Ruth C. Carlos
2019-2020 ARRS Scholar

According to the January issue of AJR, women occupy only 14% of available leadership positions in academic nuclear medicine departments, both at American and Canadian institutions. A recent Emory University assessment of gender disparity in labor divisions found that female general, abdominal, and musculoskeletal radiologists read fewer advanced imaging modalities like CT and MRI. Perhaps more lopsided is the male-to-female ratio, itself—approximately three men for every one woman among radiologists and radiology residents, as per ACR’s annual industry survey. Furthermore, according to the October edition of AJR, just 8% of all interventional radiologists in the United States are women.

Like much of the news, health care headlines such as these can leave us asking ourselves, “How much progress have we made?” Dredging this sea of conspicuous data points and trends on gender inequality in medical imaging, men and women alike question, “What does ‘progress’ even look like?”

One hundred years removed from the ratification of the Nineteenth Amendment to the U.S. Constitution that confirmed my right to vote, as the 119th ARRS president, I am proud to join the august ranks of Kay Vydareny, Theresa McLeod, Ella Kazarooni, and Melissa Rosado de Christenson—four previous female presidents who have served this oldest radiology society in North America. And now, for the first time ever, six major radiology organizations are all led by women—International Society for Magnetic Resonance in Medicine, Radiologic Society of North America, Society of Interventional Radiology, American Society of Neuroradiology, American College of Radiology, and, of course, the American Roentgen Ray Society.

In the wake of this boom of female leadership in our specialty, why is it that more women continue to enter other specialties such as pediatrics and gynecology, while radiology remains a male-dominated field? The proportion of women in our specialty has remained static at 20–25%.

Might this radiological gender gap present an opportunity for “failing up” in radiology, as described in my previous column for InPractice? Conversely, are there intrinsic differences in the practice of radiology compared to, say, pediatrics that will preferentially steer women toward non-radiology specialties? Although I can’t say that 20–25% is the right or wrong proportion, we must collectively work to reduce those barriers that we can control, such as increasing role-modeling, mentorship, and sponsorship and decreasing implicit and explicit bias.

“And now, for the first time ever, six major radiology organizations are all led by women— International Society for Magnetic Resonance in Medicine, Radiologic Society of North America, Society of Interventional Radiology, American Society of Neuroradiology, American College of Radiology, and, of course, the American Roentgen Ray Society.”

Ruth C. Carlos

As an equal opportunity mentee, I have had the privilege of being supported and mentored by a wide variety of individuals such as Melissa Rosado de Christenson, who inspired my career-long affiliation with the ARRS, JACR Editor-in-Chief Emeritus Bruce Hillman, who shared his knowledge and love of scholarly publishing, and John Fennessy and Ruth Ramsey, to whom I owe considering radiology as a career. All those in a position to lead have a responsibility for closing the gender gap. This gap can be as obvious as the lagging proportion of women in radiology or as subtle as “manels,” all-male speaker panels. I applaud Francis S. Collins, director of the National Institutes of Health, for his resolution to no longer speak on all-male panels. “Breaking up the subtle (and sometimes not so subtle) bias that is preventing women and other groups underrepresented in science from achieving their rightful place in scientific leadership must begin at the top,” read his memo, “Time to End the Manel Tradition”.

A radiologist’s gender is a fact, not a quota. Nevertheless, consistent, thoughtful attention to increasing diversity not just in gender but in all the axes of diversity benefits us all.

The opinions expressed in InPractice magazine are those of the author(s); they do not necessarily reflect the viewpoint or position of the editors, reviewers, or publisher.