Women’s Caucus: Reflecting on 40 Years of Advocacy and Collaboration

As September is “Women in Medicine” month, it is important to recognize that the makeup of academic medicine has changed immensely over the past 40 years with increased proportions of women enrolling in medical school and residency and filling leadership positions.¹ It is easy to lose sight of the legacy of those trailblazers who helped reach these milestones. This column not only highlights the history and impact of the Women’s Caucus on the Society of General Medicine (SGIM) and the careers of many current SGIM members but also recognizes the many “unsung sheroes” who have elevated the field to its current state.

With assistance from Erika Baker, SGIM’s Director of Project Management, we “dusted off” prior internal SGIM files, which included living and historical documents and proposals. A document compiled by Rowena Dolor, MD, highlights a decade of initial milestones; it first describes the concept of the Women’s Caucus in 1986 after a group of women faculty (including Drs. Sarah Williams, Debbie Swiderski, Carola Marte, Ellen Cohen, and Kathy Anastos) recognized the need for collective advocacy and collaboration towards change.² SGIM convened its first Women’s Caucus a year later at the 10th Annual Meeting in Washington, DC. Over the course of the next 12 years, the Caucus outlined its purpose regionally and nationally, assembled geographically diverse delegates, formulated a system to work together (pre-Zoom), and collected dues to support this mission for academic GIM women physicians. The Caucus grew and created programming at the annual meetings, with varied topics that advocated for women as academic physicians and women as patients. A sampling of early SGIM programming sponsored by the Women’s Caucus included the following:

• 1988: “Women as Patients/Women as Providers” (symposium)
• 1990: “Women Physicians: Climbing the Ladder or Breaking New Ground?” (Susan Okie, MD, Medical Reporter, The Washington Post)
• 1991: “Key Elements of a Successful Change Strategy” (Discussion Moderator, Patricia Williams*)
• 1992: “The Use and Abuse of Power” (Leah Dickstein*)
• 1993: “The Body Politic: Women, Body Image, and Culture” (Catherine Steiner-Adair, EdD)
• 1996: “Update on Women’s Health Fellowships/Residencies” (Saralyn Mark, MD) and “Mentoring: Creating Opportunities” (Kathy Croft*)
• 1999: “Update in Hormone Replacement Therapy” (pre-course)
• 2000: “Issues in the Professional Advancement of Women” (Phyllis Carr, MD)

Early Caucus-sponsored topics from the 1990s are still relevant today to SGIM members, demonstrating the need for continued structural improvements.

The Caucus provided intentional resources for networking and support. A place where women in SGIM gathered for camaraderie, education and career development. In subsequent years, an assortment of interest groups relevant to SGIM’s female members blossomed, including the Women’s Health Medical Education, Obstetric Medicine, Intimate Partner Violence, and Gay & Lesbian Interest Groups. From 2005-07, Drs. E. Bimla Schwarz, Michael Carson, and Pam Charney worked with these interest groups to draft a precursor to the recently published “core competencies in women’s health.”³ These SGIM members experienced considerable challenges when seeking the support and endorsement of SGIM leadership in specific areas, so they partnered with Drs. Karen Freund, Missy McNeil, and Ellen Yee to focus on processes, programming, and a united ask. Their goal was to ensure that issues of importance to SGIM’s women members could be effectively communicated to SGIM Council.

In May 2007, SGIM Council approved the formation of the Women’s Health Task Force (WHTF) marking a pivotal transformation. The task force’s goal was to facilitate dialogue through monthly conference calls between these interest groups and the Women’s Caucus, to advance research, education, clinical practice, and health policy relevant to women’s health.

Initially, the WHTF promoted faculty development and educational opportunities in women’s health for SGIM members funded in part by an unrestricted grant. Collaborating with the Annual Meeting program committee, the WHTF celebrated the work and expertise of women professors through sponsored keynote lectures, poster tours, and the Distinguished Professor in Women’s Health award. In 2007, Dr. Deborah Grady was the first recipient of this award which continues to recognize accomplished women leaders annually.

In 2011, SGIM President-elect Dr. Harry Selker recognized the importance of developing a structured mentorship program to enhance women’s career development. Under the leadership of Dr. Amy Gottlieb, the Women’s Career Advising Program (CAP) launched in 2012. CAP aimed to reinvigorate efforts towards the career advancement of women, aligning with the original interests of the Women’s Caucus. CAP has since supported nearly 500 participants with an emphasis on sponsorship.

Over the subsequent years, the WHTF transitioned to the Women and Medicine Task Force (WAMTF) to reflect its broader mission beyond women’s health. In 2018, SGIM Council decided the WAMTF should become the Women and Medicine Commission (WAMC). Now with ongoing organizational resources and direct communication to SGIM Council, WAMC encompasses multiple interest groups with dedicated leaders and members focused on diverse gender equity topics. The Women’s Caucus, now a subcommittee of the WAMC, focuses on its original efforts (mentorship, networking, and advancement of women) but adapts to meet the dynamic needs of women in SGIM.

This formal and intentional recognition and support of women members by SGIM has been invaluable in spurring innovative work and cross-institutional collaboration within the Women’s Caucus and beyond. Members still recognize common historical obstacles at academic institutions across the country. In recent meetings, members note a lack of women leaders at the Division, Department, and Dean levels. They express concerns regarding part-time employment as a barrier to career advancement and leadership opportunities. Most recently, Caucus attendees expressed limited awareness of or comfort in negotiations—specifically focused on retention packages. Some found the entire concept new, allowing gender inequities to persist.⁴ Much like in prior decades, scholarly collaborations are developing from these discussions so that shared experiences can be disseminated for shared solutions.

To address these current concerns, Caucus leaders, with the support of WAMC, aim to build stronger ties at regional SGIM meetings by creating local Caucuses as first-line contacts for members. With a clearer understanding of regional issues and the convenience of geographic proximity when networking, members can leverage the regional Caucuses to advocate for needed change with a ground-up approach.

As the Caucus liaisons between WAMC, SGIM Council, and the SGIM regions, the Caucus plans to partner with other groups under the WAMC umbrella, including the Parenting Interest Group and the Scholarship Group. These groups share the vision of advancing the careers of women by helping navigate parenthood and non-traditional work schedules and creating pathways to publication respectively. Caucus leaders are also working on outward partnerships by strengthening ties with Association of Chiefs and Leaders in General Internal Medicine (ACLGIM), negotiating initial ACLGIM memberships for LEAD mentors and CAP sponsors for Caucus members.

The Caucus was created thanks to the collaborative efforts of many women. A number of these early members became full professors with leadership roles and scholarly success in academic medicine, and today these women still support and champion SGIM. In this current iteration of the Women’s Caucus, its leaders aim for continued advancement of women through promotion and into leadership, to coordinate collaboration through scholarship, and to foster a community through networking. Over the next 40 years, future generations of SGIM members will celebrate improved parity in leadership and true professional equity as the Women’s Caucus’s efforts lead to further change!

The authors express specific appreciation to Erika Baker and Dr. E. Bimla Schwarz for their help with this column. We included the names of women of whom we had clear documentation of their impact; we know more faculty had a hand in this work despite not being named, and for that we are grateful.

(*It is unclear what professional degree these presenters had as it was not in the associated documentation.)