Women in White

Although women make up nearly half of the nation's medical-school enrollment, it's still hard for female physicians to balance training, career, and family. Enter the Women's Committee, a forum for gender issues at the U of C Medical Center.

My first thought was: 'Oh, my God,'" recalls Funmi Olopade, "How could I have three children?" An immigrant from Nigeria, she was in the second year of a very competitive and all-consuming oncology fellowship at the University of Chicago when she found out she was pregnant with her third child. With two toddlers at home, a physician husband who also worked long hours, and another baby on the way, how could she possibly maintain her already overstuffed schedule, in her laboratory or in the clinic?

For most of the history of academic medicine, there was no good answer to that question. In 1970, only 10 percent of medical students and fewer than eight percent of doctors were female. For many of these women, especially those with academic aspirations, choosing to enter medicine meant deciding not to have children.

After four years of college, four years of medical school, five or six years in a residency, followed by a two-year fellowship, these women, by now well into their thirties, were just entering the academic fray, beginning the long battle for promotion and tenure-perhaps not the optimal moment to begin a family. After all their training and personal sacrifice, female physicians still found themselves at a disadvantage. A 1987 study found that male M.D.s who started academic jobs in 1976 were 50 percent more likely to have won tenure, and four times as likely to have become full professors than women. They were also more likely than their female counterparts to have had children. The women who wanted both career and family, the study suggested, were either diluting their professional ambition to give time to their children, or taking their genes out of the pool.

Today, nearly half of every medical school class in the nation is female. (This year's entering class at Chicago's Pritzker School of Medicine is 52 percent female.) Certain fields such as obstetrics, gynecology, dermatology, and pediatrics are dominated by women. Even male bastions like orthopedic and vascular surgery have been infiltrated. But men have not yet begun to have babies, and very few have chosen to cut back substantially at work to care for their children. So half of the brightest, best trained, most promising candidates for medical residencies, fellowships, or junior faculty appointments are now faced with a horrendous decision: do I cut corners at work or with my family?

Olopade, however, lucked into some options. "My section chief was Harvey Golomb," she says. "I went to talk to him, very concerned about how he might respond, and he simply said, 'This is what we will have to do.' We worked out a reasonable plan including some time off and reduced clinical obligations. He made sure there was a way I could have both a career and a family."

As chief of a section with quite a few women, including Janet Rowley, PhB'45, SB'46, MD'48-one of Chicago medicine's shining stars-Golomb, AB'64, has long been recognized by the section staff as very "pro-women," recalls Olopade. "He always made certain that we interviewed women for our fellowship program, and that we brought in the best women in each group.

"When he turned over the reins to the fellowship program to me, the first group we selected was all men," she says. "When Harvey found out he screamed, 'I can't believe I put you in charge and you chose five men.' That was when I realized that if you really want to recruit and retain the best women, you have to make an extra effort." In 1998, when he became chairman of medicine, Golomb interviewed dozens of department faculty and found that a lot of the women felt a lack of support. For example, there were only three female full professors in all of medicine, the largest department in the University. Two of those professors, Rowley and Michelle LeBeau, came from Golomb's former section of hematology/oncology. So he made the first of many extra efforts, quickly doubling the ranks of female professors. Now there are six. One of the newly appointed, Halina Brukner, is vice chair of the department.

Then, in January 1999, Golomb asked Olopade to form the women's committee, with one representative from each section. The committee includes Brukner; Diane Altkorn, MD'82, from general medicine; Amy Bales, cardiology; Deborah Burnet, MD'89, primary care; Suzanne Conzen from oncology; Linda Druelinger from emergency medicine; Michelle Josephson from nephrology; Karen Kim from gastroenterology; Kim Rusk from medicine administration; Anne Sperling from pulmonology; and Janet Tobian, MD'91, from endocrinology.

"I wanted the group to serve as a forum for women's concerns," he says, "to search for gender-based obstacles to women's careers in the department, and to come up with solutions."

Those who may have doubted Golomb's sincerity were convinced when he put Olopade in charge. "I think he asked me because we had worked together and he knew that this was something I had strong feelings about," says Olopade. Explains committee member Kim Rusk: "He chose Funmi because she's afraid of nothing."

Because study after study has shown that men get paid significantly more than women for the same work, the committee decided that its first concern was salary. The members launched their own semi-scientific survey, selecting ten female assistant professors and ten associate professors and matching them up with men of equivalent rank and accomplishments. At the assistant professor level, they found no difference in salary. At the associate professor level, six of the women actually made slightly more than the men. "We were relieved to find apparent parity in salaries," says Olopade, "but troubled that there weren't enough women at the upper levels to compare full professors."

The committee then turned to subtler signs of discrimination, such as the allocation of laboratory space, the shortage of female mentors, and possible disparity in granting tenure. Studies at other universities have found that even female senior faculty have not received resources or rewards at the same level as men. Again, to everyone's pleasant surprise, the University of Chicago emerged as comparatively fair and flexible on these issues. There were more women than men on alternate tracks; research associates and clinical educators don't face quite the same time pressures as those on a strict tenure track. But this shift away from the standard tenure track was a consequence of a flexible system, which allows faculty to make choices and to change tracks as needed. There was even a policy that allowed tenure-track faculty to stop the clock for a while, allowing them to spend more time with their young children without damaging their efforts to get tenure. In fact, Brukner reduced her clinical schedule by about 20 percent when her children were young.

"As we looked around, the one problem that really stuck out" at Chicago, says Olopade, was child care. Women often delay having children until they finish their training, so they tend to need child care at the time of their initial faculty appointment. Again, the committee launched a quick survey of other major educational institutions. "We visited modern research labs like Argonne and the most conservative, most ancient universities we could find," says Olopade. "We went to Yale, to Harvard, to Kings College in London. Every single place we looked at offered childcare, within the institution, beginning at six weeks. Argonne had a wonderful program. In Hyde Park there was nothing until the child is ready for pre-school."

"We have made it our major goal to bring this deficit to the attention of the administration," says Olopade.

It's not a new issue. Many previous attempts have come to naught after getting entangled in endless discussions about the lack of space, liability concerns, or conflicting approaches. "Doctors want high-quality child care," points out committee member Anne Sperling, "while graduate students need inexpensive child care."

But keep in mind: Olopade is afraid of nothing. A quick study, she recites lessons learned from Bernice Sandler, a senior scholar at the National Association of Women in Education, whom the women's committee brought in last fall to educate female doctors about subtle forms of discrimination and the not-so-delicate arts of negotiation.

"One," recites Olopade, "publicize your problem." (You're reading this, right?) Two, form alliances. "Childcare," she insists, "is a major need for all female faculty and staff, and for many men, not just within the department of medicine but for the entire institution. We now have the dean's office trying to find us space, and the university's vice president for community affairs is supporting our efforts. Three, sharpen the discontent of others," continues Olopade. "That an institution of this size and distinction doesn't have decent child care is inexcusable," she says. "It's 19th century. It's the number one problem for women faculty. Without it, launching your career can become a nightmare."

Step four? Make no small plans. The committee, working with the Biological Sciences Division dean's office, has already met with consultants, completed a needs assessment, identified suitable space, and come up with a blueprint for action. They hope to present the child-care plan to President Randel this fall. "We didn't want it to be the first project he had to face when he came to Chicago," says Olopade, "but we don't want to make him wait for it either." If all goes well, they move on to step five: celebrate your victories.

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John Easton, AM'77, is director of media relations at the University of Chicago Medical Center. His most recent article for the Magazine was "Hyde Park Revisited" (June/00).