When Colleen Brown graduated from the Indiana University School of Medicine in May, she was part of a class making history. For the first time, the medical school was graduating more women physicians than men-131 and 128, respectively.
Since 1970, there has been a 10-fold increase in the number of women physicians, according to a February 2006 study by the American Medical Association.
In 1970, only 25,404 women graduated in the United States in all medical specialties. By 2004, the number had risen to 235,627, accounting for one quarter of medical graduates.
Indiana's numbers have been almost as dramatic. In 1970, the school graduated a mere 25 women physicians, compared to 193 men.
Dr. Deborah Allen, a professor of family medicine at the IU School of Medicine, has written three books on women in medicine. Allen, a 1976 graduate of the school, remembers the first woman who went into obstetrics-gynecology at IU-a member of the class of 1975. This year, eight women entered the specialty at IU and nationally it's one of the most popular areas of practice for women.
Brown, 41 and single, is a native of Wilmington, Del., but has lived in Indianapolis for 30 years. She plans to practice obstetrics and gynecology in under-served populations after completing her fouryear residency. It was a rotation at a Wishard Hospital clinic that solidified her decision.
"In the field that I'm going into, there are many advantages to being a female because there are people-whether culturally or because of their own personal reasons-who don't want a man [as an Ob/Gyn doctor]," Brown said.
There was a patient who refused to be examined by the male director of the program and instead wanted Brown to do the examination.
"She said, 'You're a girl, you'll understand,'" Brown said. "She actually waited an extra hour so a female attending [physician] could come in and make sure that everything was OK, because she couldn't leave under my exam because I was a student."
The path to medical school for Brown was markedly different than for many of her younger female classmates. She said she went from being "a woman in business to being a woman in school."
Brown was vice president of community affairs at Bank One from 1991 until 1996. She left banking to work as director of outreach and marketing for The Wellness Community, a not-for-profit organization based in Indianapolis that provides support to people affected by cancer. Interacting with physicians and patients cemented her lifelong desire to be a doctor.
"I had always wanted to be a doctor from the time I was 8 years old, but I never really liked science courses that much," Brown said. Instead, she majored in economics at Lake Forest College near Chicago.
She put medicine out of her mind for nearly 20 years, she said. "It wasn't until I was at the Wellness Community that I started working with doctors and realized that medicine was much more than chemistry."
Making the change from the corporate world to medicine meant many sacrifices.
"I went from owning a home, having a new car and flying places pretty freely to being in debt and driving an old, beat-up clunker," Brown said. "Even with the sacrifices, it's been worthwhile. I didn't want to be 80 years old and looking back saying, 'Man! I always wanted to be a doctor.'"
Rachel Scott, 25, is also a graduate of the 2006 medical school class. The Roachdale native has a long road ahead toward her goal of being a surgeon. A surgical residency is five years of additional work, and most people complete an additional research year and a two- to three-year fellowship, Scott said.
She knows her choice to be a surgeon will affect her personal life.
"While it is possible to have a family, it's certainly not easy," Brown said. "There are a lot of tradeoffs. For some of the women [in medical school] who didn't go the traditional route and had families and children, there's an increased burden dealing with family demands vs. medicine."
And while Brown doesn't think she faced "any significant challenge that guys wouldn't have faced," the field of surgery is still dominated by men.
Allen believes that the length of time necessary to complete a surgical residency may be one factor that contributes to the small number of women who enter the specialty.
Specialty practice areas like Ob/Gyn, pediatrics and family medicine are no longer dominated by male physicians, Allen said. For example, in this year's graduating class of the IU School of Medicine, nine men plan to practice family medicine, compared to 24 women. In pediatrics the increase is even greater-22 women vs. two men.
Factors that steer more women into these specialties include women's desire for more personal interaction with patients and a short residency time before beginning private practice.
"By the time you're 26 or 27, you're interested in getting out and on with your life," Allen said. "There is a biological clock ticking that enters into it. Men don't have that problem."
Women are more likely than men to drop out of medical school or residencies, a phenomenon Allen has studied. Children play a role, she said.
"My guess is women look from the outside and think they can be 'superwoman' or they think they can do it in portions-be a resident during these three years and then have my kids," Allen said. "The reality is much different."
"When you go into medicine, it's a jealous mistress," she said. "It allows you little time-especially during your training-for anything else. If you think you're going to be able to juggle all of these roles well, you'll be in for a rude awakening."
Both Brown and Scott know that their struggles haven't ended with graduation. They face enormous student loan debt and long years of sleep deprivation as residents.
Brown says that her choice to serve impoverished women-both here and as a volunteer in African and Central American countries-means that she'll have to sacrifice even more.
"It may not be the most economically sound decision to go into medicine-especially being out of school for a while-but as important as finances are, you still have to go with your gut and do your life's calling," she said.
"I expect at some point in my career to be paid in chickens," she said laughing, "but I do have a significant amount of student loans that I will have to repay."
Both women feel that the Department of Labor's Bureau of Labor Statistics report stating that nine of the 10 highest-paying jobs are in the medical field is misleading.
"As an in-state student, I have about $160,000 in medical school debt," Scott said.
"When you're going to see a physician, keep in mind what they've had to outlay in terms of money and the best years of their life when you think about how much they're making. They sacrificed to do that."