Searching for the Garden of Equality

For women in radiology, finding a fair deal is as elusive as Eden

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Marie Curie is best known for the discovery of radium and as the first person to win two Nobel prizes. However, her work also changed the commonly held belief that only men could succeed in science.

It's hard to believe that so few women are entering the field of radiology. After all, the first known X-ray was of a woman's hand. Mrs. Roentgen played a key role in the early research of X-rays serving as Wilhelm Roentgen's brave subject. (ECR)

A lesser known pioneer is Elisabeth Fleischmann, who was probably the first woman to have her own X-ray laboratory in 1896. (ECR)

Against the Grain
ASRT power trio reverses gender trends

Although most of radiology is experiencing a decrease in the number of women entering the field, one radiology organization is not only bringing more women into the discipline, it's also molding the leaders of the future. For the first time in its 84-year

history, the American Society of Radiologic Technologists (ASRT) has an all-female board of directors. It's a unique situation, but don't think these ladies take it for granted.

"All across the country, the ASRT affiliate societies are grooming female leaders," says Dawn Fucillo, MA, RT(R)(T)(QM), CMD, president-elect of the ASRT. "There is a strong structure in place for leaders to advance at the state level. It's almost a proving ground for the national society."

Fucillo credits the society for doing a great job mentoring female leaders and preparing them for leadership positions. "There are a number of different women in the field that serve as mentors. It's a huge part of advancing careers, and as president-elect, I take the responsibility personally. In a way, I am a role model not only for women, but also for my profession. Mentoring is a very large part of raising the level of our profession," she says.

Some people would argue that an all-female board brings a different perspective because of the reversed gender roles, but President Eileen Maloney, MEd, RT(R)(M), would argue that professional background has more of an impact. "There's more diversity in your background other than gender," she says. "Our current board is completely diverse. From radiation therapists and dosimetrists to radiography educators, we represent a variety of modalities. Yet we are all women, and I think our background has made us one of the most diverse boards the society's had."

Leading the ASRT has been a rewarding experience. However, balancing their leadership roles with family can be tough, says Donna Newman, BA, RT(R), CNMT, chair of the board. Approaching the end of her term this summer, Newman looks forward to spending more time with her family, but she also appreciates what the opportunity has taught her. "It's been a wonderful experience. You truly learn more about yourself during the time on the board," she says. "Because of the extensive traveling, I've missed out on a part of family life. But there are some sacrifices that are made. I'm glad I'll be spending more time at home, but also very fortunate to have had the opportunity to lead."

Power Trio: (From left) ASRT President Eileen Maloney, MEd, RT(R)(M), Chair of the Board Donna Newman, BA, RT(R), CNMT, and President-elect Dawn Fucillo, MA, RT(R)(T)(QM), CMD, flex their muscles when it comes to leadership. For the first time in its 84-year history, the ASRT has an all-female board of directors. (ASRT)

– J.K.

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Long gone are the days of glass ceilings, blatant sexism and strident inequality, right? Think again. Although women have made significant strides breaking into business-world boardrooms, there is still a dire need for their gains to be expanded in the field of science – especially radiology, says Ewa Kuligowska, MD, FACR, president of the American Association for Women Radiologists (AAWR).

Women are still under-represented on radiology faculties, underpaid compared to their male colleagues and passed over for promotions time and time again, Kuligowska says. Even more frightening, the latest surveys show that fewer women are choosing radiology as a career path, a situation which she fears will only perpetuate the cycle of inequality.

"Across the country, only nine women currently hold the position of chief radiologist at a hospital or medical center," says Kuligowska, "and only 11 percent of female radiologists are full tenure professors in academic medicine. When you look at the numbers you realize there is a long way to go to gain the same professional status and recognition as our male colleagues. Unless something changes, it will be a long time before we get to where we want to be."

Kuligowska, the chief radiologist of the ultrasound section at Boston University Medical Center, finds the current situation alarming, and it may get worse before it gets better. Radiology remains the only residency program experiencing a decrease in female enrollment, despite other residency programs posting significant gains. "Not only are women in radiology fighting a battle for equality," she says, "but now there are fewer women entering the field altogether."

Is it sexism? Gender bias? A good old boy network conspiring against women to keep them from entering radiology? Actually, says Kuligowska, the main culprit can be traced to widely held misconceptions about the practice of radiology itself – although others say unconscious sexism is also partly to blame.

Myths and Misconceptions

"To understand the problem, it's essential to recognize that radiology has been viewed for many years as a male-dominated field, which makes it very tough for women to enter," says Kuligowska. "But there's also a widely held misconception that radiology is far removed from patient care. People outside the field think radiologists sit at their computers and read films all day."

Kuligowska believes this misconception has a significant effect on women choosing radiology as a career because they are generally very compassionate and search for patient contact in medicine. "Women strive for that feeling of being able to make a difference," she says. "But they think radiologists are distant and in the background. They don't see that we have a tremendous amount of patient interaction, especially radiologists who work with ultrasound or perform interventional procedures. We spend hours with patients."

Even if radiology is able to shake its reputation as a haven for men who enjoy working out of sight of the patient, there's still another misconception that has curbed women from entering the field. According to Kuligowska, some women are nervous about being around radiation during their reproductive years. There's a fear among some residents that even extremely low doses of radiation will somehow affect their fertility or that there would be harmful side effects from working with radiation. "It's simply not true," she asserts, "and we need to fight these misconceptions."

In order to fight these myths, Kuligowska says an arsenal of information needs to be taken to the roots – back to the schools, where med students originally form their perceptions of various practices. Unfortunately, there is a lack of women radiologists mentoring in the schools, and it's a fact the AAWR is working to change. "We need to provide an example to female medical students and let them know what we do," she says. "We're working very hard to let people know that it's a safe, rewarding profession for women. And with teleradiology changing the way we practice, combined with the growing specialty of women's imaging needs, there's never been a better time for women to enter the field. We're trying to get the word out to them."

The lack of female mentors is something that bothers Cathy Trower, PhD, researcher at Harvard University's Graduate School of Education in Cambridge, Mass. As an expert in gender and education issues, Trower also sees the lack of women mentoring other women as a crucial barrier to gaining equality.

"There is a scarcity of effective women mentors – effective meaning those in leadership positions who really have the ability to help someone," says Trower. "Effective mentors are people who are networked. Even if you find women in science and technology, they may not be connected to the power structure that can really help you move up."

However, developing mentors can be a complicated chicken-or-egg scenario, she adds. In order for women to gain leadership positions, they need more mentors in leadership positions to guide them. Yet, there's a lack of women in leadership positions to recruit more women leaders, and so the cycle continues.

Gender Bias

If it were a matter of simply breaking down the widespread myths and misconceptions surrounding radiologists, the task of changing the status quo might be possible. However, Trower sees a bigger problem at hand, a dilemma deeply rooted in the minds of men and women alike. And she points to a number of studies about gender bias that have pinned down some of the underlying causes slowing the path of women seeking equal footing. The biggest problem? The fact that many people aren't even aware of the problem. They may not even know they are a part of it.

One important study Trower cites is the Grace Project from the University of Arizona, which examined gender bias in the university's medical school. "The study found women were not being asked to be in leadership positions," says Trower. "The issue is not that women don't want to lead or that they don't have the right stuff to be leaders, the issue is that they are not being asked. So the real problem is, "Why are women not being asked?'"

The study pointed to a few barriers. The first restraint is traditional gender roles, which involve the typical family-work balance dilemma. "Traditional gender roles, which place pressure on women to stay home to raise a family, affect women everywhere," says Trower, "but it hits especially hard in the academy because the tenure clock collides with the biological clock. A young woman scientist or physician earns a doctorate and then completes a post doc. By the time she's on faculty somewhere, she's likely to be in her mid- to late-30s."

Considering that the current tenure system requires six to eight years of "up or out," says Trower, it's easy to see the work and family conflict. "Even in your mid-30s, it's higher risk to have a child. Thus, there may be incompatibility between family life and work in academia. And the simple fact is that this does affect women more than men. Women have the babies. It's a pretty obvious thing, but not a whole lot is being done about it."

Even if women were to successfully navigate the slippery slope of balancing family and work, the study cites a second major barrier – manifestations of sexism. "Sexism still exists in corporate America and it still exists in the academy," says Trower. "The authors of the study have shown that there are cases of sexism in tenure decisions. It may not be what we would consider outright sexism, but a certain amount exists."
For example, Trower says sexism can be seen in the male-dominated view of science that insists on science being very rationale, linear and a solo act. "The institution of science says there is a "right' way which is linear and rational, and some women have a "different' way. I'm not saying that women are irrational, but we do bring intuition to bear. We bring non-linear thinking to science, which is sometimes viewed as the "wrong' way."

The fact is that men and women are different, and they think in different ways. Virginia Valian, PhD, a professor of psychology and linguistics at Hunter College in New York City, has written extensively on the subject of cognitive differences between the genders. In her book Why So Slow? (MIT Press, 1998), Valian looks at gender differences in the academy and the lack of females in leadership positions and asks, "Why do so few women occupy positions of power and prestige?"

Using psychology, sociology, economics and biology, she analyzes the claim that men and women have implicit hypotheses about gender differences – gender schemas – that create small differences in characteristics, behaviors, perceptions and evaluations between the sexes. According to Valian, the problem lies in the fact that those small imbalances accumulate to advantage men and disadvantage women. The most important consequence for professional life is that men tend to be overrated and women underrated.

"Although most men and women in the professions sincerely hold egalitarian beliefs," writes Valian, "those beliefs alone cannot guarantee impartial evaluation and treatment of others. Only by understanding how our perceptions are skewed by gender schemas can we begin to perceive ourselves and others accurately."

In her book, Valian reveals the invisible factors that prevent women's progress so that fair treatment of both sexes will be possible. For example, Valian says gender schemas explain why men and women are perceived differently by their peers. When women exhibit leadership traits – the same leadership traits that are exhibited by men – they're viewed negatively. If women exhibit decisiveness or assertiveness, it's a problem, yet men who exhibit these traits are lauded.

"What's interesting is that the book uncovers hidden or unconscious sexism in the academy and says that these gender schemas are held not only by men, but women as well," says Trower. "Essentially, we treat boys differently than girls. We're socialized and we see different gender roles as we grow up. We're led to believe that men and women should act a certain way.

And this explains, in part, why there are fewer women in leadership positions. There is a certain unconscious bias involved in the treatment of men and women."

Concrete Numbers

The discourse about gender schemas, unconscious acts of gender bias, can be a tough pill to swallow for many men and women. It's difficult to grasp the concept that people may be unfairly judging women or making biased decisions based on unconscious beliefs. And yet, some people dismiss gender bias altogether because of the lack of measurable differences. How can you be sure if men are favored over women in the work world or professional situations? Isn't it possible that one candidate is just better than the other, regardless of sex?

While she agrees that is often the case, Trower cites numerous studies that set out to acquire concrete data of measurable differences between the sexes, like salary figures. Numbers, after all, are a little bit easier to put your finger on, a little more concrete than ideas and theories about gender schemas, she says.

"If it's numbers you are looking for, you can find them all over the place," says Trower. "From the number of women who are asked to be peer reviewers to those who are on editorial boards to the number of women who are asked to be principal investigators on research grants, there are numbers that clearly show that women are not on equal footing."

One particular study from Massachusetts Institute of Technology shows that not only are there salary differentials between men and women, but also lab and research space differentials – even a difference in the amount of funding allotted to women. "When you look at lab space, office space and other resources that are distributed on campuses, women often receive less," says Trower.

And it's not just in the sciences. Trower points to an article in the July 13, 1997, edition of the Washington Post that found blind auditions can explain 30 percent to 50 percent of the increase of women getting more jobs in orchestras. "When they couldn't see who was playing the violin during tryouts, suddenly women were getting hired," she says. "This takes you outside the realm of academia, science and medicine, but it's a great illustration of what women are struggling against."

When you look at the studies, it's easy to be disheartened, she continues. "I'm concerned that despite goodwill, despite affirmative action, which is now being rolled back, we are still pretty much where we were, especially in the sciences," says Trower. "During the past 30 years there have been a lot of policy changes to level the playing field. But even if we equalize space and resources are we doing enough? Or is there something else that needs to change to prevent the perpetuation of status quo? Only time will tell."

Kuligowska also hopes that change is on the way. "I think it will take time, maybe another generation," she says, "but I think we are moving toward a balance between the genders. The AAWR is trying very hard to address the issues that are unique to women in radiology and we hope we can make a difference."

– Jeremy Kuhar is the senior editor of RT Image. Questions and comments can be directed to jkuhar@rt-image.com.