Ahead of Us Nothing Has Changed

IF YOU ARE A SENIOR PROFESSIONAL woman inmedicine—and I will define "senior" as

someone over 45—you are in a unique posi-tion. You have had to make your way withoutthe help or examples of women before you. Butyou have been in that position for all of yourprofessional life, as I have. After 30 years ofbeing a professional and 20 in the field ofobstetrics and gynecology, I have made severalobservations regarding gender disparity. Themost obvious one for me is that women whoare older and more experienced than I am

cannot be found. It simply is not possible tomanufacture out of thin air qualified womenwho were not around before, though we

greatly need them. Unfortunately, I do nothold much hope for the future, because thepath ahead of us looks much the same.

Because of my intense emphasis on wom-

en's health issues, I often find myself in groupsthat are either predominantly male or female,but rarely mixed. Frequently, I am with groupsof women who are doing interesting work andperforming interesting tasks. I am thrilled bytheir thinking and their advances. I am sure theworld is changing, but then I am allowed tofantasize for only so long. Next I attend amedical meeting of the movers and shakers inobstetrics and gynecology. There are 400 men

and only 20 women at the meeting. Althoughthis particular meeting is not my whole profes-sion, much of what happens there is symbolicof it. This particular meeting is held the firstweek of our children's school year. It is held ata fancy resort where the registration fees are

separate from the room charge. So youngwomen with family responsibilities who can-not bring their families and who cannot justify

the room rate for just themselves find that theymust stay at cheaper accommodations awayfrom the meeting. The meeting takes place in aresort area, where summery clothes are pre-scribed by the weather, but suits are requiredby the arrogant ambiance of the meeting. Theparticipants' wives are all there. They are listedin the program by their first names only. Tra-dition has it that they are to be quietly presentin the back of the room when their husbandsgive their presentations. On the other hand, itis clear that the women participants cannot asktheir male partners to take off time from workto come to this meeting. Further, there are fewolder, more experienced women in the societyfor the younger women to identify with, andagain they cannot be produced out of thin air.For these women, my society has demon-strated no understanding of their needs andhas done little to encourage even their atten-dance at the meeting, much less their advance-ment in the field.

Who are these people? They are the men ofmy profession. They have worked hard anddeserve recognition and our respect, but theydo not know how to make their female stu-dents and colleagues welcome. They havebeen shielded from the need to change by a

society that has rules and traditions. Realisti-cally, if women want to get into a society, theymust abide by its rules. Unfortunately, in mycase, I have not always understood when join-ing a group was important and when it wasnot. Therefore, I must rely on the advice ofothers, and, as I have said, in obstetrics andgynecology my powerful colleagues are over-

whelmingly male. Although I will listen to theolder men, I now rely more on input from

many young men. If a young man tells me it isimportant to be in the organization, I accept iton face value. I do not argue, even if for the lifeof me I cannot understand it. This is because Ihave learned that young men still see andvalue the important symbols of our profession.

I have said that behind me the profession haschanged some, but ahead of me, nothing isdifferent. From time to time, I am lulled into a

sense of change, because my daily work re-

quires me to focus on the younger profes-sional. In reality, however, medicine is stillvery much an old boys' network. And if theyoung men say that I must still be vigilant for

their sake, I can only assume that I must alsopay even more attention for the young women.All of our young colleagues deserve our ad-vice, encouragement, and respect, but nonemore so than our young women students anddoctors. My field, as with all the medical spe-cialties, must find a way to promote morewomen to visible leadership positions. Untilthat happens—and in real numbers—eachgeneration of women entering medicine is leftwith precious few role models and mentors to

help them advance in their careers.

Florence Haseltine, Ph.D., M.D.