Monday, March 11, 2019

University of Maryland Celebrates 100 Years of Admitting Women

Empowered to Practice: Maryland Celebrates 100 Years of Admitting Women

By Christianna McCausland

Prior to 1918, women had made progress into the medical world. The first woman to graduate from medical school in the United States—the first modern woman doctor of medicine, in fact—was Elizabeth Blackwell. She matriculated at Geneva Medical College (now Hobart) in 1849, graduating first in her class. Despite her accomplishments, she consistently found herself shutout of hospital posts. Reflecting on her life she stated, “A blank wall of social and professional antagonism faces the woman physician that forms a situation of singular and painful loneliness, leaving her without support, respect or professional counsel.”

Blackwell had to forge her own path. She opened her own dispensary, the New York Infirmary for Women and Children, and opened the Woman’s Medical College there in 1868. In her article, “The Entry of Women into Medicine in America: Education and Obstacles 1847-1910,” Meryl S. Justin explains that all-women medical colleges like Blackwell’s flourished in the mid-to-late 19th century.

The Women’s Medical College of Baltimore opened its doors in 1882 and during its 28-year history graduated 116 physicians. Justin states that female physicians were particularly successful in western states where the desperate need for doctors overrode any gender bias.

By 1900, there were 7,387 female practitioners. Then, women’s colleges began to shutter their doors. Much of the blame likely lies in the release of The Flexner Report, an exhaustive study of medical education published in 1910 by Abraham Flexner and underwritten by The Carnegie Foundation. According to “The Flexner Report—100 Years Later” published in The Yale Journal of Biology and Medicine, while the report created the academic model still used today, it also caused approximately one-third of American medical schools to close.

In the report Flexner noted that there were an increasing number of co-educational schools available to women and yet there was a decrease in the number of women attendees. He theorized that women clearly were just not that interested in going to medical school: “Now that women are freely admitted to the medical profession, it is clear that they show a decreasing inclination to enter it. More schools in all sections are open to them; fewer attend and fewer graduate…their enrolment should have augmented, if there is any strong demand for women physicians or any strong ungratified desire on the part of women to enter the profession. One or the other of these conditions is lacking, perhaps both.”

The Flexner Report explained that it wasn’t financially worthwhile to fund women’s medical colleges, as those few women who were interested in school could attend co-educational schools.

Flexner neglected to consider that the decrease in female enrollment was due to the bias women faced when applying to coeducational institutions, and in the classroom should they be admitted. Even if they made it to graduation, a new set of challenges awaited. Like Blackwell, most women physicians were blocked from observing in clinics or training as interns and barred from admission to medical societies.
Flexner did seem to understand this when he noted that if the women’s colleges were to close, “interne [sic] privileges must be granted to women graduates on the same terms as to men.” Many women’s colleges, including Baltimore’s, went out of business. It’s not surprising that with nowhere to go to school, this era saw a marked drop in the number of female doctors. Things began to change after the turn of the century. A new wave of feminism, evidenced by suffrage, coalesced with women’s increasing involvement in social justice movements, particularly those having to do with the health of women and children. Medical societies began opening to women; in 1915 the American Medical Association admitted its first females.

At Maryland several factors contributed to the decision to accept women. There was a shortage of physicians due to World War I and it was increasingly seen as inappropriate that a medical school accepting an appropriation from the state did not consider female candidates. In addition, women had been attending the schools of dentistry and pharmacy for many years, with exceptional results.

The first woman to successfully take advantage of the medical school’s new policy was Theresa Ora Snaith. Snaith grew up in the bustling manufacturing town of Weston, West Virginia, the daughter of a well-to-do well-driller. Snaith transferred to Maryland from the Women’s Medical College in Philadelphia and became its first female graduate in 1923. After graduation she was a successful pediatrician in Weston until her death at age 61. The auxiliary at Stonewall Jackson Memorial Hospital in West Virginia is named in her honor.

One can only speculate what academic life was like for these pioneering women, though Snaith’s entry in the university yearbook gives an indication of the scrutiny female medical students experienced. “I am sure we all agree,” it states, “that she has not detracted from the prestige of our Alma Mater.”

In the 1920s women accounted for one percent of the student population. By the 40s that number had risen to just 5 percent. Yet women were making their mark on the profession. Eva F. Dodge, ’25, for example, became Maryland’s first rotating intern and resident in obstetrics and gynecology. During her five-decade long career she was a teacher, physician and public health administrator. In 1967 she became the first woman to receive Medical Alumni Association Honor Award and Gold Key. Ruth W. Baldwin, ’43D, co-discovered the causes of congenital cerebromacular degeneration and established the seizure unit at Maryland in the 1950s.

Martha E. Stauffer, ’60, grew up in a family of physicians. Her father’s Hagerstown practice was on the first floor of the home where she grew up. She remembers going through his office wastebasket as a young child, fascinated to read the old drug circulars. When she opted for medical school after attending Vassar, her family was supportive but her initial interviews at Maryland made it very clear the environment she was entering.

“I met with a surgeon first and he said, “I don’t know why I’m wasting my time interviewing you. Medical school is no place for a woman.” That was my first introduction,” she recalls. “He said women don’t go into medicine, they ought to be home taking care of the family.”

Unsurprising, that surgeon did not support her admission, but the other two interviewers, a researcher and an internist, did not share the prejudice of the first. Stauffer entered the school in 1956, one of three women in a class of 98 people, and graduated four years later. She explains that it is in her nature to ignore nonsense, a quality that served her well when there were off-color comments about female genitalia in anatomy classes, or when someone mentioned that she was taking a spot at the school from a more deserving man.

“I looked at my goal—to be an MD—and decided to stay focused on my goal, to do the best I could, to work as hard as I could, keep my grades up, and not ruffle any feathers,” she states. “I let all the comments rub off.”

She did, however, raise concerns over the accommodations for women on call during their junior and senior year clinical rotations. Men were provided a twin bedroom; if a woman was on call they were sent to a basketball court-sized room with approximately 20 cots lined up for every single woman on call in every specialty.

“There was one telephone that hung by the door, so you wanted to make sure you didn’t take the bed by the door because you’d be answering the phone for everyone in the room all night,” she recalls. “Looking back now it was just outrageous, but it’s just an illustration of how the focus had not yet been given to women’s comfort and health. It’s an example of the barriers that faced women at that time.”

By the time Stauffer left, there were plans to improve female on call accommodations. Stauffer’s father was an internist and she thought she would follow his footsteps. But she also loved pathology and endocrinology. At Maryland she found great professors and mentors and did two sequential summer fellowships in endocrinology. The chief of endocrinology, Tom Connor, ’46, became a mentor. He encouraged her to write up her research on a young patient with oxalosis and submit it to the student essay contest at The New England Journal of Medicine. The essay won in 1960.

Stauffer remembers that Harlan Ferminger, MD, head of the department of pathology, inspired students to think about pathology in new ways. She also recalls her Saturday morning rounds with Jacob Finesinger, MD, chief of psychiatry, who taught her how to effectively speak with patients. Theodore Woodward, ’38, chief of the department of medicine, she recalls as being a master of small group teaching. After graduation from medical school, Stauffer completed residencies in internal medicine, anatomic pathology, laboratory medicine and nuclear medicine and became board certified in each of these specialties. She then spent two years doing research on metabolic disorders of bone, such as osteoporosis, which she continued until her retirement. Today she’s a retired professor of pathology at the Dartmouth Hitchcock Medical Center in New Hampshire and retired chief of pathology and laboratory services at the Veteran Administration Hospital in Vermont.

During her career she states, “I never noticed any prejudices against me as a woman, however I did notice, and I think it is still the case today, that even if you did good work you were much less likely to be promoted up the academic ranks than if you were a man.” “I’ve had a very gratifying career and enjoyed medicine,” she continues, “I feel grateful to those who have helped along the way and I attribute a lot to the University of Maryland.”

Bella F. Schimmel, ’52, began at Maryland four years earlier. She was one of five females, though two left during the first semester. Like Stauffer she remembers there being plenty of supporters of women at the school and some detractors. Like Stauffer, she found the detractors were more often professors, not students, and that their reasoning was that women were “taking” spots from men who would do more with their degree than a woman ever could.

“There were some people who felt this was no place for a woman, that you were taking a man’s place and that a woman would not devote her life to medicine as a man would,” she states. “It was frustrating to hear but, “I belong here” was always my answer.”

Like Stauffer, Schimmel has proved the naysayers wrong, making medicine her life’s work. Born and raised near Druid Hill Park in Baltimore City, Schimmel studied zoology at University of Michigan. Though she considered lab work or working with animals, “I decided medicine could offer me a wide range of career possibilities, be it research or teaching or clinical work,” she states. “However, I had no notion that I could get into medical school and carry out the intense requirements necessary.”

Schimmel remembers that growing up, doctors were afforded a special status, that they were respected members of the community. She wanted that, too. In addition, she wanted to work with people and medicine offered many ways to do so.
Schimmel was interested in pediatrics at Maryland. She recalls Milton Sachs, MD, as being a mentor and great listener at the school. After graduation she took a pediatric residency position at UCLA and worked as an intern at Los Angeles County General Hospital. She also worked overseas doing pediatrics in Germany with the U.S. Army. Through her work she began to see how connected child health was to the health of the family, particularly the mother. She switched her specialty to psychiatry, studying three years in adult psychiatry and two years in child psychiatry. She’s also trained in psychoanalysis. She’s taught at UCLA most of her life and worked in, and led, children’s clinics. Now 90-years-old she still sees some patients in clinics and in her private practice. She also provides horticulture therapy to special education classes in California schools. She raised four children and has four grandchildren.

“The School was gracious enough to admit me and I have always been grateful for that,” Schimmel states. “It enabled me to have a career and gave me my life’s work.”

Despite women’s obvious commitment to the field of medicine, their desire to be physicians, and the need for women in the medical field, enrollment at Maryland as with all U.S. schools, remained scant through the 20th century. That changed with a new wave of feminism in the 1970s and particularly with the passage of Title IX in 1972. After Title IX, which prohibits discrimination based on sex in any education program or activity receiving Federal financial assistance, women’s acceptances at medical schools exploded.

At Maryland, the percentage of women jumped from 10 percent in the 1970s to 40 percent in the 1980s. In 1996 the school graduated its first predominantly female class, and the attendance of women has hovered above 50 percent virtually every year since.

With growing equality at medical school, women began to reach the upper echelons of achievement once reserved for their male counterparts. Catherine N. Smoot-Haselnus, ’85, became the first female president of the Maryland State Medical Society in 2002 and Willarda V. Edwards, ’77, succeeded her, becoming the first female African American president of the society in 2004.

In 2017, the Association of American Medical Colleges (AAMC) announced that for the first time there were more women enrolled in medical school than men. However, AAMC research also shows that that even as the bench of qualified women gets deeper, their representation in positions of authority is not commensurate. 

According to the AAMC’s 2013–14 The State of Women in Academic Medicine, women make up a little more than one third (38%) of full-time academic medicine faculty and the percentage of permanent women department chairs (15%) and deans (16%) at U.S. medical schools remains low. As Maryland celebrates its 100th year accepting women, it is positioned to take the next great step toward parity: to graduate a new generation of female physicians who will not only be empowered to practice, but to lead.

Permission to reprint was granted by Medical Alumni Association of the University of Maryland, Inc.