Women in the medical profession

By F. D. C. Wijesinghe
When one considers the place that women enjoy in the medical profession today it is amazing that women had a hard struggle to obtain acceptance to enter the medical profession in bygone days.

When Sarah Adamson applied to the Jefforson Medical College in Philadelphia the dean told her that it would be impossible in this century for a lady to mingle with five hundred young men ...... in the same lecture room without experiencing many annoyances.

At Harvard university students explained their opposition to women colleagues in a series of public resolutions:

Resolved that no woman of true delicacy would be willing in the presence of men to listen to the discussion of the subjects that necessarily come under the consideration of the student of medicine:

Resolved that we object to having the company of any female forced on us and to sacrifice her modesty by appearing with men in the medical lecture room.

The long journey to acceptance for medical study had taken women almost literally to the ends of the earth. Beginning with Elizabeth Blackwell (1914) women from many parts of the world had repeatedly been forced to leave home, family, occasionally children and sometimes country to find a place in a school of medicine.

According to "To the ends of the earth" by T. N. Bonner "the picture that emerges across the intervening years of these determined woman is of hundreds, at times thousands, of women in unceasing motion, their lives marked by struggle, suffering and disappointment and constantly engaged in a conflict with social expectations and established custom."

The Great War (1914 — 1918) did bring unprecedented opportunities and a smashing of barriers to medical study in nearly every country. The women physicians of Britain, Russia and Germany in particular, reached new levels of acceptance in the terrible devastation of war.

Men of the warring nations were given a sympathetic reception as they returned from military service to medical schools or training hospitals. But women were blamed for lowering the quality of university degrees during their men’s absence in wartime. The Chairman of the London Hospitals Board, Lord Knutsford declared in 1922 that his hospital, now that the crisis had passed, would take in no more women students.

Although Oxford University conferred its first medical degree upon a woman in 1922, the situation in London remained threatening to women’s interests. By the end of the decade, only the London School of Medicine for Women and the University College Hospital, which admitted only twelve women each year, were teaching women in London. The main reason for the exclusion of women students, "according to the Journal of the American Medical Association, was the objection of men students to co-education."

A report to the Senate of the University of London in 1929 stated that "with few exceptions, the authorities of the medical schools appear convinced that men, if they have a choice, prefer to go to schools that do not admit women". The Committee nevertheless declared that it "is unable to see any valid argument against the provision of coeducation in medicine" but stopped short of urging the complete opening of London’s medical schools to women.

The role of powerful private interests in thwarting medical coeducation in London was matched in many of the private schools and hospitals of America in the 1920s and 1930s. "I am a bit skeptical as to the real value" of encouraging women to apply, wrote Dean William Pepper of the University of Pennsylvania to the Dean of the Harvard Medical School in 1926, ‘my present feeling would be that we might admit each year to our First Year Class which numbers 110, some three or four women."

However, by the end of the 1980s, nearly half of those entering medical school in Britain were female as it is in Sri Lanka today. According to T. R. Bonner "The new women doctors as described by surveys in several countries in the 1980s, were more likely than men to see their profession as a human vocation to be less interested in the pecuniary rewards and to concentrate in such specialities as internal medicine, paediatrics and general practice. More than their predecessors, the women physicians at the end of the twentieth century were apt to marry, to remain in active practice, and to carry on their work in a hospital based clinic. More significantly, the old prejudices against women in medicine had begun to fade as their numbers approached near equality with men."

The profession in Sri Lanka

Dr. C. G. Urogoda in his book "A history of Medicine in Sri Lanka" (p 117) says –

"The Colombo Medical School opened by Sir Hercules Robinson on 1st June 1870, came under the PCMO (the Principal Civil Medical Officer) and a fee of 2 was charged at the beginning of each session. Dr. Loos was fittingly appointed its first principal. Women students were admitted for the first time on 1st May 1872. The first prospectus was issued in 1870 when the course was spread over three years. The second prospectus was issued in 1873 when the course was extended over four years. In 1884 it was further extended to five years."

Kamalika Pieris in "The medical profession in Sri Lanka 1843 — 1980" (p 115) says:

"Women seemed to have gained access to the Colombo Medical College without any difficulty. Some were co-erced into it by their elders. Dr. Verona F. Weerasekera, who entered the Medical College in 1903, recalled that ‘joining the Medical College was certainly no wish of mine; it was my father’s wish (Weerasekera 1920; 22, 23). Many women doctors have expelled in examinations and have gone on to specialize and to reach positions of professional eminence. More than one held a professorship at the Medical Faculty. No speciality was closed to them and the only field they naturally avoided was surgery (Perera, K. H. M. 1980 2,3)

"Women doctors were honoured by their peers. Drs. May Ratnayake and Daphne Attygalle were elected president of the BMACB (SIMA) for 1943 and 1976 respectively. Dr. Ruby Pararajasingham and Dr. I. Sri Skandarajah were elected President of the Ophthalmological Society of Ceylon for 1965 and 1967 respectively. Dr. Gladys Jayawardene held the position of Director of the Medical Research Institute. It is therefore evident that obtaining access to medical education did not involve any protracted feminist struggle, and genderwise their passage through the medical world has been easy."

Carlo Fonseka, in "The Story of the Colombo Medical 1870 — 1970" in the Colombo Medical School Centenary Volume stated "In 1892 women were admitted to the schools for the first time. For the record, the first women to be admitted were Misses E. Davidson and H. Keyt. The first women licentiate though was Miss A. de Boer who joined the school in 1893.

When Prof. Carlo Fonseka wrote in 1970 the ratio of women to men was 1:2. "One of the highest for any medical school in the world". But today I was told by an eminent lady doctor that the ratio is 1:1. Without doubt this is a remarkable achievement for lady doctors in Sri Lanka.