In 2000, when Nita Ahuja was a general surgery resident at Johns Hopkins, she gave birth to her first child. She worked until the hour she went into labor and returned to her grueling schedule six weeks later. In a department that was overwhelmingly male, she didn’t want to call attention to her femaleness.
When Ahuja completed her residency and joined the Department of Surgery faculty in 2003, she and her husband had two children. Mimicking her male colleagues, Ahuja didn’t talk about her family.
That changed later that year, when Julie Freischlag came to Johns Hopkins as the first female chief of the Department of Surgery. Freischlag did something radical: She brought her own young son to Saturday-morning meetings.
“Julie let me know it was OK to be a mom,” says Ahuja, now chief of the surgical oncology division.
Surgery, with its long hours and physically demanding work, has traditionally been a male-dominated field. It doesn’t help that residencies last at least five years and tend to fall during the years women are most likely to have children. But a growing number of strong-willed, talented and ambitious women are breaking down gender barriers at Johns Hopkins, encouraged by leaders who made a priority of hiring and promoting female surgeons.
In 1999, the Department of Surgery was 7 percent female, with three female surgeons out of 44. Today, 22 of 81 doctors in the department are women, or 27 percent. Nationally, about 21 percent of U.S. surgeons were women in 2016, according to the American College of Surgeons.
“We want to be representative of the community we serve,” says Robert Higgins, director of the Department of Surgery and surgeon in chief of Johns Hopkins Medicine. “A critical part of my job is to recruit excellent candidates from all backgrounds, especially those who are women and underrepresented minorities.”
Higgins has worked to create a more inclusive and diverse environment. When he succeeded Freischlag in 2015, no woman had ever served as chief of one of the Department of Surgery’s divisions. Now women head three out of seven divisions. Gina Adrales leads minimally invasive surgery; Ahuja helms surgical oncology; and Jennifer Lawton, hired as associate chief of cardiac surgery in 2016, was promoted to chief later the same year.
Adrales, recruited by Higgins from Dartmouth College, was the first. “It’s such an honor,” she says. “But it was also a little startling that it took until 2016.”
That same year, Higgins’ office established WISH, or Women in Surgery at Hopkins, which holds twice-a-year dinners where female surgeons socialize and compare notes. They discuss challenges, such as patients who refuse treatment from female surgeons, while praising the support they receive from school of medicine peers and leadership.
They also talk about how much they love their jobs. “There’s nothing like taking patients from certain death through a huge operation and hearing them say they feel better than they have in years,” says Lawton.
Lawton recently completed a term as president of the national Women in Thoracic Surgery nonprofit. While there, she established a fund that pays travel expenses for general surgery residents to shadow female cardiothoracic surgeons, since only about 3 percent of cardiac surgeons are women.
“I hear from women who say they’re nervous because they don’t see anyone who looks like them,” she says. “I’m hoping over time to change that.”
A Collaborative Atmosphere
That change is happening, and not just in the Department of Surgery. The residency program in the Department of Neurosurgery is now nearly a third female, and all four residents in the 2023 postgraduate class are women.
That’s important to pediatric neurosurgeon Mari Groves, who joined the residency program in 2007 and stayed on as faculty. She and others praise the department’s director, Henry Brem, for supporting work-life balance—as much as possible, given the physical and emotional demands of the work.
“We place a high value on family interactions so that our surgeons are happy and well balanced,” says Brem.
“It’s not that he’s singling out women; he’s supportive of all residents and faculty,” says Judy Huang, vice chair of the neurosurgery department, who was the first woman to join the neurosurgery faculty when she came to Johns Hopkins in 2002.
Neurosurgery professor Shenandoah Robinson, who joined Johns Hopkins last year, describes an “invigorating, collaborative atmosphere” that allows her and other surgeons in the department to reach their full potential.
Founded in 1893, the school of medicine was the first graduate-level medical school in the nation to accept women, a condition imposed by the four women who donated the funds needed to start the school.
Elizabeth Hurdon, hired in 1897 as assistant gynecologist, was the first woman on the medical staff of The Johns Hopkins Hospital and the first to be on the faculty of the school of medicine at the same time. Hurdon was born in England and earned her medical degree in Canada. While at Hopkins, she taught and conducted research, but it’s unclear if she was allowed to perform the surgery for which she was trained.
One photo shows her wearing a dark dress and a serious expression, standing in a sea of men arrayed behind Howard Kelly, one of four founding physicians of The Johns Hopkins Hospital and the man widely credited with creating gynecology as a medical specialty.
Fifty years later, Rowena Spencer, a 1947 graduate of the school of medicine, became the first female surgery intern at The Johns Hopkins Hospital. She went on to become the first female surgeon and the first pediatric surgeon of either gender in her native Louisiana.
Reflecting on her Hopkins residency in 1992, Spencer remembered that she had to fight for permission to participate in the urology rotation because it wasn’t considered appropriate for a woman to treat male anatomy.
Pamela Lipsett became the first female professor of surgery at the Johns Hopkins University School of Medicine in 2003, and program director for general surgery two years later.
Despite the leadership of these women and so many others, the message that women can’t be surgeons is slow to disappear.
In 2003, while Freischlag, Lipsett and Huang were breaking gender barriers at Johns Hopkins, Miho Tanaka was a student at New York Medical College, listening in disbelief as an adviser told her that women couldn’t be orthopaedic surgeons.
Tanaka had known since she was 11 that she wanted to join the specialty. So that’s what she did.
After her Johns Hopkins residency, she practiced in St. Louis, earning a World Series ring for treating members of the St. Louis Cardinals baseball team. Then, in 2015, the former Stanford University track and field star returned to Hopkins to build a women’s sports medicine program.
Six years after she completed her orthopaedic surgery residency, Tanaka’s specialty remains about 95 percent male. Tanaka is often invited to give advice to female medical students.
“I tell them, just because it’s never been done before doesn’t mean it’s not possible,” she says. “If I listened every time someone said no, I wouldn’t be here. The world is changing and it’s changing because of people like me and like you.”
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