Moving the Needle Forward
Increasing the proportion of women in radiology will demand proactive efforts to change the perception and culture of the specialty.
(Left to right) Courtney B. Dey, MD, Michele V. Retrouvey, MD, Frances B. Lazarow, MD, and Shannon Kim, MD, are radiology residents at Eastern Virginia Medical School.
As a fourth-year medical student, Lori A. Deitte, MD, FACR, chose a career in radiology because it held the captivating aspects she was seeking: the opportunity to be intellectually stimulated, the ability to solve problems, and the empowerment to impact patient care.
“I really enjoyed rotating through the various specialties,” says Deitte, chair of the ACR Commission on Publications and Lifelong Learning and professor of radiology at Vanderbilt University School of Medicine. “When I experienced radiology, I immediately knew that I wanted to become a radiologist.”
About half of all medical students are women, according to the Association of American Medical Colleges (AAMC). Yet in radiology, Deitte is in a significant minority as a wide gender gap remains in full force. Increased efforts to attract more women to the field have yielded limited success, but leaders in radiology say the cultural headwinds are shifting.
Radiology practices are turning to recruitment efforts that appeal to women, including offering competitive compensation, flexible work schedules, and a visible path to promotion and leadership roles. Medical school departments and women’s specialty groups are leveraging mentoring, training, and social programs to support and encourage female students to pursue the field.
What hasn’t changed is the timing of when students are exposed to radiology and its subspecialties, says Susan J. Ackerman, MD, FACR, chair of the ACR Committee for Women. Ackerman believes introducing female students to radiology in the early years of medical school might be the single most important factor in their decision to choose the specialty.
“You have to show medical students that radiology is interesting and exciting,” says Ackerman, an associate professor of radiology, vice chair for clinical affairs in radiology, and division director of ultrasound at the Medical University of South Carolina in Charleston. “Our department has a robust program that introduces first-year medical students to radiology. Students have basic lectures on how to interpret a chest X-ray and are shown examples of common abnormalities such as pneumonia. We have ultrasound labs in which residents learn how to scan patients and identify organs such as the gallbladder. Students need to understand that radiology can be an important part of managing a patient’s care.”
Michele V. Retrouvey, MD, former chair of the ACR RFS Women and Diversity Advisory Group, says misunderstandings about what radiology entails have likely kept students away. “There’s this perception that we’re sitting in the dark in front of our computer screens 24/7,” Retrouvey says. “We’re not doing as good a job as we could about promoting how much patient and clinician interpersonal contact we get throughout the day.”
In an American Journal of Roentgenology study, nearly 95 percent of female medical students indicated that they decided not to pursue radiology because of a perceived lack of direct patient contact. Retrouvey says she was involved in a similar study several years ago and also found a majority of female medical students were interested in specialties that were widely seen as providing patient interaction.
To attract more female trainees to radiology, Ackerman recommends that faculty and department leaders mentor medical students, support radiology interest groups, and promote social activities to foster engagement and forge close bonds. According to Ackerman, friendships are more likely to develop when students, residents, and faculty gather for potluck dinners and other informal events, and share advice that might not be covered in a classroom.
“In my department, we have a ‘Women in Radiology’ group that meets quarterly,” Ackerman says. “We have social events, fundraisers at holidays, and an end-of-year dinner for graduating residents and fellows. It’s about creating opportunities to involve women, regardless of career level.”
The American Association for Women Radiologists, the ACR, and the Women in IR Section of the Society of Interventional Radiology have also promoted outreach and engagement by sponsoring social gatherings, mentoring sessions, and workshops to attract female students and trainees to the field. Still, only about 27 percent of radiology residents are female, according to the AAMC 2015 report on residents.
According to Carolyn C. Meltzer, MD, FACR, chair of the department of radiology and imaging sciences at Emory University School of Medicine, changing the culture of a field can be a slow and daunting process. “In my department we’ve been working for more than a decade to make our department and our leadership more diverse,” says Meltzer. “It has to be intentional. You have to instill greater diversity at all levels of an organization in order to promote an inclusive culture and better decision-making. It starts with leadership. We’re not there yet.”
Not surprisingly, women are more inclined to join radiology practices that visibly employ and promote other women, says Lakshmi Balachandra, MBA, PhD, assistant professor of entrepreneurship at Babson College in Wellesley, Mass., and a Radiology Leadership Institute® faculty member. Balachandra advises recruiters to think about how they can showcase to women the perks of a particular job: flexible schedules that help make work-life balance more manageable, competitive compensation, parental leave policies to accommodate new or growing families, and demonstrating how their contributions will be valued and rewarded through career advancement.
According to Retrouvey, recruiting female medical students and trainees to radiology by touting direct patient care, accommodating work environments, opportunities for leadership roles, and other highlights will ultimately benefit healthcare outcomes. “When women radiologists join medical teams, differing perspectives and new approaches to patient care are likely to emerge,” Retrouvey says.
Deitte agrees. “I firmly believe that there is no better time to be a woman in radiology than now,” she says. “It’s time to move this needle forward.”
By Carole Fleck, freelance writer, ACR Press
1. Association of American Medical Colleges. Table 1: medical students, selected years, 1965–2015. Available at bit.ly/AAMC_Table1.
2. Fielding JR, Major NM, Mullan BF, Neutze JA, Shaffer K, Wilcox CB, Paynter L, Pisano ED. Choosing a specialty in medicine: female medical students and radiology. AM J Roentgenol. 2007;188: 897-900. Available at bit.ly/AJR_Table4.
3. Vassar L. How medical specialties vary by gender. AMA Wire. February 18, 2015. Available at bit.ly/AMAWire_SpecialtiesbyGender.