The second year of AWN started with a new set of duly elected officers. I served as President that year. Ellen Li was President-elect. Sue Cullen and Sherida Tollefsen served as Secretary and Treasurer, respectively. The counselors for that year were: Dixie Anderson, Helen Donis-Keller, Elaine Krul and Diane Merritt. AWNings reported that AWN membership was 112 women.

Brown bag lunches were first instituted in 1992 and were the brainchild of Ellen Li. The first ever Brown Bag Lunch sponsored by AWN was held on July 27, 1992. It included a panel discussion on tenure given by Helen Donis-Keller, Deborah Gersell, and Sherida Tollefsen. A month later, the session on Juggling a Career and Family drew an overflow crowd. Rounding out the sessions was a discussion on September 28 about "Delaying Parenthood". Throughout our 10 year history, AWN has sponsored many brown bag lunches and they have invariably been successful events.

During this second year of our existence, AWN began participating in discussions with university administrators who were in the process of establishing a uniform maternity leave policy. To determine what type of family leave policy academic women felt was reasonable, the AWN Committee on Childcare and Maternity Leave, chaired by Elaine Krul, polled our members and tabulated the results. Greater than 90% of the respondents felt that the policy should include six weeks of paid leave. The average leave taken by faculty women in the survey was 6-8 weeks. The information was passed on to the Administration.

AWN members (myself included) also participated in numerous private discussions with members of the Administration regarding whether accrued sick leave could be used to pay for maternity leave. Progress was slow. (Famous quote from a male in charge: "But women are not sick during maternity leave and shouldn't be allowed to use sick leave." I'm sure he never had a baby and couldn't sit down for a week. And I guess C-sections don't count either) Establishment of a family leave policy took several years and required federal legislation. But I like to think that our final policy which does allow one to use sick leave to cover time off for maternity leave is a reflection of the efforts of AWN.

The Women's Health Update column written by Helen Kornblum debuted in the December 1992 issue of AWNings. In it, Helen reported on efforts to have women included in medical research, discussed the efforts of the Congressional Caucus for Women's Issues, and the establishment of the Office of Women's Health Research at NIH. Helen clearly had her finger on the pulse of the times and has been there ever since. Over the ensuing decade, she has been a reliable contributor to AWNings on a variety of political issues regarding women and women's health.

The Spring 1993 dinner was held at Balaban's. The room in the basement was private but it also was dark and had low ceilings. We had several dinners there but eventually gave it up because, despite the proximity to the medical center and the good food, the ambiance was not very upbeat. Former U.S. Congresswoman Joan Kelley Horn was our speaker. She discussed her experience in the House of Representatives and described various options being considered by the task force on health care reform (we're talking Clinton-era here).

In July, 1993, Ellen Li took over as President with Helen Donis-Keller serving as President-Elect. Sue Cullen continued to serve as Secretary and Debbie Gersell was elected as Treasurer. The two new counselors were Penny Shackelford and Jessie Ternberg with Diane Merritt and Elaine Krul serving the second year of their 2- yr terms. One highlight of that year was AWN sponsoring a talk by the very controversial Surgeon-General, Dr. Joycelyn Elders. This was the handiwork of Diane Merritt, as I recall, and the seminar was well attended. However, no hot tidbits came out in her talk. But perhaps we got the best of all possible outcomes--a famous speaker but no news-worthy quotes.

The Parenting Resource Handbook was published for the first time in the summer of 1993. It included information on resources for childcare and also local attractions that were family-oriented. The book, which was, as still is, unique at this institution, became an immediate hit. I am certain that I have lent out my copy at least a dozen times if not more. If everyone has had the same extent of "pass-on", AWN has provided information on childcare to thousands of women at this institution, from graduate students to residents to faculty.

The Parenting Resource Handbook was expanded during its last revision (~1998) to include information on Eldercare. It is now called the Family Resource Handbook and costs for its printing and distribution are borne by HR on Hilltop campus. This was negotiated after AWF (Hilltop campus⤙ AWN equivalent) became involved and wanted to expand distribution to faculty on main campus. Nonetheless, AWN is still responsible for the contents of this valuable resource.

Spring, 1994 saw the institution of the first award given by AWN. This is the Student Leadership Award presented annually to a graduating female medical student and a graduating female graduate student who have demonstrated outstanding leadership in service to or advancement of women within the community. Sheri Tollefsen was responsible for getting this started. Currently, Kathleen Sheehan is the chair of the Leadership Awards Committee.

Helen Donnis-Keller became President of AWN in July, 1994. Sue Cullen was President-Elect. Barb Cole was Secretary and Jo Seltzer was Treasurer. Joan Downey and Kathy Parker-Ponder were the new counselors and Penny Shackelford and Jessie Ternberg were the continuing counselors.

There was some concern among many of the Board members that year regarding how we would get on with Helen Donis-Keller. Helen had a reputation for being difficult and we weren't sure what to expect. We should have expected the unexpected. Our first Board meeting was held in the conference room adjacent to Helen's lab. We walked in at noon to find that Helen had a Crockpot of home-made soup bubbling on the table, along with fresh bread and drinks. The meeting was one of the most organized we had ever had and we all left feeling good. (Helen kept this up the whole time she was President and no one has come up to this standard since.)

Helen and I eventually became friends and scientific collaborators. I have always found her to be thoughtful and considerate. Before she left Washington University, I took her out to lunch and she gave me a going away present-- a package of note cards that were adorned by photos that she had taken. They were beautiful, so beautiful that I haven't been able to give them away by writing on them.

Helen moved to Boston and went back to her first love--art. I recently had a note from her and an announcement of her final exhibition for the completion of her Masters in Fine Arts from Tufts. Starting this Fall, she will be Professor of Biology and Art at the Olin College of Engineering. The best of both worlds for her and I wish her the best of luck.

During her term, Helen undertook a survey of AWN members attitudes regarding various issues at the Medical School. Three quarters of the respondents felt that uniform standards were not followed by chairmen regarding tenure decisions and 89% supported efforts by AWN to improve equity and accountability by chairmen during this process. Nine-five percent of the respondents encouraged the governing body of WUMS to recruit more senior women faculty, including department chairs, and 80% of the respondents felt that the policy of constituting chairmen search committees solely of Executive Faculty Members should be changed as this effectively excluded women from these committees. Finally, three-quarters of the respondents disapproved of the practice of holding medical school functions at private clubs that exclude women and minorities from membership.

Helen sent a letter describing these findings to the Dean as well as to Ed Macias who was Provost at the time. Subsequently, the AWN Board met with Dean Peck to discuss the survey results. It was an interesting meeting.

Each member of the Board has investigated some aspect of women's representation and came prepared with appropriate statistics. Someone had the numbers of the percent of women faculty at each rank at WUSM. My job was to get similar numbers from other 'comparable' institutions such as Hopkins and Cornell. We met with the Dean over lunch and reported on our findings, which were that WUSM had a lower representation of women at all ranks than comparable medical schools and that in particular, we had no women chairmen. We recommended that chairmen search committees be expanded to include women.

The Dean must have been having a bad hair day because the response we got was incredibly un-P.C. "Washington University is great because we do things the way we do them and we're not going to change."

Fortunately for us, that's not what he did. Effective essentially immediately, women were put on chairmen search committees. That's the good news. Having served on a search committee, I can tell you that the bad news is that some search committee members are more equal than others. The department chairmen are all assigned C.V.'s to evaluate for the committee. The participating faculty members (male or female) are not assigned this task and so we just sit and listen. We also do not participate in the 'site visits' in which several department chairs go to the prospective candidates institution and talk with him about the job and his vision for the department.

Overall, AWN's advocacy for this change has been positive as a number of women have at least become familiar with the process of chairman selection. However, we have a long way to go until our participation is on par with that of other members of the committee.

So much for AY 1994 of AWN. In July of 1995, our new officers took over. They were: Sue Cullen, President; Sherida Tellefsen, President-Elect; Barbara, Cole, Secretary and Jo Seltzer, Treasurer. The new counselors were: Barb Monsees and Susan Wente with Kathy Parker-Ponder and Joan Downey continuing their terms.

The year got off to a good start with AWN going AWN-line with our new website and with the publication and distribution of the second printing of the AWN Parenting Resource Handbook. Also, the Executive Faculty endorsed the recommendations that AWN made pursuant to our member survey. This included provisions that: 1) Department chairmen would meet on an annual basis with their junior faculty to inform and advise them regarding the tenure process; 2) Senior faculty, and in particular women, should be represented on major University committees, including search committees for departmental chairmen; and, 3) Washington University School of Medicine functions should not be held at private clubs that deny membership to women.

AWN kept up a dialog with the Administration that year, meeting again with Dean Peck in March to discuss ways to improve recruitment and promotion of women faculty and having Chancellor Wrighton as the after dinner speaker at the Spring dinner. Maintaining open lines of communication with the Administration has been an important part of AWN's mission and I feel, has benefited both the women faculty and the institution.

WASHINGTON FAX
July 19, 2000

Gender value differences may be hindering women's chances of promotion in academic medicine's highest ranks, according to a study published in "Academic Medicine" by researchers at Virginia Commonwealth University (VCU). The study concludes male and female faculty members differ in how they value career accomplishments such as scholarship, leadership and national recognition.

The VCU findings follow a study published in the February 10 "New England Journal of Medicine," which found despite increasing numbers of women at all levels of academic medicine, women continue to trail men in the profession's senior ranks.

"Women on medical school faculties face important obstacles to career development and promotion. External factors like family responsibilities can affect career success. But not enough attention has been paid to whether internal factors--such as a woman's attitude toward scholarship and professional recognition--can also have a role," said Lenore Buckley, associate professor of internal medicine and pediatrics at VCU.

Buckley's conclusions are based on 567 responses to questionnaires mailed in 1997 to 918 male and female faculty at VCU's School of Medicine and its associated Veterans Affairs Medical Center. Roughly a third of the 918 faculty who received questionnaires were women.

The study found women's and men's perceptions of success differ and could have an impact on the promotion process. While women tend to value patient care and teaching, elements that contribute to a medical school's local mission, men are more likely to value accomplishments such as national visibility, leadership and scholarship, career components that are crucial in the promotion process.

Currently, over 20,000 faculty in U.S. medical schools are women, but male professors still outnumber women by a ratio of 10-to-1. While the national percentage of women entering faculty positions at academic medical centers has significantly increased in the last two decades, the proportion of women at the level of professor has remained at 11%.

Promotion criteria at most academic medical centers were developed many years ago when the major mission was research, explains Buckley. "America's health-care environment has changed, and medical schools should reflect that in their reward structures and recognize innovative patient care and new clinical programs in addition to scholarship and national contributions," adds Buckley. Unless that happens, the imbalance in the proportion of female faculty who reach the highest ranks and assume leadership roles likely will continue.

To address that imbalance, the Association of American Medical Colleges has led a national move to increase the number of female leaders in academic medicine, and VCU has joined a growing list of schools who have established faculty organizations to further the professional goals of women physicians and scientists.

The Breast Cancer site has a deal with its advertisers. Whenever the site gets a certain volume of clicks, the advertisers have agreed to donate one free mammogram to an underprivileged woman. So, far the site's had trouble getting enough traffic to meet their goal of getting at least one free mammogram a day. But it's easy to help out. No forms to fill out, no money to spend, just visit the site (which, by the way, you can do each day) and click on "Donate free mammograms. Here's the website!

http://www.thebreastcancersite.com

Copy, paste and share with family and friends!

1. "Clinical Chairs on Why There Aren't More Women Leaders in Academic Medicine," Michael J. Yedidia and Janet Bickel, Academic Medicine, 2001;76:453-465.

2. "Gender Equity in Undergraduate Medical Education: A Status Report, Janet Bickel, Journal of Women's Health and Gender-Based Medicine, 2001;10:261-269.

3. "Advancing Women and Closing the Leadership Gap: The Executive Leadership in Academic Medicine (ELAM)) Program Experience," Rosalyn Richman, Page Morahan, D. Walter Cohen, Sharon McDade, Journal of Women's Health & Gender-Based Medicine, 2001;10:271-277.

4. Mentoring resources - www.mentors.ca/topmenbks.html

Women's Health is Political

"Contraceptives are part of a basic health care package for women of reproductive age. It makes no sense that health plans routinely deny this essential coverage and force women to pay out-of-pocket for this care. This lack of coverage is even more troubling when we consider that insurers are more likely to cover Viagra, the male impotency pill, than they are to cover methods that allow women and men to prevent pregnancy."

Write your members of Congress to urge them to support the Equity in Prescription Insurance and Contraceptive Coverage (EIPCC) Act. This legislation seeks to establish equitable coverage for contraceptive prescriptions and related medical services by insisting that insurance include equal coverage for prescription contraceptive drugs and devices as well."

You can do this quite easily by signing up for Planned Parenthood's Responsible Choices Action Network at http/www.plannedparenthood.org/rchoices/join.

On the Home Front

Governor Holden recently signed a bill that makes Missouri the 15^th state to mandate that employers and insurance companies that cover prescription drugs include contraceptives in their plans. Missouri's bill, however, has a "conscience clause" (otherwise known as a refusal clause). The bill, which takes effect January 1, 2002, will have the added support of two recent Federal Court decisions that ruled that insurance plans that do not cover contraceptives violate sex-discrimination provisions of the 1964 Civil Rights Act and the 1978 Pregnancy Discrimination Act.

Old-boys Club in National Academy of Science

"The Chronicle of Higher Education," recently wrote that "critics question why so few female and minority scholars are elected to the National Academy of Science. Being elected to the academy is regarded as one of the highest honors to which an American scientist can aspire, after a Nobel Prize. It is a distinction that relatively few women, and only a smattering of minority scientists, have received. The academy's membership is overwhelmingly white, male, and concentrated at a select group of research universities. Critics call it an old-boys club, in part because only members may nominate and elect newcomers. Only 7 of the 72 new members who were picked at the recent meeting were women, and women make up just 6.6% of the academy's 1960 American members. . . . Just as MIT and other universities have faced complaints that they are not doing enough to move female scientists up from junior ranks, so do critics say the academy should diversify more quickly.

Maxine Singer, president of the Carnegie Institution of Washington, and an academy member, was quoted as saying "It's just astounding that in a lot of scientific disciplines, there's not a woman who turns up on the final ballot, when you know that there are people doing interesting and exciting work in those fields." Marlene Belfort, a professor of molecular genetics at the State University of New York was quoted: "Some form of affirmative action is appropriate at universities to help female scientists. If universities gave female scientists more assistance and encouragement while they raised children, fewer might quit science before achieving senior status." And, Harvard's Mr. Dowling: "But the strongest excuse may be that academy members don't want to make their insular club less exclusive. The proposal to expand the freshman class by just 12 failed at least once before 1999. When people belong to an exclusive club, they try to keep it exclusive. As a result, the academy is not as representative as it could, be, should be, and has to be."

The Breast Cancer Wars

The book was recently excerpted in the Washington Post. Barron Lerner, physician and medical historian examines how American culture and politics, as much as medical research, have driven diagnosis and treatment of the disease--not always to women's benefit. In Lerner's words: "For decades, politics, economics and culture have shaped the American response in breast cancer. And they have influenced patients and doctors, by affecting how the disease is diagnosed and treated, and which elements of the breast cancer war receive emphasis and funding. Women with breast cancer and those at risk for disease need to realize that ostensibly scientific decisions cannot be separated from the larger culture setting."

Washington University's Own--

"When Science Offers Salvation: Patient advocacy and research ethics."

Rebecca Dresser is a professor of Law and Ethics in Medicine at Washington University. This beautifully written and thought-provoking book was just published by Oxford University Press. "Dresser is the first to examine patient advocacy through the lens of research ethics. She reveals the many ways in which a quest for cures and improved therapies shapes advocacy work. She exposes the bright and dark sides of patients' expanded opportunities to enroll in clinical trials and join researchers in planning and evaluating studies. . . . Patients advocates can help make research more ethical, but advocacy raises ethical issues of its own." Dresser's book is a great read! I strongly recommend it. There is a personal women's health connection here. Almost ten years ago when I began raising the banner of women's health inequities and specifically women's exclusion from participation in clinical trials, Rebecca's landmark article became my "bible". The article, "Wanted: Single, White, Male for medical Research" was published in the "Hastings Center Report" in 1992.

Women's Health and Art

Washington University Gallery of Art is organizing an exhibition, "Inside Out Loud, Visualizing Women's Health." The exhibition, designed to travel to several venues, will be accompanied by a book. It is scheduled for 2004. Enthusiastic support from AWN, Women's Studies, Art History and WUMS is much appreciated. Stay tuned!!!!

Women just don't get it--recognition or high-ranking positions, that is. "Vertical segregation" is the trendy sociological term, but while the proportion of female graduates in many scientific disciplines has shot up, the proportion of women reaching the top is still low. In most European countries, women occupy fewer than one-in-ten top slots in science faculties.

Mookambeswaran Vijayalakshmi is head of a bioengineering laboratory at the Universite de Technologie de Compeigne in France. Recently, she became the first winner from France since 1985 of the International Excellency Award in the field of affinity technology and biological recognition. Viji, however, is aggrieved that her university failed to communicate the news to the media positively. "They did not want to mention my name or my identify as head of this lab," she says, "nor even to mention the research field. The local press was not even present during the award ceremony." Is this a case of unwitting discrimination?

What is going on? Haven't those tough old glass ceilings long since been smashed and piled up in scrap heaps along with that other structural blunder, asbestos? Seemingly not.

According to Nicole Dewandre, head of the European Commission's Women and Science sector, there are several factors that underlie the slower progress of women's careers in science. Surveys, she pointed out during an online debate organized by the journal Nature, consistently show that women scientists more often follow their partners than the converse when a job change is in the offing, and women are also more commonly forced to compromise their careers in order to balance the issue of childbearing and child rearing. While efforts are made by some establishments to assist with relocation through bridging finance and job offers for partners, the so-called received wisdom is that women follow their men. "When women go into the workforce, they almost never have the kind of support that men enjoy,their husbands have lives and careers," says Nancy Cox, who is researching the genetic basis of diabetes at the University of Chicago. "Fewer men have that kind of support either, but there are still some that do, and it's difficult to break standards set in a different time."

A disturbing study in 1997 by microbiologist Christine Wenneras and immunologist Agnes Wold, funded by the Swedish Medical Research Council uncovered a strong gender bias in the way research funds are doled out. "The system is revealed as being riddled with prejudice," the authors claimed. It became apparent that women needed to be at least twice as productive to reap the rewards. The revelation has prompted greater interest in the issues, and inspired an EC conference in April 1998 that determined that beyond the need to be fair to women, the promotion of women in science is crucial to European society as a whole. The EC has now set itself a 40 percent target for female participation in its Fifth Framework research program and the pressure is on to ensure women are fairly represented, and represent fairly the program's expert committees. Currently, however, only 15 percent of applications are from women, although the Sixth Framework rather optimistically to achieve 50 percent women participants.

So where are the women in the upper echelons of science? There are a few famous names, admittedly, but women seem to remain foot soldiers, or else leave the ranks altogether when faced with a lack of professorships available to them. There is a well-worn argument that science, with its goal-oriented attitudes and methodology, is more masculine than feminine pursuit. Women are said to be more interested in finding ways to reach a solution and in learning from the experience, where as men tend to gain more from getting the results and disseminating them in order to gain peer recognition. But, this argument relies on the archaic white-coated-male stereotype. "I don't think the problems women face in science and academia are so different from the problems they face in trying to move into the upper echelons anywhere else," says Cox.

Some commentators believe it will take more than conferences and proposals to eradicate inherent and ancient sex discrimination in society. According to Anthony Engwirda of Griffith University, Brisbane, Australia, the underlying reason that there are so few women in positions of power is purely historical. "When a woman, her mother, and her grandmother have no memory of personal discrimination, then we could justify a belief about the integration of equal rightism" he says. The duration and prevalence of an idea might hint at the difficult in revoking it, but Engwirda adds, "changes to society are difficult and take time. The right of a woman to equality must become a pervasive global idea for several generations before the concept becomes self-perpetuating."

Lane emphasizes that women have been waiting for more than a decade to see a gradual filtering of women up through the system. It has not yet happened. Some argue that women are excluded from male lobbies, and so have to work harder to get what they need, something certainly confirmed by the 1997 Swedish report, Fiji recounts a half-serious comment she heard from a colleague: "Decisions are so often made in the washrooms among men that women can do nothing but be excluded from participating in the decision making process." Cox adds that, "Women scientists are often underestimated because we are more social," she says, "which can make it harder to recognize that you are serious."

Time will tell if the huge number of women in biological sciences as students now will rise to populate academic positions higher than assistant professor," affirms Karen Cone, a geneticist and molecular biologist at the University of Missouri at Columbia and joint owner of the WIS-L list-server discussion group. "We still have a long way to go, and the prospects for the "harder science" fields of chemistry, engineering, math, and physics have a steeper climb because the number of women choosing to enter these fields at the college level is incredibly low."

It was not so long ago that society created a stifling atmosphere for women aspiring to engage in scientific research. Collaborations with male colleagues were almost a necessity for women's research to be heard. The astronomer Caroline Herschel relied on her brother William and his son John to disseminate her research results. Archetypal role model Marie Curie received the Nobel Prize in physics apparently on the insistence of her husband Pierre, who would not accept it alone. Curie, of course, won the Nobel Prize in Chemistry in her own right after her husband's death.

Taunts of "unladylike behavior" are disguised in modern terms.

Society frowned on women in science with taunts of "unladylike behavior," "immodesty," and worse were bandied about, according to physicist Gina Hamilton, a staff astronomer at the University of Southern Maine, writing in Physics World recently "the goading still goes on, albeit in more "modern" language. Hamilton adds that while various efforts have been launches, in the United States and elsewhere, to increase the number of women studying university science these "well-meaning attempts are often frustrated by the reality of the numbers game." In the more mathematically inclined physics and astronomy, there are simply not enough women with the right skills who are interested in entering the field.

It is not all doom and gloom. Hazel Moncrieff, working in the labs of Bristol-Myers Squibb in England, is more positive about the issue. "I have not been put off applying for jobs since the jobs I would be looking for would require technical qualifications which are equal irrespective of gender." She adds that within her company, most people are B.S./Ph.D qualified, and she does not sense any obvious gender bias. Women, she says, are well-represented in management although maybe not at the director level. "I don't think this is due to a direct gender bias, but is rather attributable to a wider issue of not affording flexibility to workers."

Isolated examples are not enough. Things may truly have moved on little since the Herschel's day. Perhaps it is all about mobilization. Maybe action plans will create integration, but nothing substitutes for the involvement of women scientists. All the initiatives, committees, proposals, and programs in the world only make sense and deliver results if women are involved and make their voice heard.

By David Bradley

In HMS Beagle: The Biomednet Magazine

www.biomednet.com/hmsbeagle/90/notes/adapt