Ask women in radiology about their profession, and you are likely to hear rave reviews, some of which are contrary to popular perceptions about the field. These women talk about positive interactions with patients and colleagues, as well as intellectual stimulation that is not as scientifically daunting as some would believe. They also talk about having more control over their schedules, and about how technology, such as teleradiology, can provide even more flexibility.
Knowing this information, many in the industry wonder why more women do not enter the field of radiology. Although the number of female radiologists has increased since many of today’s female leaders first entered the profession, the statistics do not mirror the number of those in the medical field at large. The challenges faced by women in radiology?such as balancing work, family, and personal needs?are hurdles faced by women in medicine in general, as well as other demanding professions, so these cannot be the major deterrents.
Members of medical associations have gathered statistics that illuminate the problem and are studying ways to reverse it. How can more women be drawn into radiology, and how can they succeed? We spoke to several leading women in the field?and one man (it is an equal-opportunity world, after all)?to gather opinions on the topic.
Simple Stats
Looking first at the research, Kimberly E. Applegate, MD, pediatric radiologist at the Riley Hospital for Children (Indianapolis) and associate professor of radiology at the Indiana University School of Medicine (Indianapolis), summarizes the situation. “There are now an equal number of women and men in American medical schools,” she writes. “The 2003 entering medical school class was comprised of, on average, 50% women and 50% men. Yet only 25% of diagnostic radiology and radiation oncology residents are women. The proportion of women radiology residents has remained stable for approximately 15 years, despite the rapid increase in women in medical school in general.”1
According to James P. Borgstede, MD, FACR, chair of the American College of Radiology (ACR of Reston, Va) Board of Chancellors, “The number [of women entering radiology] is not as high as we would like. We want our fair share. Women bring unique perspectives and are a large segment of the medical student population. If [the radiology field is] not attracting them, we are missing out on bringing the best and brightest into the field.”
Breaking Misperceptions
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| Valerie Jackson, MD, finds the field of radiology to be fun and has never regretted choosing the profession. |
The question then becomes, “Why doesn’t radiology attract more women?” Valerie Jackson, MD, John A. Campbell professor and chairman of radiology at Indiana University School of Medicine, found consistent misperceptions about the field in her discussions with students. “There is the impression that those in radiology have little contact with patients. The misperception exists that radiologists sit alone in a dark room and talk into a box. This is not true. Students also perceive the field as being too ?techy.’ Some even worry about exposure to radiation being a large risk factor,” says Jackson, who dismisses the concern as “nonsense.”
But the misperceptions persist. Jackson believes they could be corrected by early exposure to the field. “In many schools, students are not exposed to radiology until the fourth year, when, really, it’s too late,” she explains. “In programs where they start radiology in the first year, you see a higher proportion of women choosing the field.” She believes that the early exposure allows students to see that radiology does have interaction with patients and colleagues, and is fun.
Jackson chose radiology as her specialty precisely because she found it fun. After narrowing her options to radiology or pathology, the latter of which was her father’s specialty, she opted for radiology. “My field is constantly changing, and there is always something to learn. I have never regretted selecting radiology,” she says.
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| Sarah Donaldson, MD, admits that there are issues regarding the balancing act of professional and family life. |
Sarah Donaldson, MD, Catharine and Howard Avery professor and associate chair of radiation oncology at the Stanford Cancer Center, Stanford School of Medicine (Stanford, Calif), shares Jackson’s passion but also admits that she had some of those false impressions about the field at first. “I thought you had to be a physics genius or a computer nerd to succeed in the field, and I didn’t think I had the skill set,” she says. “But a mentor suggested that it would be a good field for me. When I asked him about having to know physics, he replied, ?You’ll have a good physicist.’ And it’s true. First and foremost, I need to be a good clinician and be able to interact with patients and other experts. My focus is making people better using radiation. The patients are extremely grateful, and the work is extraordinarily rewarding.”
Success through Mentorship
Having had a positive mentoring experience, Donaldson feels that mentors are invaluable in that they provide tips, strategies, and other aids for success. But she knows from experience that a mentor does not need to be of a specific gender or even someone in the same field. Her mentor was a male cancer surgeon.
Jackson agrees, as she also had male mentors. “My mentors were men because that was who was ahead of me,” she says, referring to those under whom she studied and worked.
Robyn Birdwell, MD, section head of breast imaging at Brigham & Women’s Hospital (Boston), also had male mentors. “It’s difficult to find female mentors,” she notes. “I don’t know if it is because there aren’t enough women around or that women in the field have so much on their plates that there is no extra time to mentor.”
Some members of the radiology community feel that having female mentors could be one key to inspiring more women to enter the field. But this leads to a chicken/egg issue, as ACR’s Borgstede points out. “The associations can provide aggressive encouragement of women in the field to help promote it,” he says. Mentorship programs might be one way, but Birdwell warns that it’s difficult to force a relationship. “Sometimes, they work wonderfully,” she says. “Other times, they fizzle.”
Balancing Acts
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Mentors can provide advice on how to tackle some inherent challenges of radiology. Many women today, whatever their role, are more concerned about quality of life than equality at work. Many don’t feel discriminated against, either in opportunity or pay, though they do feel that they must meet higher expectations. “The woman is typically the primary caregiver, so women must be wives and mothers and professionals. Women in science also have to be scientists. We have to wear multiple hats at the same time, and we have to be really good because there are more expectations. We can’t slack off,” Donaldson explains.
Although some studies indicate that discrimination might exist, the experts included here say that they’ve seen more and more women entering radiology and moving up the ranks over the years; they add that few have experienced any direct discrimination.
“I belong to AHRA [American Healthcare Radiology Administrators of Sudbury, Mass], and its membership was mostly male 15 years ago,” says Georgia Hitzke, VP of clinical and product management at Hologic Inc (Bedford, Mass). “Now, it’s mostly female.”
Elizabeth McFarland, MD, body and 3-D imager at the Center of Diagnostic Imaging and St Louis Hospital as well as adjunct professor of radiology at the Mallinckrodt Institute of Radiology, Washington University (St Louis), notes that the same is true in academia, where she has seen an increase in women promoted to leadership positions.
All of this progress doesn’t mean that the challenges of the field have disappeared. Concerns of the first executive committee of the American Association of Women Radiologists (AAWR of Houston) in 1982 included some key issues still being tackled today: maternity, quality of life, promotions, and development of professional skills (negotiation, publication, and presentation).
Whether and when to have children remains an issue that many try to manage with careful planning and advantageous timing. For some, this process works. Hitzke, who started in the field as a technologist and moved into the corporate segment, had a child early in her career, when she was able to stay home on nights and weekends. Now, her child is grown, and Hitzke is able to devote more time to a job that requires a lot of travel. However, for some, efforts at good timing are fruitless, particularly for physicians. “There always will be issues regarding balancing a professional life with a family life,” Donaldson says.
This doesn’t mean that women need to forego having a family. The experts included here have families, and, although they find it challenging to balance everything, they are happy to do it.
Working Smart
Fortunately, technology can help. Advances like teleradiology enable a radiologist’s schedule to be more variable, and email helps everyone by saving time and increasing flexibility. But McFarland warns that such technology?specifically teleradiology?can be a double-edged sword. “We need to counterbalance a physical presence and professionalism in medicine with this flexibility,” she says. “We don’t want the radiologist’s role to become marginalized and isolated.”
It’s also important to stay on top of the technology. “I’ve always made it a goal to learn the new technologies,” says Hitzke, who believes it contributes to background knowledge and outside perception. “A woman does really have to show, more so than a man, what her abilities are and what she can do.”
Still, women radiologists have an advantage that is not shared in the corporate world: a severe staffing shortage. If one environment doesn’t work, other opportunities can be found. More women are working part-time, which allows them to meet familial obligations while keeping up with the field. Donaldson warns, however, that job-sharers often end up contributing more than the expected 50%. “People ask more, and you give more. But it’s worthwhile to not lose professional momentum. If you drop out in a technically demanding profession, you can fall behind quickly,” she notes.
But again, the shortage can prove advantageous. “Sure, people with their own ideas or agendas will hire based on inappropriate criteria, but I have no examples of this behavior,” Borgstede says. “People are well aware of the staffing shortage, and it would be foolish to turn someone away because of gender.” Indeed.
Wren Davis is a contributing writer for Medical Imaging.
References
- Knepper K, Donaldson SS. Women in Radiation Oncology and Radiation Physics. In: Gagliardi RA, Wilson JF, eds. A History of the Radiological Sciences. Reston, Va: Radiology Centennial Inc; 1996:231?262.
Marie Curie: First Among Many
Marie Sklodowska Curie (1867?1934), perhaps the world’s most well-known female scientist, is best remembered for winning two Nobel Prizes, discovering radium, and dying from exposure to the substance that she spent her life studying. However, she also managed an impressive (though less-publicized) series of “firsts” that contributed to her legacy. Born in Poland on November 7, 1867, Marie Sklodowska moved to Paris at age 24, where she became the first woman in Europe to obtain doctorates in physics and math. In 1894, she met Pierre Curie, who became her husband and research partner. The two had a string of successes, but tragedy ended their collaboration when Pierre was killed in a carriage accident in spring 1906. Marie Curie, now a single mother of two young daughters, balanced parenting with an inspiring career that attracted international acclaim.
In addition to her groundbreaking doctorates, Curie was:
Marie’s daughter Irene followed her parents into science. Marie and Irene worked together during World War I, driving radiologic cars (X-ray?equipped cars that Marie donated to the Army) to the front to train personnel and care for the wounded. From 1916 to 1918, the two trained 150 technicians at the Radium Institute, the foundation of which was organized primarily by Marie. In 1935, Irene and her husband were awarded the Nobel Prize in chemistry, making the Curie women the first mother and daughter to both become Nobel Prize Laureates. Marie was not the first to die as a result of her exposure to radiation?she died July 5, 1934, of leukemia?but she still achieved a notable first in death, becoming the first woman to be interred in the Pantheon for her own achievements. |
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A Review of Women in Radiology
1887Nikola Tesla investigates X-rays, eventuallydeveloping the single-electrode X-ray tube. 1890sElizabeth Fleischmann, one of the earliest US radiographers, performs a fluoroscopic examination.1 1895Wilhelm Conrad R?ntgen details his discovery of X-rays in his preliminary report, “On a New Kind of Ray: A Preliminary Communication.” 1897Marie and Pierre Curie discover radium and polonium, named for Marie’s native country, Poland.
1898May Cushman Rice becomes the first woman to teach radiographic technique or therapy in the United States when she starts teaching at the Illinois School of Electrotherapeutics.1 1901R?ntgen wins the first Nobel Prize in Physics for his discovery of X-rays.
1902Florence Ada Stoney, MD, founds the X-ray department at the Royal Free Hospital (London). In 1877, the facility was England’s first general hospital to permit the clinical instruction of women physicians.2
1903Marie Sklodowska Curie and her husband, Pierre Curie, win the Nobel Prize in Physics for their research in radiation. She is the first woman to receive the award; it is shared with Antoine Henri Becquerel, who is recognized for his discovery of radioactivity. 1906Following the death of her husband, Marie Curie becomes the first woman professor at the Sorbonne. 1911Curie wins her second Nobel Prize, this one in Chemistry, for the discovery and research on radium and polonium. She is the first person to be honored with a Nobel twice.
1912?13Anabelle Davenport teaches roentgenology at the University of California, San Francisco. She is the first radiologist at the school; however, despite a long tenure, she never rises past the post of clinical instructor.2 1915Stoney becomes the first woman physician to be accepted for full-time work under the War Office when she is appointed head of the X-ray department at Fulham Military Hospital (London).2
1917 The Medical Women’s National Association founds American Women’s Hospitals (AWH) to organize a means for women to serve. Unable to be commissioned officers, women served as contract physicians, with 31 registered or “known to be doing X-ray work.”2
1918?19Photographed in her lab with a patient, Gisela von Poswik, MD, is the first woman physician to own her own X-ray equipment, part of the private practice she establishes at this time.2 Born in Germany, she was trained in the United States.
Ruth Ingraham, MD, is a radiologist at the first AWH in 1918. One year later, she returns to Brooklyn Hospital. It’s possible she was the first woman to head a radiology department in the United States.2
1921 Melson Barfield-Carter, MD, becomes the first woman radiology resident at Massachusetts General Hospital (Boston). The supervising physician was upset to learn that “M. Barfield” was a woman, a misunderstanding that spurs mandatory personal interviews.2 Two years later, Barfield-Carter becomes the first woman medical professor at the University of Alabama at Birmingham.2
1931Radiobiologist Anna Goldfeder comes to the United States, where “she develops methods for culturing human breast cancer cells, breeds a strain of mice with no naturally recurring tumors, researches the effectiveness of different radiation doses, and demonstrates the necessity for shielding during treatment.”2
1934 Von Poswik is “one of four women in the first group of radiologists to become certified by the American Board of Radiology.”2
1935 The American Radium Society elects Zoe Allison Johnston, MD, as its first woman president.2 She also will serve as president of the Pittsburgh Roentgen Society, the Pennsylvania Radiological Society, the American Medical Women’s Association, and the Allegheny County Medical Society.2
1954Edith Hinkley Quimby is the second woman and first nonphysician elected as president of the American Radium Society.2 Quimby published the Quimby Data Tables in the 1930s and co-authored The Physical Foundations of Radiology.
1956 Carye-Belle Henle, MD, is the only woman radiologist in New Jersey. Later, she is elected the first female president of the New Jersey Radiological Society.2
1974Vera Peters graces the cover of Cancer Research in recognition of her pioneering work in the treatment of breast cancer and Hodgkin’s disease.3 1982 The first executive committee of American Association of Women Radiologists (AAWR of Houston) meets to discuss issues facing women in the field.
1987 Lucy Frank Squire, MD, receives the AAWR’s first Marie Curie Award for a distinguished career that includes leading work in radiologic education.3 Images courtesy of Radiology Centennial Inc ? 1993 American College of Radiology Timeline References:
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