Introduction: Women in Medicine

The percentage of women physicians in the United States is increasing, as women currently make up 35% of the active physician workforce but nearly half of all US medical school graduates.¹  Although progress has been made in increasing the number of women in medicine, equity issues remain, as women physicians report having less control over day-to-day aspects of their work, are often compensated at a lower rate, experience more challenges in the balance between work and home life, and are more likely to report burnout than their male counterparts.^2,3  Furthermore, women physicians with multiple identities that have been historically marginalized and excluded, including those who identify as Black, Indigenous, and/or people of color (BIPOC), experience additional disparities in terms of pay and discrimination.^4–7  Rooted in organizational and societal culture, these disparities cause stress and burnout among women. Working to create gender equity in health care can help ameliorate this additional stress and burnout, resulting in increased wellness among women physicians. Furthermore, as the next generation of health care leaders, there is also a need to empower women with skills in leadership and equity. Developing and promoting these skills can help accelerate changes in a medical culture that currently disadvantages women.

In 2018, the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), American College of Physicians (ACP), American College of Obstetricians and Gynecologists (ACOG), American Psychiatric Association (APA), and American Hospital Association (AHA) formed a partnership to develop the Women’s Wellness through Equity and Leadership project (WEL).⁸  Collectively, these 6 organizations were committed to addressing issues of equity and leadership for women physicians by fostering needed and sustained changes. Funded by the Physicians Foundation, this project convened a diverse group of 18 early- and mid-career women physicians (the WEL “cohort”) who engaged in networking and training around wellness, equity, and leadership over the course of an 18-month curriculum. Expert national faculty from these organizations addressed intersectionality throughout their presentations and discussions. Seeking “to describe how race, class, gender, and other individual characteristics “intersect” with one another and overlap,”⁹  intersectionality offers “a lens through which you can see where power comes and collides, where it interlocks and intersects.”¹⁰  This interdisciplinary supplement was created to highlight the issues faced by women in medicine and disseminate the portfolio of learnings that resulted from the WEL curriculum.

As a final contextual point of background, it is essential to recognize the challenges facing our world at the time of this writing (Fall 2020/Winter 2021). Over the past several months as the coronavirus disease 2019 (COVID-19) pandemic has unfolded, the need for support for physicians has grown significantly. The pandemic has rapidly impacted communities, physicians and other health care professionals, and health care systems. Numerous accounts have documented the acute and long-term stress that physicians are experiencing associated with the pandemic, both professionally and personally.

However, like the trajectory of COVID-19 itself, certain groups of physicians have faced even greater threats to their well-being during the pandemic. Women physicians with children are one such group. Past research has found that childcare responsibilities typically fall on women, even women who work outside the home.¹¹  Many women physicians with children have therefore faced additional challenges as they attempt to continue work during the pandemic, either because of a need to separate from their children to avoid exposing them to COVID-19 or because of pandemic-related barriers to childcare and/or managing their children’s remote learning. Another group facing increased threats to their well-being includes BIPOC physicians. The COVID-19 pandemic has exacerbated the significant inequities existing in the US, making the negative effects of racism and discrimination even more evident, often with devastating and fatal outcomes. Furthermore, the racial disparities in COVID-19 positivity and death rates have been compounded by the most recent rampant and egregious examples of racism in the US with accompanying calls for addressing racial injustice. These events have only heighted the need for individual level support and training, and organizational and systemic change, to promote wellness among the diverse group of physicians who are women.