NEJM on women in medicine leadership; viewpoint from the subject of media attention

About 10 days ago, I wrote a post on my thoughts regarding gender issues in science and medicine. In the post, I made note of the recent recruitment of Nancy Andrews, MD, PhD, from Harvard to become the new medical school dean at Duke University. In my post, I noted:

What would normally be a modestly newsworthy story for a dean who happened to be a man is instead noted in the press release and on the webpage as:

Andrews, 48, is the first woman to be appointed dean of Duke's School of Medicine and becomes the only woman to lead one of the nation's top 10 medical schools.

When I read that, I wonder why the heck it took until 2007 for such a step forward? Is it really true that none of the nation's top medical schools had a female dean until now?

Today's issue of the New England Journal of Medicine contains an article, currently free text, by Dr Andrews herself entitled, "Climbing Through Medicine's Glass Ceiling." Here's her opening paragraph:

Earlier this year, I was named the first female dean of the Duke University School of Medicine, an event that National Public Radio summed up in the headline: "Andrews Makes History at Duke Med School." Why should the appointment of a woman dean still be big news in 2007? Perhaps because, with a few localized exceptions, there has been little change since the 1970s in the barriers to women's full participation in academic medicine.

I do not know Dr Andrews nor was I privy to her manuscript that has now appeared in the NEJM. But my observation that her appointment made big news wasn't far from her own perception of the attention. Her short, thoughtful essay is worth reading for anyone involved in mentoring medical students or graduate students, but here are some key quotes in detail in the event that free access is only available for a short time:

...it continues to be true that we do not expect women to hold certain positions in society or medicine. Recently, I witnessed firsthand the persistence of such expectations, when my husband, our children, and I went to visit a school in North Carolina where Duke staff members had made an appointment for the family of the new dean of the medical school. As we entered the school, its principal vigorously shook my husband's hand and welcomed him, saying, "You must be the man of the moment." Unfortunately, it is quite understandable that it wouldn't have crossed his mind that I might be the "woman of the moment" instead...

...It is also important not to make assumptions about what women will and will not do. After my appointment at Duke was announced, many people told me that they'd assumed I would not be willing to move out of Boston -- that I would not leave Harvard, that I would not move my children before they finished high school, that I would not uproot my husband. Obviously, all those assumptions were incorrect. My own choices notwithstanding, however, the "two-body problem" -- finding a position for a new appointee's spouse -- remains a major obstacle to the recruitment of women in particular and of academic leaders in general....

...Some of our counterparts in the corporate world may do better, for they are beginning to recognize that women are an undervalued resource. The teaser for a recent Boston Globe article began: "Hungry for talent, big companies have started to pursue women who have dropped out of the workforce. How this could redefine the whole notion of a career."...

...As I look to the future, I wonder what my 15-year-old daughter thinks about all the publicity surrounding my new deanship. Until recently, she had been telling people that she was interested in medicine, but she's been uncharacteristically quiet of late. Will she end up being a top clinician, a chief, a chair, or a dean someday? Or will she compare academic medicine with other fields that seem more open to women and decide that it's not the right place for her?

In the essay, Andrews also draws attention to her participation in establishing The Rosalind Franklin Society; "The goal of the group, made up of prominent scientists of both sexes, is to ensure that outstanding women are recognized in ways that its namesake, Rosalind Franklin, was not."

From their current webpage:

The Rosalind Franklin Society will recognize, foster and make known the important contributions made by women in the life sciences and affiliated disciplines. In so doing, we will significantly honor the achievement of this pioneer in the discovery of the structure of DNA, whose accomplishments were not fully recognized during her lifetime, were not awarded posthumously, and are still not fully acknowledged. To most effectively honor her important scientific contribution, The Society will recognize the work of other prominent women scientists, foster greater opportunities for women in the biomedical sciences, and motivate and educate by example young generations of women who have this calling.

I am encouraged by the appointment of Dr Andrews that the culture of medicine can and will change to be as inclusive of women and minorities as in other professions where greater equality operates currently. I look forward to the day when, perhaps, her own daughter is appointed a medical school dean and the headlines read, "Outstanding Physician-Scientist to Take Top Medical School Post."


Andrews NC . Climbing through Medicine's Glass Ceiling. New Engl J Med 2007; 357:1887-1889.
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Hear, hear. I watched a recent interview with PepsiCo's CEO, Indra Noori, and she stated that she needed to be "twice as good as her male counterparts" to get to where she is today. So in medicine, as in business, there are still a lot of unspoken and invisible barriers to career advancement for women. I hope we can change this for the next generation.