The Illusion of Choice: Gender Segregation and the Challenge of Recruiting Women to Radiology

Abstract

In recent decades, the feminization of medicine has promised equal educational and professional opportunities for women pursuing medical careers [1,2,3]. Yet despite encouraging statistics that now show near even numbers of women (48%) and men (52%) enrolled in US medical schools [4,5], vast inequalities remain. Radiology is just one example of the persistent gender gap that plagues many medical specialties, with women representing fewer than 30% of total practicing radiologists and trainees in the United States [6,7,8]. Radiology educators have long debated the most effective means by which to improve the recruitment of women to our field, but they have managed to identify only potential contributing factors [9,10]. OBSTACLES TO RECRUITING WOMEN IN RADIOLOGYOne barrier to recruitment commonly cited in the literature is the widespread presence of misconceptions regarding radiology as a career [7]. Common misconceptions include: too little impact on patient care, a dark and isolated working environment located far from patient care areas, and too competitive a match process to get a residency position [5,7,11]. Unfortunately, because radiology is absent from the core curricula of most medical schools in the United States, these false stereotypes remain unchecked in the minds of most students when they make their specialty decisions [7,9,10].In addition to the long-held misconceptions about radiology, the poor exposure that medical students get to the field is itself a serious obstacle to the recruitment of women [5,10]. Radiology must compete for student interest against specialties that have the luxury of one or more required rotations within the medical school curriculum. Because radiology is not a required core clerkship at most medical schools, the specialty cannot demonstrate to students just how patient-centered and interactive it really is. Students aren't afforded the opportunity to see the value that radiologists bring to patient care or to even imagine themselves in a radiology career. Instead, the misconceptions go unabated and eventually help to exclude radiology as a potential career choice in the minds of most students.A third obstacle to recruiting women to radiology is the persistent shortage of women to serve as visual role models for students [9,10,12,13,14]. The importance of female role models in shaping the career decisions of women has been established in many medical fields including radiology, surgery, and internal medicine [15,16,17]. The educational theorist Etienne Wenger claims that medical students decide on specialties by drawing upon their medical school experiences to visualize themselves working within a particular field, an exercise he calls "paradigmatic trajectories" or career trajectories [13,18,19,20]. To do this, students need to physically see role models with which they can identify to know that specific careers possible for them [13,20]. The shortage of women in radiology may simply make it too difficult for female medical students to see themselves in the profession.