Blazing a Trail for Women in Medicine and Academia

Linda P. Fried, MD, MPH, dean of Columbia University’s Mailman School of Public Health, is a pioneer in the science of aging.

She also is a trailblazer in advancing opportunities for women in medicine and academia, playing a key role in groundbreaking analysis of sexist practices and institutional solutions during her career at Johns Hopkins in the 1980s through 2008. She is the 2019 recipient of the Alma Dea Morani Renaissance Award, the most prestigious honor bestowed by the Women in Medicine Legacy Foundation.

“When I was a very junior faculty member in the department of medicine in 1988 at Hopkins, the culture and behaviors were demeaning to women and the environment was very adverse for women,” Dr. Fried recalled. “The experiences of individuals were supported by a report by the Provost at that time recognizing consequences in terms of lower salaries and slower advancement for women.”

In agreeing to chair a new task force in 1989 to investigate gender-based disparities, Dr. Fried took a calculated risk.

“I was invested in getting my academic career up and running and recognized it was risky for a young assistant professor to get involved in something like this. I had seen women trying to change things solo lose their jobs over it,” she recalled.

‘A Leader I Could Bet On’

She decided to take on the challenge because she had the support of female colleagues – most of whom believed that their careers would not succeed without changes in the culture and institution – and male leadership. 

“I believed that Jack Stobo, then Chair of the Department of Medicine, was a man of integrity who would not kill the messenger if we brought him bad news. He was a leader I could bet on,” Dr. Fried said.

The initiative was a structured scientific process designed to understand and then solve the problems; it included qualitative interviews, hypothesis development, and quantitative surveys and evaluations to test the hypotheses. As a result of findings, Hopkins rolled out more than 35 interventions over the next five years.

Salaries for women physicians and researchers rose. The number of women associate professors increased by 550 percent, from four to 26. Sexist remarks and practices by male physicians, once commonplace, were no longer tolerated. Revered practices were changed; for example, the department ended its 100-year tradition of holding grand rounds on Saturday mornings, when it was difficult for parents with small children to attend. 

“What we learned laid the basis for 30 years of change,” Dr. Fried said. “We saw huge improvements for women in the department of medicine, signified by dramatic improvements in optimism about promotion and the likelihood of staying in academic medicine. This work led to changes in the school of medicine and across the university. I and many colleagues benefited as a faculty member and a leader because of the work we did at Hopkins.”

Supporting women in medicine also reaps far flung benefits for patients and for population health.

“When women felt optimistic, that they were valued in their careers for potential as well as progress, many women reported a huge surge in creativity that they did not experience when they did not, previously, feel safe or valued,” she said. “Academic medicine, when it supports women, contributes unparalleled opportunities to improve health and well being. It’s deeply fulfilling and incredibly important.”

The Power of Collective Action

Still, the work continues. She notes that paths for advancement are still slower and frequently blocked for women. Women are recruited less often for leadership positions. They are often excluded from informal leadership networks, and deferentially experience isolation. And demeaning sexist stereotypes still persist at the highest levels of academia.

To keep progress going, Dr. Fried encourages women physicians and scientists to support one another, and set the expectation that leaders will lead to build an inclusive culture in which everyone flourishes.

“Protesting environments that do not support women requires collective action,” she said. “You need to take things on as a group and present a shared analysis. Having a shared analysis is also liberating. It shows you when these problems are not idiosyncratic to yourself.” 

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