Setting an Example

Surgery has seen gains in female representation. What can radiology learn from the field?July Images 4 web5

Radiology is one of the least diverse specialties — lagging behind much of medicine when it comes to participation by women and underrepresented minorities (URMs).1 Currently, only 25 percent of radiologists are women.2 While the current ACR president, vice president, BOC chair, Council vice speaker and JACR® editor are all women, as are 11 of the 33 members of the BOC, diversity in leadership remains low — only 17 percent of academic radiology department chairs are women.1

Having greater female representation in leadership is important — and can lead to better female representation in radiology as a whole, says E. Isin Akduman, MD, program director of radiology at Saint Louis University Hospital. Susan J. Ackerman, MD, FACR, chair of the ACR Committee for Women, agrees. “When medical students see someone like themselves and that person is at the decision-making table, they want to be like that leader.”

Although radiology has not yet seen increases in female representation and leadership, other historically male-led specialties — such as surgery — have. In 2008, women made up only 37.5 percent of the trainee population. In 2018, however, nearly 43 percent of surgical trainees were women.1

Dana A. Telem, MD, MPH, associate professor of surgery at the University of Michigan Medical School, credits culture change with the increase in female representation. “When duty hours changed across medical and surgical disciplines, surgery re-emerged as a popular field for students to enter,” says Telem. “We were no longer viewed as a discipline where you were on call every night, not sleeping, and not engaging in life outside of the hospital.” Telem adds, “Additionally, the historical version of a surgeon (male or female) — ill-tempered, aggressive, and sharp — is no longer tolerated. And as such, more women have come on board.”

This is not to say that surgery doesn’t have work to do, notes Telem. “We still have less than 5 percent of women in high-level leadership positions such as chairs or deans of academic medical centers, and when you look at URM women, those numbers plummet further.”4 So, what can medicine do to promote more women in leadership?

One method Akduman, Ackerman, and Telem all agree on: sponsorship. “Mentorship is helping someone get to where they need to go,” says Telem. “Sponsorship is taking that a step further by giving an individual opportunities and putting your name behind them in recommendations.” Ackerman adds, “Every chance I hear about an opportunity for someone to be on a committee at any level, if I know someone I think would be a good fit, I recommend them. Women need to become better at recommending women.”

Ackerman also recommends that radiology departments seek ways of exposing students to radiology. “One reason that female medical students choose not to go into radiology is because they believe radiologists have no patient contact — which we know isn’t true,” she says. “If you wait until fourth year when they graduate, it’s too late. They’ve already made their decisions.”

According to Akduman, “Female leaders also need to make themselves available to these medical students and to their residents. Not only are you a role model, but you can also help the program feel more welcoming to them. My residents feel like they’re able to come to me with their concerns, and through that I’ve been able to determine that a lot of medical students are concerned about family planning and the possible radiation exposure they could have as residents.” Because of that, starting this month, Akduman’s department will have information that goes out in the resident welcome packet that explains that a resident’s rotation can be adjusted to accommodate for pregnancy. “When we do that, we show we’re considering their unique needs,” notes Akduman. “Pregnancy is a life event and the female residents should not be blamed or feel guilty about planning a family. By addressing this ahead of time, they feel more welcomed and less stressed.”

No matter the profession, the bottom line is that diversity in leadership creates diversity in a specialty and, overall, a more diverse medical field — able to care for the already diverse pool of patients that physicians encounter every day. “We have to consider: what do we want our patients, the teams we’re building, and our recruits to look like?” says Telem. “Does our leadership represent that? If not, I think it will be a hard task to bring everyone in.”

By Meghan Edwards, freelance writer, ACR Press

1. Umer A, Bassuner J, Akduman I. A Bonis ad Meliora (“From Good to Better”). J Am Coll Radiol. 2019;16(5):664.
2. Bender CE, Bansal S, Wolfman D, Parikh JR. 2018 ACR Commission on Human Resources Workforce Survey. J Am Coll Radiol. 2019;16(4):508-512.
3. Canon C. “Building the Pipeline of Female Radiology Leaders.” Voice of Radiology. ACR. May 9, 2019.
4. American Association of Medical Colleges. Diversity in the Physician Workforce: Facts and Figures 2014. Washington, D.C.: AAMC; 2014.

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