Inside Doctoring: Stages and Outcomes in the Professional Development of Physicians

Donna K. Whitney

In considering issues related to women in medicine, frequently we hear discussion of discrimination regarding medical school admissions, residency selections, faculty appointments, and academic advancement. We hear also about the effect of gender upon choice of specialty, referral patterns, and income. I will say at the outset that I have no knowledge of the statistics on these topics, little desire to learn them, and no intention of discussing them. My concern is with the people who study and practice medicine. How do they respond to the challenges of their profession, how do they change and grow? What becomes of their values, their ethics, their personalities, their beliefs? With regard to these issues, I am concerned equally with male physicians and females, even though in some ways the two genders probably experience these issues differently.

By now you may have heard it said that medical education and training are as much a process of being socialized as of being instructed. I would agree that there are certain normative beliefs and mores which are subtly but firmly urged upon us during the progressive rites of initiation into the profession, and I would contend that these values and mores tend toward the masculine rather than the feminine. We learn to speak with power rather than with authority, to give commands rather than to speak, to demand rather than suggest, to cure rather than to heal. These values and nuances of personal style can advance so insidiously as to go unnoticed until they are well established in the medical initiate. I personally have observed the gradual but inexorable leaching out of much that is soft, tender, humble, and creative from young physicians, to be replaced by an unnatural cockiness and brusqueness. I have observed this in myself, and have sometimes been surprised to hear myself speak with a voice that is not my own.

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