Women Surgeons — Still in a Male-Dominated World

ARTS & HUMANITIES

Julie A. Freischlag, MD

The William Stewart Halsted Professor; Chair, Department of Surgery; Surgeon-in-Chief, The Johns Hopkins Hospital, Baltimore, Maryland

“There are two ways to live My career path led me to taking on your life. One is as though leadership roles as Chief of Vascular Sur - nothing is a miracle. The other is gery at the West Los Angeles VA, Chief of as though everything is a miracle.” Surgery at Zablocki VA Medical Center in — Albert Einstein Milwaukee, Chief of Vascular Surgery at My approach, as I reflect on the 32 years UCLA, and currently Chair of Surgery at since I first began medical school at Rush in Johns Hopkins, Baltimore. Chicago, has been according to the second Initially in one’s career, one wants to part of Einstein’s quotation. It has always do it all, accomplish much in a short time, seemed a bit of a miracle to see my patients and for women in surgery, I think we can survive incredible ordeals, to have my family blaze ahead and just do it. It is like most and friends continue to support me and my surgical emergencies — get the data, make occupational choices, and to have my career the diagnosis, and go for it. It is our nature. take a frequently serendipitous path. Monica McGrath describes this as the first I went to college with the goal of be - phase of women’s careers, not only in med - coming a high school biology teacher, but icine or surgery. the education program had closed because In the middle portion of our careers, of a glut of students who wanted to be we obtain a symbiosis with work and life teachers. So my love of science led me to accomplishments. Perhaps it is because we the pre-med program. then have families and need space and time In medical school, my ambition was to to be many places, seemingly at once. Life become a pediatrician. However, I did my can get complicated with divorce, health is - surgery clerkship first, just to get it out of the sues, child issues, and parent issues, yet way because I was convinced I wouldn’t most women find this to be part of what we like it. need (must? want?) to do. That clerkship changed everything. I McGrath describes a third phase — went to UCLA to train to be the best aca - sort of where I am now — that asks, “Now demic vascular surgeon. what?” Inner meaning is essential to

To whom all correspondence should be addressed: Julie A. Freischlag, MD, The William Stewart Halsted Professor; Chair, Department of Surgery; Surgeon-in-Chief, The Johns Hopkins Hospital, Johns Hopkins Medical Insitutions, 720 Rutland Avenue, Ross 759, Bal - timore, MD 21205; Tele: 443-287-3497; Fax: 443-287-3500; E-mail: [email protected]. 203 204 Frieschlag: Women surgeons

women’s careers all along the way. Perhaps Surgery programs today are attracting for men’s, too, but men do not usually talk about one-third women. We need to do bet - about it as vibrantly as women. ter. In these three phases of career devel - Most professions change when more opment, what women see as obstacles and than a third of their constituents become dif - concerns change, too. ferent in nature — age, ethnicity, gender, or In 1980, when I entered General Sur - other background. However, in order to at - gery, three women were in my intern class tract more women to surgery and see a and the first woman Chief Resident fin - change, we need to actively pursue it. ished at UCLA. However, women were in Over the past 25 years, the increase in the minority in the field. the number of women in surgery has fol - In one particular interview, the Chair lowed a natural selection process of sorts. I said in his remarks, “Gentleman and, uh, love Darwin and find his observations fas - one lady,” when he saw me sitting in the cinating. However, I feel now we need to audience in a green dress. alter the environment and actively make At that time, I did not care what the raising the number of women in surgery one ratio or odds were. I just wanted to be a sur - of our priorities. geon so badly that I forged ahead. Years How should one do that? later, I found out that at one place I inter - Women faculty members and partners viewed they had removed all women from should be asked what they want and need to their rank list — including me. progress in their careers and practices to I was the sixth woman to finish General make them enjoyable, tolerable, and Surgery at UCLA in 1986, the second durable. Most women need and want flexi - woman vascular fellow there in 1987, the bility and can tell you how they want to fourth woman to receive her vascular work their day. We, as leaders, should not boards, the first woman faculty on staff at react as if their requests are not appropriate, UCSD in 1987 and UCLA in 1989, and the condemn their requests, or talk about them only woman in the country serving as a Vas - among others. The environment must be cular Surgery Division Chief from 1998 to made more amenable for women. 2003. We also need to actively recruit female I was told by one Dean who inter - medical students into residency programs viewed me for his Department Chair of Sur - and subsequently into our departments or gery that he just couldn’t give that surgery practices. Only then will the numbers in - job to a woman. And he didn’t. That was in crease. 2002. And lastly, we must provide avenues I am now one of only three women De - and opportunities so the women we work partment Chairs in Surgery in the country — with can lead. We cannot rely on serendipity and one of only six ever. to increase the number of women in surgery The field of surgery is still male domi - or the number of women who will lead. nated. Medical school enrollments, on the There are those who feel only a miracle other hand, are 50 percent women. When I will allow women to reach their equal repre - began my career, the percentage was 15 to sentation, not only in surgery but in other 20 percent. My class at Rush was 42 percent fields such as politics and business. women, which was unusual. Norma Wag - But we create our own miracles with a oner, PhD, Dean of Students, was a mar - bit of help from our leaders. And our leaders velous recruiter of women. are you and me.