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Historical Perspectives |
1 From the Department of Radiology, Georgetown University, 2801 New Mexico Ave NW, Washington, DC 20007. Received December 20, 2004; revision requested February 16, 2005; revision received March 9; accepted March 16. Address correspondence to the author (e-mail: alewicki{at}juno.com).
It all began at the Association of University Radiologists when the late Joseph E. Whitley, MD, decided that the time had come to appoint a women liaison officer to the Association of American Medical Colleges (AAMC). That happened in 1979, and Dr Whitley was the president-elect of the Association of University Radiologists, and I became the woman liaison officer (1) (Fig 1).
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Background
Around this time and the early 1980s, the Equal Rights Amendment to the U.S. Constitution was widely debated, and advocates argued that it was the only way that sex discrimination could be abolished (2). That amendment was eventually defeated.
On July 7, 1981, President Ronald Reagan appointed Sandra Day O'Connor to serve on the U.S. Supreme Court (3). He thus broke with 191 years of tradition and fulfilled a campaign promise that he had made.
What was happening in medicine? How did women physicians fare there? They had arrived and were represented, more so in some specialties than in others, but certainly not many at the top of any field, and not many as equal partners in practice settings.
In 1976, several student affairs deans met with AAMC staff to organize the Women in Medicine Program, and Judy Braslaw was assigned as the support person (4). One year later, at the annual meeting of the AAMC, the first Women Liaison Officer's Luncheon was held. The Women in Medicine Program at the AAMC continued, with Kathleen Turner in the office of the president at the AAMC taking charge in 1980; and in 1987, it became part of the Division of Institutional Planning and Development. It was at that point that Janet Bickel took responsibility for this venture. In 1988, the first Women in Medicine Professional Development Seminar was held at Georgetown University (4) in Washington, DC.
In the late 1970s, the American Medical Association noted that only a minority of women were joining the American Medical Association. Of the 13 461 women physicians in the United States, 29.9% were American Medical Association members, whereas 46.8% of the 211 000 male physicians had joined the American Medical Association (5). The Ad Hoc Committee on Women in Organized Medicine was formed, and this committee studied the characteristics of these two groups in depth. A report was released from the ad hoc committee in May of 1980; one of its recommendations was that the American Medical Association endorse the Equal Rights Amendment (5).
Founding of the AAWR
As the Woman Liaison Officer of the Association of University Radiologists, I found at the AAMC a well-developed Women in Medicine Program, with speakers, discussion groups, and a luncheon with speakers of prominence who addressed the many special needs of women in medicine. Those of us who occasionally met another woman colleague had explored many of these issues before, but I had never heard these concerns voiced so publicly or heard them discussed so openly, and without fear. I very soon realized that what I was hearing and learning at these AAMC meetings needed to be communicated to other women in radiology, and it seemed that the only way that that could happen was by organizing our own group, a group of women in radiology. I contacted women around the country and was amazed at how receptive everyone was.
The first of two preliminary meetings before the actual founding of the AAWR was held in Dallas, Tex, in conjunction with the 1980 RSNA Annual Meeting. It was announced as a Women in Radiology Session, with a program that featured the following speakers: Marie A. Capitanio, MD; Frieda Feldman, MD; Rosalind H. Troupin, MD, and I (6). Also present at this meeting were representatives from the major radiologic societies. A sizable group of women attended this session, and it was considered a success by most. We know from existing board meeting minutes of the RSNA Board of Directors that they had received an announcement of this Women in Radiology Session and designated individuals who should attend this meeting (7). Richard E. Buenger, MD, and James J. McCort, MD, were appointed to attend, as also was Adele Swenson, the executive director of the RSNA.
Early in 1981, I was invited to a meeting of the RSNA Board of Directors in Chicago, Ill (8). RSNA records note the following (9):
ITEM 7 Women In RadiologyA. Ann Lewicki, M.D. appeared before the Board and made the following statements and requests for Women Radiologists.
1. That they be accepted as equal professionals.
2. That they do not want a position they are not qualified for.
3. That the RSNA aid in the education of the public to accept the woman physician.
4. That they do not want a quota but would like to have representation in committees and editorial boards of the RSNA.
5. That RSNA provide a child care center for women with children at the Annual Assembly.
6. That an article appear in RADIOLOGY giving endorsement to the development of a Women's Radiological Society.
7. That there was a need to obtain mailing lists of women radiologists and a data bank for geographical location and occupation of women radiologists.
The Board of Directors responded to these requests, and that response is recorded also under item 7:
The following actions were then taken by the Board of Directors.1. M.S.C. when the Women's Radiological Society is organized, RSNA will contribute $500 for organizational costs. Timing of this is at the discretion of Ms. Swenson.
2. M.S.C. to set up a child care center at the 1981 Annual Assembly. Ms. Swenson is to arrange for this.
3. Dr. Lester directed Dr. Tristan to write an editorial on "Women in Radiology".
4. M.S.C. the RSNA is to supply staff support and the organization including the writing of the constitution and by-laws for the Women's Radiological Society.
5. Dr. Lester directed Dr. Brady to suggest enlistment of women instructors by the Refresher Course Committee.
We assume "M.S.C." means "moved, seconded, and carried" (Barbara Jarr, RSNA, written communication, September 28, 2004).
The second of these preliminary meetings occurred in March 1981 in San Francisco, Calif, in conjunction with the annual meeting of the American Roentgen Ray Society (10). There was no formal program at this time. Instead, the women who came forward to serve on the steering committee, approximately 13 women initially, addressed urgent organizational issues (11).
In the following months, the bylaws of the AAWR were drafted, circulated, and finalized. The late Helen C. Redman, MD, contributed to this effort, as also did Ayn Woodruff, MD, and Katherine A. Shaffer, MD. They were assisted by Ms Swenson and Marian Godiksen from the RSNA (12). It is of interest that Dr Redman later became the first woman to serve as president of the RSNA (13).
At the same time, Dr Shaffer and James E. Youker, MD, drafted a resolution, which was later presented before the council at the annual meeting of the American College of Radiology (ACR) in Las Vegas, Nev. This is the resolution they drafted (14):
Resolution No. 5Whereas, women have always played a strong, vital role in the practice of radiology in this country, and have made significant contributions over the years to the efforts of the American College of Radiology, and
Whereas, the number of women in medical school has increased dramatically, and
Whereas, many of these women are choosing radiology as a career, and
Whereas, women perceive a difficulty in achieving leadership positions in the College and in obtaining practice opportunities in the community; therefore
Be it resolved
that the American College of Radiology and its State Chapters make every possible effort to increase the number of women in leadership positions, and that the American College of Radiology through its various Commissions and Committees attempt to identify special problems that women face as they enter the practice of radiology.
Sponsor: Wisconsin Chapter
Drs Shaffer and Youker were helped in their efforts by Robert Becker and Barbara E. Chick, MD (15). At the time, Dr Chick was the chairman of the Commission on Radiologic Practice. That resolution was defeated (James I. Morrison, MS, executive director, ACR, written communication, October 20, 2004).
At the end of 1981, the AAWR was ready to emerge as a full-fledged organization. This happened in Chicago during the 1981 RSNA Annual Meeting. Officers of the AAWR were elected. Carol M. Rumack, MD, became the first president of the AAWR. The other officers elected were Linda M. Fahr, MD, vice-president; Dr Shaffer, secretary; and the late Nancy O. Whitley, MD, the wife of the late Dr Joseph Whitley, treasurer (16,17). Dr Nancy Whitley had already assumed many of the duties of the treasurer before her election. She established an account for the AAWR with the Equitable Trust Company, and into that account she deposited $335, which had been collected from dues. Dues had been assessed at $25 per year. She also deposited into this account the $500 donation from the RSNA (18). Her efforts helped tremendously in developing this organization.
As I remember it, it was L. Anne Hayman, MD, who came up with the idea of a booth for the AAWR at the RSNA Annual Meeting; again, the RSNA obliged and provided space free of charge. A photograph in an ACR publication shows Dr Hayman and her assistant Joyce Stedman at this booth busy recruiting members for the AAWR (16). Also at the 1981 RSNA Annual Meeting, a refresher course conceived by the AAWR was listed in the regular program of the meeting. Its title was Practice Patterns of American Radiologists: Do They Differ for Women and Men? Nine individuals were scheduled to participate in this discussion (19). H. Paul Jolly, PhD, represented the AAMC. Dr Jolly is still with the AAMC and now serves as senior associate vice president. At the time, Dr Troupin was one of two associate editors of the American Journal of Roentgenology; Paul A. Riemenschneider, MD, and Dr Chick represented the ACR; also scheduled to participate in this refresher course were Eugene C. Klatte, MD, Anne G. Osborn, MD, Dr Redman, Theodore A. Tristan, MD, and I. This first AAWR refresher course was well attended and drew a capacity crowd. Panelists and those in the audience engaged in a lively discussion (16). Some of what Dr Jolly presented was later published (20).
At the conclusion of the 1981 RSNA Annual Meeting, the AAWR had approximately 200 members; of those, 120 alone had been recruited at the booth (16).
Dr Tristan's editorial was published in November of 1981 (21). When we read Dr Tristan's editorial today, we learn that what he said in 1981 is still pertinent and applies to women in radiology now. To quote from the editorial, it is still "difficult for a woman radiologist to be a wife, mother and brilliant radiologist." Dr Tristan continues, saying that professional socialization is difficult and complex, something the more general radiological organizations are not prepared to address. I urge the reader to read the entire editorial. In another editorial, I tried to reassure everyone that women in radiology have the same professional goals as do men and the same commitment to the profession as do the men of the profession and that we are more similar than dissimilar (22).
The Next 25 Years
How the AAWR developed over the next 25 years and how it succeeded in addressing the unique problems that face women in radiology is well documented in the various Focus publications. Focus is a quarterly newsletter that the AAWR publishes. Of particular interest is the issue of Focus that was dedicated to the 20th anniversary celebration (23) (Fig 2). I will draw on that 20th anniversary publication as I highlight the growth of the AAWR. Before doing so, it needs to be emphasized that, above all, progress and success of AAWR over the years were possible because many talented women volunteered to work for this effort and volunteered to help in all sorts of ways. Some were willing to serve on committees; others even volunteered to serve as officers. All of these volunteers felt compelled to share what they knew, but, above all, they were compelled to share their experiences, and they always kept in mind, in particular, the needs of those women who were just starting their training or career in radiology.
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Radiation oncologists have been eligible for full membership since the founding of the AAWR, and their participation in every facet of the AAWR has always been welcomed (Fig 3). In 1990, Eleanor D. Montague, MD, became the first radiation oncologist to receive the prestigious Marie Sklodowska-Curie Award of the AAWR. Ritsuko U. Komaki, MD, later served as 2001 president of the AAWR and was the first radiation oncologist elected to this position. In 1995, the AAWR started sponsoring a luncheon at the annual meeting of the American Society for Therapeutic Radiology and Oncology; a more formal program was developed for the 2004 American Society for Therapeutic Radiology and Oncology meeting (25).
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Women and men in radiology agree that radiation exposure poses more of a risk to women, in particular during pregnancy. That problem has been explored in a number of publications, some of them by AAWR members (27,28). Amazingly, no uniform policy has as yet been developed that can be applied by the program directors of radiology residency programs.
It is generally recognized that professional women bear a greater responsibility for family, be it in caring for children, caring for elderly parents, or caring for other family members, than do men. How to integrate this responsibility with what is expected of them in the profession has been, and continues to be, a dilemma for women in radiology. The AAWR has addressed this issue in a number of ways, such as in writing a child care monograph and in sponsoring many panel discussions and presentations over the years in which options and choices were explored. The most recent panel discussion on this subject took place at the 2004 American Society for Therapeutic Radiology and Oncology meeting. The title of this panel discussion was "Mission Possible: Balance Career, Yourself and Family" (25). Part-time work has been, and continues to be, explored as an option, but part-time work is not widely available as yet (29).
Because women in radiology have limited access to mentors, and only if they aggressively seek out whoever is available, the development of their professional skills suffers. The AAWR has tried to fill in this void. It has sponsored refresher courses about how to get work published, how to be effective in making presentations, and how to ascend in the professional hierarchy in academic rank, or how to ascend to positions of leadership in organized radiology (23). It is interesting to note that a frequently visited page on the AAWR Web site is one that offers instructions on how to write a proper curriculum vitae that will be effective (30). The AAWR has maintained a relationship with the AAMC and each year sponsors attendance at professional development seminars, one for early-career faculty members and another for midcareer faculty members.
The AAWR has also sponsored discussions and panels in which contracts, issues related to job negotiations, and other work-related issues are explored, keeping in mind the special problems that women in radiology encounter in nonacademic settings. Women have been able to venture into private practice with opportunity for full partnership only in recent years and have been able to do so only in small numbers (23).
The AAWR early on recognized that women needed to be recognized more often for their achievements. That led to establishment of the following awards: the Marie Sklodowska-Curie Award, with the first recipient in 1986, and the Alice Ettinger Award, which was given for the first time in 1998. Distinguished Resident Awards were inaugurated in 1990, one designated for a resident in diagnostic radiology and a second one designated for a resident in radiation oncology. The resident awards later were renamed and now carry the names of two distinguished women; thus, the resident award in diagnostic radiology became the Lucy Frank Squire Distinguished Resident Award, and the resident award in radiation oncology became the Eleanor Montague Distinguished Resident Award (23).
In 2000, the AAWR established a relationship with the Journal of Women's Imaging through the efforts of M. Ines Boechat, MD, (23). That publication makes it possible for the AAWR to address special concerns in regard to women's health and the imaging challenges they pose.
Corporative sponsors made possible many of the programs that the AAWR pursues and likes to support. Commercial sponsorship started soon after the founding of the AAWR and has continued over the years. These corporative sponsors are listed in the 20th anniversary issue of Focus; a more updated list is posted on the AAWR Web site (23).
Corporative sponsorships and private donations made it possible for the AAWR to establish the AAWR Research and Education Foundation. This foundation was established in 1991, and in addition to the funding of the AAWR awards, now also funds each year a seed grant of $5000 to a woman who needs such support for a worthy research project (23).
The AAWR has reached out and has provided input to the Intersociety Meeting, has had two representatives at the ACR, and, more recently, has appeared more formally on the international scene by having a booth at the 2004 European Congress of Radiology and representation at the last International Congress of Radiology in 2004 (31). Ewa Kuligowska, MD, has played a big role in developing international outreach. She and Judith K. Amorosa, MD, developed the criteria for international membership and represented the AAWR at the European Congress of Radiology (32).
In 1997, the AAWR launched its Web site. That Web site was expanded in scope and complexity when Katarzyna J. Macura, MD, PhD (written communication, October 18, 2004), assumed responsibility for it a year later (Fig 4). Because women in radiology remain a minority, Dr Macura soon recognized that networking and/or mentoring also could occur over distance. Thus, the Virtual Mentoring program was developed and recently was posted on the AAWR Web site (33).
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To provide a forum for issues unique to women in radiology, radiation oncology and related professions; to sponsor programs that promote opportunities for women[;] and to facilitate communication among members and other professionals (34).
Comment
In this report, I have focused on the early days of the AAWR. I have done so because that part of the history of the AAWR is less well known. This focus may also reflect my own bias. As a witness to this part of the history of the AAWR, I have recounted its birth as I recall it.
I am still amazed how quickly the idea for forming this organization developed, how rapidly it spread, and how widely it was accepted by the radiology community. It seems that so much progress was made early, while progress in the status of women in radiology was much slower in the years that followed. Could it be that the Equal Rights Amendment played a much bigger role in the founding of the AAWR and in the progress that women in radiology made around this time than we are now willing to admit? The debate about the Equal Rights Amendment reached into the radiology community. For instance, on the flyer that announced the second preliminary meeting in San Francisco, Calif, Dr Hayman also was trying to conduct a survey, and one of the questions that she posed was a question about what position the AAWR wanted to take in regard to the Equal Rights Amendment (10). Dr Chick, in her letter to Dr Shaffer, went on record saying that her support of the Wisconsin resolution did not mean that she was also supporting the Equal Rights Amendment (15).
Sandra Day O'Connor is still serving on the U.S. Supreme Court, but she is no longer the only woman. When she was chosen, it was pointed out that no president had reached down so far into the state judiciary for such a high-level appointment (35). Justice O'Connor has an established record in her position at the court, and in a recent article in the Washington Post Magazine, Lane called her a defining force in many decisions (36). When she accepted the Jobs for America's Graduates Role Model Award of the Year in 2003, she told those who were present that she had never heard about the concept of a role model until she reached the Supreme Court (36,37). When Attorney General William F. Smith drew up a list of possible Supreme Court Justice choices for President Reagan, he included O'Connor's name on the list. Justice O'Connor had once applied for a position at Smith's firm in California after she had graduated from Stanford Law School, and she was indeed offered a job with the firm, a job as a secretary (36). Justice O'Connor is now much in demand as a speaker, so the radiology community can consider itself fortunate that it was able to recruit her as a keynote speaker to deliver the 1990 Caldwell Lecture at the annual meeting of the American Roentgen Ray Society in Washington, DC (38). It was noted with interest that an unusually large number of women were in the audience (38).
The Women in Medicine Program of the AAMC has continued. Today, there are about 240 women liaison officers appointed by medical school deans, by the Council of Academic Societies, and by the Council of Teaching Hospitals (39). At present, 12 women deans lead medical schools in the United States (40). Most medical schools, approximately 70, have a Women in Medicine Program, but only a few are well funded, such as that at Harvard Medical School and at the University of Pennsylvania (40).
The professional landscape has changed considerably for women in radiology since the founding of the AAWR. Now, women not only teach refresher courses but they also chair refresher course committees. It is no longer unusual for a woman to chair a scientific session or to serve on the editorial board of one of our major radiologic journals. Women have ascended to the highest office of president in all major radiologic societies. They have been honored with the highest awards given by these societies. How much credit can the AAWR take for these changes? We will, of course, never know, but it is of interest that many of these accomplished women were and are AAWR members and have held positions of responsibility with the AAWR. Some of us like to think that this experience helped them prepare for what was ahead when they moved into an environment that they perhaps found to be less supportive. The AAWR, in some cases, served as a training ground for these talented women.
When the Wisconsin resolution about women in radiology was defeated at the annual meeting of the ACR in September of 1981, there were only a few women among the new ACR fellows. I know, because I was one of those women. As of 1981, the ACR had a total of 307 fellows, including those who had retired. Five (1.6%) of these 307 ACR fellows were women. In 2004, the ACR could count a total of 3488 fellows among its membership; 255 (7%) of the ACR fellows are women (James I. Morrison, ACR, written communication, October 21, 2004). Only four of the 10 women who were honored by an ACR fellowship in 2004 are AAWR members (41); yet, all women in radiology, whether they are AAWR members or not, benefit from the advocacy of the AAWR. The AAWR, in a few instances, has proactively supported nominations for positions and awards.
Is there still a need for the AAWR? Responsible men and women will agree that there is, because complete gender equality has not as yet been achieved. As recently as 1999, considerable discrepancies in opportunities for research by women scientists were discovered and openly discussed at the Massachusetts Institute of Technology. To correct these inequities, an institutional study was conducted, and it was led by Nancy Hopkins (42). That Massachusetts Institute of Technology report and the recommendations it produced seem to have had a wide impact beyond Massachusetts Institute of Technology (Fig 5).
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What is ahead? Perhaps the most important challenge for women in radiology is not to forget that, as physicians, much has been invested in us by society through our education and training. We are expected to return some of this investment. Being a physician and radiologist does not mean that we just chose a life style or a job. It is a calling to join a privileged profession. We can pay back some of what was given to us by making a true commitment to the profession through our work and by advancing knowledge in our specialty. Such commitment must be based on understanding one's potential and always insisting on conditions that make it possible to realize this potential to the fullest. For a while yet, I believe, all women in radiology will need the AAWR and its advocacy.
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ACKNOWLEDGMENTS |
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References |
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 TOPINTRODUCTION References |
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This article has been cited by other articles:
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  T. L. Angtuaco, K. J. Macura, A. M. Lewicki, M. L. Rosado-de-Christenson, and C. M. Rumack Radiologic History Exhibit: The American Association for Women Radiologists (AAWR): 25 Years of Promoting Women in Radiology RadioGraphics, March 1, 2008; 28(2): 573 - 582. [Abstract] [Full Text] [PDF]
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