ALAN WEBER: After the pioneering efforts of 19th century American and European women to pry open the doors of the elite medical schools, more and more schools began to open their doors to women, and the number of female medical students rose dramatically by the end of the 19th century. But the early part of the 20th century was a period of stagnation and backlash for women physicians. The precise reason for this backlash at the turn of the century is difficult to pinpoint.
As more female medical students entered coeducational institutions in the US, the exclusively female women's medical colleges almost entirely disappeared by 1903. The percentage of women entering coeducational medical colleges was quite high in 1893 to 1894, with institutions such as Kansas Medical College achieving an astounding enrollment figure of 31% and Tufts University, a rate of 28%. Only 14 years later, however, in 1907 and 1908, the enrollment of women students at Kansas Medical College fell to 4%, and at Tufts, to 9%. Across the nation, the average female enrollment in medical colleges stabilized at between 5% and 10%.
The expansion of the field of nursing during this period may have siphoned off some of the female health care workers who would have become doctors. This 5% enrollment figure became so widespread in US medical colleges up until the early 1960s that many historians suspect it reflected an unwritten quota for female students. A handful of medical school deans have admitted to covert discriminatory practices during this period.
Because women were held to higher medical school entrance requirements, and because women were constantly forced to prove their intellectual abilities in order to survive in medical schools, female medical students generally studied longer and harder than men, and they often graduated at the top of their class. When the first wave of women doctors graduated in the early 20th century, male doctors instantly realized that women doctors represented a serious economic threat to their livelihoods. Moreover, male doctors viewed the rise of the new medical colleges, both coeducational and female only, as a serious problem because of the sheer numbers of doctors which these degree mills were graduating.
As early as 1901, an editorial in the Journal of the American Medical Association warned that "The multiplication of doctor factories has gone far enough in this country." A concerted effort during the first two decades of the 20th century to limit the number of US doctors to reduce competition for patients resulted in the merging or closing of over 92 medical schools. Women suffered most from these efforts by male professionals to reduce the overall numbers of doctors in practice. Thus, for most of the 20th century, US women medical students, making up only about 5% of all students, were faced with the multiple barriers of a lack of female role models in positions of power, the high cost of medical education, hostility from male students who were their competitors, and the lack of support groups.
In 1915, a group of feminist physicians headed by Dr. Bertha Van Hoosen founded the influential Medical Woman's National Association, later called the American Medical Women's Association, or AMWA, in 1935. Bertha Van Hoosen was elected the first president and the association began publication of the Women's Medical Journal. Later, the organization introduced the Journal of the American Medical Women's Association, or JAMWA, in 1945 to address the professional issues of women's physicians.
During World War I, when many male medical students entered the military, 13 medical schools who were hard pressed for students, including Yale and Columbia, finally agreed to admit women for study. Women physicians attempted to enlist in the Army as doctors during World War I, but the US Army rejected their petitions and letters. About 55 women eventually contracted privately with the Army as surgeons, and the contribution of women to World War I was primarily in the field of nursing. In France, however, Marie Curie, the co-discoverer of radium, organized a fleet of mobile x-ray trucks for the war effort. She described the medical use of x-rays during the war in her book Radiology and War.
The inability of women to obtain medical internships in hospitals was still one of their greatest obstacles. The industrial toxicologist Alice Hamilton summed up the situation for American women doctors in her 1943 autobiography. She wrote, "In the United States, a woman finds it harder to gain entrance to the medical schools than does a man, much harder to get her internship in a first class hospital, and difficult, if not impossible, to get on the staff of an important hospital.
Yet without such hospital connections, she can never hope to reach the highest ranks of her profession. As for private practice, I sometimes wonder whether it was not easier to make a start in the old days when a woman doctor could count on the loyalty of a group of devoted feminists who would choose a woman because she was a woman. We do not find their like now."
When World War II broke out, women were again only accepted as contract physicians in the war effort. But recognizing a pressing national need, and after lobbying efforts from the American Medical Association of Women, President Roosevelt signed the Sparkman Johnson Bill in 1943, which allowed women to join the Army and Navy Medical Corps.
Merely by their presence as figures of medical authority, women instituted important changes in the military. Mabel Keaton Staupers, for instance, helped to ease racial bias in the military by integrating the nursing corps of the US Army and US Navy. Florence Aby Blanchfield led the Army nurse corps. And when General Dwight D. Eisenhower commissioned her as lieutenant colonel, she became the first woman ever commissioned by the US Army.
As in World War I, medical schools during World War II sought women to fill the spaces vacated by male soldiers, and many increased their female enrollments. But this practice ended abruptly when the veterans returned home. Just as Rosie the Riveter was asked to leave the factory to make way for returning veterans, so many women lost their positions of medical authority after the war.
The 1950s and early 1960s was a static period for women professionals in medicine. And by the end of the 1960s, the unequal numbers of male and female practitioners became glaring. Feminists popularized the idea of women working outside the home and they fought for educational and professional equality in medicine. The medical profession could no longer withstand popular pressure to eliminate restrictive quotas and institutional barriers to women in the medical schools.
The year 1970 was a watershed in US medical history for women. A special congressional subcommittee on education discrimination uncovered both overt and hidden enrollment preferences for men at a number of medical schools. As a result of these hearings, the Women's Equity Action League filed a class action suit against medical schools in the United States.
The results were immediate and stunning. Between 1970 and 1976, the percentage of women medical students more than doubled in the United States. Today, about 28% of US physicians are women.
In summing up this momentous 100-year period in medical history, it is interesting to know that women did not slowly accumulate rights and privileges within the medical profession, but rather, the process for obtaining equal access to medical schools involved dramatic victories and equally dramatic reversals and setbacks. It is also interesting to note the variety of ingenious strategies employed by the first women physicians to enter the medical profession in the United States and England, exploiting the language of professional charters, threatening lawsuits, using the influence of powerful men, and seeking foreign medical degrees. But more than anything else, it was the vision and perseverance of the pioneer medical women Elizabeth Blackwell, Elizabeth Garrett Anderson, and Sophia Jex-Blake that paved the way for equality in medical education in the United States and England.
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This is a story of perseverance and courage, but also about disappointment and social prejudice as women fought to establish themselves as respected health care practioners in Europe and America.
This video is part 5 of 5 in the Storming the Citadel series.