zurich University in 1879 [91]
  • Karola Maier Milobar (born 1876), became the first female physician to practice in Croatia in 1906.[70][92][93]
  • Maria Montessori (1870–1952), one of the first female MDs in Italy; renowned educator
  • Hannah Myrick (1871–1973), helped to introduce the use of X-rays at the New England Hospital for Women and Children
  • Concepción Palacios Herrera (1893-1981), the first female physician in Nicaragua.[94]
  • Ernestina Paper (b. unknown, circa mid-1800s), first Italian woman to receive an advanced degree (in medicine), 1877.[95]
  • Edith Pechey-Phipson (1845–1908), pioneering English doctor in the India; MD 1877, University of Bern and Licentiate in Midwifery, 1877 Royal College of Physicians of Ireland.
  • Susan La Flesche Picotte (1865-1915), the first Native American woman to obtain a medical degree.
  • Ann Preston, (1813–1872), first female dean of any medical school.
  • Muthulakshmi Reddi (1886–1968), one of the early female medical doctors in India and a major social reformer.
  • Bertha E. Reynolds (1868-1961), among the first women licensed to practice medicine in Wisconsin, serving the rural communities of Lone Rock and Avoca.
  • María Elisa Rivera Díaz (b. 1887), one of the first four women from Puerto Rico to earn a medical degree (which she did in 1909); the other three were Ana Janer in 1909, Palmira Gatell in 1910, and Dolores Piñero in 1913.[85][86][87] María Elisa Rivera Díaz and Ana Janer graduated in the same medical school class in 1909 and thus could both be considered the first female Puerto Rican physician.[88]
  • Laura Esther Rodriguez Dulanto (1872–1919), the first Peruvian woman to have obtained a medical degree.
  • Andrea Evangelina Rodríguez Perozo (1879-1947), the first female medical school graduate in the Dominican Republic.[96]
  • Florence Sabin (1871-1953), the first woman elected to the US National Academy of Sciences.
  • Mary Scharlieb (1845-1930), pioneer British female physician.
  • Constance Stone (1856-1902), first woman to practice medicine in Australia.
  • Nadezhda Suslova (1843–1918), the first Russian female MD, a graduate of Zurich University[97]
  • Ah-hsin Tsai (1899-1990), colonial Taiwan's first female physician.[98][99]
  • Lucy Hobbs Taylor (1833–1910), the first female dentist in the United States.
  • Merbai Ardesir Vakil (1868 - 1941), Indian physician and the first Asian woman to graduate from a Scottish university.
  • Anna Petronella van Heerden (1887–1975), the first Afrikaner woman to qualify as a medical doctor.[100] Her thesis, which she obtained a doctorate on in 1923, was the first medical thesis written in Afrikaans.[101]
  • Emma K. Willits (1869–1965), believed to be only the third woman to specialize in surgery and the first to head a Department of General Surgery at Children's Hospital in San Francisco, 1921-1934.[102]
  • Yoshioka Yayoi (1871–1959), one of the first women to gain a medical degree in Japan; founded a medical school for women in 1900.
20th century
  • Dorothy Pantin (1896 -1985), was the first woman doctor and surgeon of the Isle of Man.
  • Safieh Ali (1900-1952), first Turkish woman to have obtained a medical degree.
  • Kornelija Sertić (b. unknown, circa 1900), the first woman to graduate from the Medical School in Zagreb, which occurred in 1923.[70][103][104]
  • Agnes Yewande Savage (1906-1964), the first woman in West Africa to qualify in medicine[105][106]
  • Henriette Bùi Quang Chiêu (1906-2012), first female doctor in Vietnam.[107][108]
  • Yvonne Sylvain (1907-1989), the first female doctor in Haiti.[109] She was the first woman accepted into the medical school of the University of Haiti, and earned her medical degree there in 1940.[109]
  • Virginia Apgar (1909–1974), significant work in anesthesiology and teratology; founded field of neonatology; first woman granted full professorship at Columbia University College of Physicians & Surgeons.
  • Isobel Addey Tate, one of the first women to die while serving as a doctor overseas during the First world war.
  • Elizabeth Abimbola Awoliyi (1910-1971), first female physician in Nigeria.[110]
  • Badri Teymourtash (1911–1989), the first Iranian female dentist, educated in Belgium.
  • Alma Dea Morani (1907-2001), the first woman admitted to the American Society of Plastic and Reconstructive Surgeons [111]
  • Margaret Allen, first female heart transplant surgeon in the USA - transplant performed in 1985 [112]
  • Jane Elizabeth Hodgson (1915–2006), pioneering provider of reproductive healthcare for women and advocate for women's rights.
  • Matilda J. Clerk (1916-1984), physician who was the first woman to obtain a postgraduate diploma in colonial Ghana and West Africa.[106]
  • Mary Malahele-Xakana (1917-1982), the first black woman to register as a medical doctor in South Africa (in 1947).[113]
  • Susan Gyankorama De-Graft Johnson (1917-1985), was the first woman to qualify as a physician in colonial Ghana.[106][114]
  • Salma Ismail (1918–2014), the first Malay woman to qualify as a doctor.[115]
  • Estela Gavidia (b. unknown, circa 1920), the first woman to graduate as a doctor in El Salvador, which occurred in 1945.[116][117]
  • Barbara Ross-Lee (b. 1942), first African American female dean of a U.S. medical school (1993), Ohio University College of Osteopathic Medicine.[118]
  • Rehana Kausar (b. mid-20th century), the first woman doctor from Azad Kashmir to graduate from Medical Schoo in Pakistan, which occurred in 1971.
  • Nancy Dickey (b. 1950), first female president of the American Medical Association
  • Madeline Nyamwanza-Makonese (b. unknown, mid-20th century), the first Zimbabwean female doctor, the second African woman to become a doctor, and the first African woman to graduate from the University of Rhodesia Medical School.
  • Nancy C. Andrews (b. 1958), first female Dean of a top ten medical school in the United States (2007), Duke University School of Medicine.
  • Clara Raquel Epstein (b. 1963), first Mexican-American woman U.S. trained and U.S. board certified in neurological surgery and youngest recipient of the prestigious Lifetime Achievement Award in Neurosurgery.[119][120][121]
  • Dr Pearl Dunlevy (13 August 1909 – 3 June 2002), physician and epidemiologist.
  • Prof. Ethna Gaffney was the first female RCSI Prof. of Chemistry
  • Tu Youyou (b.1930), first Chinese Nobel laureate in physiology or medicine and the first female citizen of the People's Republic of China to receive a Nobel Prize in any category (2015).
  • Esther Apuahe, first female surgeon in Papua New Guinea (2011).[122]

Women's health movement in the 1970s

The 1970s marked a great increase of women entering and graduating from medical school. From 1930 to 1970, a period of 40 years, about 14,000 women graduated from medical school. From 1970 to 1980, a period of 10 years, over 20,000 women graduated from medical school.[123] This increase of women in the medical field was due to both political and cultural changes.

Two laws in the United States lifted restrictions for women in the medical field -- Title IX of the Higher Education Act Amendments of 1972 and the Public Health Service Act of 1975, banning discrimination on grounds of gender. In November 1970, the Assembly of the Association of American Medical Colleges rallied for equal rights in the medical field.[124]

At the same time, women's ideas about themselves and their relation to the medical field were shifting due to the women's movement.

A sharp increase of women in the medical field led to developments in doctor patient relationships, changes in terminology and theory. One area of medical practice that was challenged and changed was gynecology. Wendy Kline [125] talks about the blurring of "clinical" and "sexual" that occurred in the medical field in the late 40s into the 60s, particularly in gynecology. Kline says that "to ensure that young brides were ready for the wedding night, they [doctors] used the pelvic exam as a form of sex instruction ."[126] In Ellen Frankfort's book Vaginal Politics, Frankfort talks about the "shame" and "humiliation" felt during a pap test; "I was naked, he was dressed; I was lying down, he was standing up; I was quiet, he was giving orders "[127]

With higher numbers of women enrolled in medical school, medical practices like gynecology were challenged and changed. One medical student is quoted in Kline's book as saying, "Since I experienced my own exams as a humiliating procedure, I feared inflicting the same humiliation on another person."[128] In 1972 the University of Iowa Medical School instituted a new training program for pelvic and breast examinations. Students would act both as the doctor and the patient, allowing each student to understand the procedure and create a more gentle, respectful examination. This method was quite different from the previous practice in which doctors were taught to assert their power over patients. With changes in ideologies and practices throughout the 70s, by 1980 over 75 schools had adopted this new method.[129]

With women entering the medical field and women's rights movements came also the women's health movement which sought alternative methods of health care for women. This came through the creation of self-help books, most notably Our Bodies, Ourselves: A Book by and for Women.[130] This book gave women a "manual" to help understand their body. It challenged hospital treatment, and doctors' practices. Aside from self-help books, many help centres were opened: birth centres run by midwives, safe abortion centres, and classes for educating women on their bodies, all with the aim of providing non-judgmental, warm, and comfortable care for women.[131] Kline speaks to this claim women were taking on their body in relation to the medical world; women felt that "not only should women have access to information about their bodies... they should also help to create this knowledge."[132] The women's health movement, along with women involved in the medical field, opened the doors for research and awareness for female illness like breast cancer and cervical cancer.

The small island nation of Tuvalu in 2008 welcomed its first Tuvaluan female doctors as a result of Australian aid.

[133]

While scholars in the history of medicine had developed some study of women in the field—biographies of pioneering women physicians were common prior to the 1960s—the study of women in medicine took particular root with the advent of the women's movement in the 1960s, and in conjunction with the women's health movement. Two publications in 1973 were critical in establishing the women's health movement and scholarship about women in medicine: First, the publication of Our Bodies, Ourselves in 1973 by the Boston Women's Health Collective,[134] and second, "Witches, Midwives, and Nurses: A History of Female Healers", a short paper by Barbara Ehrenreich and Deirdre English also in 1973.[7] The Ehrenreich/English paper examined the history of women in medicine as the professionalization of the field excluded women, particularly midwives, from the practice. Ehrenreich and English later expanded the work into a full-length book, For Her Own Good, which connected the exclusion of women from the practice of medicine to sexist medical practices; this text and Our Bodies, Ourselves became key texts in the women's health movement. The English/Ehrenreich text laid out some early insights about the professionalization of medicine and the exclusion of women from the profession, and numerous scholars, such as Diana Elizabeth Long, have greatly built upon and expanded this work.

See also

Biographies
  • Laurel Thatcher Ulrich, A Midwife's Tale: The Life of Martha Ballard Based on Her Diary, 1785-1812 (1991)
  • Rebecca Wojahn, Dr. Kate: Angel on Snowshoes (1956)

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