Radiology’s Evolution Leaves Women Behind

During the eighties and nineties — the heydays of radiology — sexism abounded on the RSNA exhibit floor. Gone today are the women who were stationed strategically along the periphery of vendor booths, hired from Chicago modeling agencies, instructed to reel in the heavily male prospects then hand them off to sales people. Gone also are the spandex-clad models who once adorned the X-ray and magnetic resonance imaging (MRI) tables. The women in mammography videos are older than 22.

But, while the most blatant instances of political incorrectness are have been vanquished, the staples of male domination in the radiology rank-and-file remain.

Only about one in five of radiologists practicing today in the United States are women, according to a 2014 survey by the Human Resources Commission of the American College of Radiology (ACR), published in the February 2015 issue of the Journal of the American College of Radiology (“Gender and the Radiology Workforce: Results of the 2014 ACR Workforce Survey”).

Representation goes further downhill when it comes to women in leadership positions. Of radiologists who are chairs, presidents, vice chairs or board members of their radiology groups, only 15 percent are women, according to the ACR survey. Women come out on the short end even when compared as a group to men. The survey found that 17 percent of men are in leadership positions versus just 11 percent of women.

If there is a bright spot, it may be in academia. The most recent ACR survey found that more women than men practice in academic/university environments. The authors conclude, however, that “the role of gender in this difference may be secondary to the benefits of a flexible schedule that allows for childcare and other family responsibility, or to a desire to contribute to the academic mission.”

There may be a darker reason. Women radiologists may not be particularly welcome in private practice.

This certainly was the case 40 years ago, when Carol Rumack, M.D., finished her residency. She recalls in an article published in the October 27 issue of the Journal of the American College of Radiology, being told by the head of one search committee: “We have 20 men in our radiology group and we don’t want to hire any women. They get pregnant and quit. Therefore, we don’t interview women.”

Since then, Rumack has done quite well. She is now a professor of radiology-diagnostics at the University of Colorado  Anschutz Medical Campus, specializing in diagnostic pediatric radiology, and past president of the ACR.

One might suspect that conditions have improved in the past 40 years. Yet there is much to be concerned about.   

As dismal as the results are from the 2014 ACR survey, it is sobering to note that they are  virtually unchanged from those obtained in a 2003 survey by ACR and published in the March 2007 issue of Radiology (“Women Radiologists in the United States: Results from the American College of Radiology's 2003 Survey”). This survey found 24 percent of radiologists in training (residents and fellows) and 18 percent of post-training, professionally active radiologists were women. Most women are more concentrated in academia, according to the 2007 survey. And, women were less likely to own radiology practices than men “in situations where radiologists are likely to be practice owners,” according to the survey — 75 percent versus 91 percent.

Put simply, the ranks of women radiologists have been at a virtual standstill for much of the past decade.

This begs the question — when will the culture of radiology change? And what must happen for that change to take place?

Editor’s note: This is the third blog in a series of four by industry consultant Greg Freiherr on The Evolution of Radiology. You can view the first blog in this series, "Radiology Faces Frightening New World," here. You can view the second blog in this series, “Imaging’s Evolution Fulfills Patient-centric Destiny,” here.