In Israel, Medicine Is Still a Man’s World

Women account for more than half of medical students, but their ranks grow thinner further up the career scale.

Prof. Rivka Carmi, president of Ben-Gurion University of the Negev and a medical doctor by training, says she became a feminist in the fourth month of pregnancy when she told her supervisor that she couldn’t accept a placement several months down the line because of her impending childbirth.

She attributes both her feminist stance and the fact that she would end up with only one daughter to his response. “His reply was: ‘Just know that all your wonderful and ambitious career plans, even if they become fulfilled, won’t reach the extent and quality you intend for them,’” she recalls.

“I was very young, in my 20s,” Carmi said last Thursday, addressing an Israel Medical Association conference titled “The Feminine Revolution in Medicine.” “It was an older and important hospital department head who was speaking to me and I took his words so seriously that it’s a wonder I didn’t go straight to the operating room. ... I decided to show that it’s possible, and quickly realized what’s happening around me. Until then I hadn’t felt any particular problem connected with my gender.”

Carmi now sees the advancement of women as a mission. “For women who go far, until there is complete equality they have an additional obligation to other women that can’t be escaped,” she told the conference. “The medical profession is masculine, it began as a masculine profession and, even though for over a decade now women constitute more than 50% of medical students, all the rules of conduct and promotion are masculine.”

Citing as an example the rounds of gynecologists in hospital wards at 5 P.M., after women doctors have already left for the day, she said: “Women are excluded from these meetings.” Another example mentioned was in the United States where, at the acclaimed John Hopkins Hospital, doctors would make the rounds on Saturday mornings accompanied by all the department heads, interns, and students. “It was medical, but no less also a networking visit,” said Carmi. “At the end of the rounds everyone sat down, ate, drank beer, exchanged opinions, and created a network that women were almost completely excluded from since they needed to stay home Saturday mornings. After recognizing this they decided to cancel the Saturday morning rounds and move them to a time when women could take part.”

Last year Carmi chaired a committee dealing with the advancement of women in academia, where the gap between the genders at the top ranks is alarming. “After trying for years to expound on the problem of women in academic life, I decided out of dedication to women to see how it was possible to make an impact on women’s advancement in academia without harming excellence,” she says. “The moment an average woman attains the position of a man we’ll know we’ve reached equality, but it still hasn’t happened.”

Tenure clock vs. biological clock

The report released by the committee delves into the nitty-gritty of how to do away with obstacles standing in the path of women in the academic world, such as selection committees comprised largely of men and the absence of women on other critical committees like those dealing with promotions, appointments, tenure and prizes. It also discussed keeping women in the academic world ‏(“The ticking clock of tenure vs. the ticking biological clock making matters very hard on women ...”‏), how to encourage women to participate in more tenders, and the difficulties of women leaving abroad with their families for post-doctoral work.

“The Council for Higher Education adopted the report’s recommendations verbatim, and inserted the activity on the matter into the budgeting model and the collection of reports that academic institutions need to submit to regulators − and this is a critical point,” said Carmi.

“The absence of women in senior positions is a real problem,” she continued. “Many women don’t have a role model, an important element for promotion.” Another thing worrying her in particular , is what she calls “latent and subconscious discrimination, which includes women discriminating against women. This is what I call the steel ceiling, because it’s really [made of] steel.”

Carmi, however, believes women, too, need to do some soul searching. “I’m concerned with the lack of motivation among women even though I’m so well aware of the hardships,” she explains. “Women need to leave their comfort zone more, there’s no choice: Promotion requires plenty of work and men work hard. I worked very hard and had to compromise here and there.

I’m disturbed with what [Facebook COO] Sheryl Sandberg said recently about very talented young women who already in their mid-20s think about their careers in terms of their families − and this is before they’re even married and have children, so from the outset there’s a form of paralysis,” Carmi said. “I get outraged when a colleague in her mid-50s tells me: ‘From now on it’s my daughter’s and grandchildren’s turn.’”

‘Categorical gender discrimination’

In a panel dealing with the promotion of women to administrative positions in clinical medicine and academia, Prof. Hava Tabenkin, a member of the presidium of the Israel Medical Association’s Scientific Council, said: “Women need to fight 10 times as hard to reach senior positions. When we set up the Israel Association of Medical Women in the 2000s it turned out there are still medical disciplines where a department head can write that ‘since she’s a woman, I don’t want her in my department.’”

Asked whether the increased numbers of women in the profession will naturally bring about their absorption into senior roles, Tabenkin was skeptical and even lashed out at the IMA: “There is categorical gender discrimination and the IMA played a leading role itself. Only since 2009 have there been women in the Scientific Council as well as in the central committee and all the institutions. Never was there a chairwoman or deputy chairwoman of the IMA.

“The Health Ministry too has a small minority of women,” added Tabenkin. “Men transfer directly from the medical corps [of the Israel Defense Forces] to the Health Ministry, and among the health maintenance organizations there’s only one woman district head and no woman CEO. So I don’t think there will be a quiet revolution: If nothing active is done, nothing will happen, and if women reaching top positions don’t promote other women it won’t happen. Quotas for women need to be set at 30% to 40% for all senior positions.”