Photo courtesy of Mattel

At the end of the movie “Barbie,” the world order is re-established as Kendom returns to Barbieland. When the Kens then ask to be on the Supreme Court, President Barbie says “no” but tells them they can have a meaningful role on a lower court. 

The radiology world, like the real world in the movie, is not Barbieland. Let’s see where women in our professions of imaging Dx/Rx have been, where we are and where we hope to go. 

First meet a few of the iconic Barbies in radiology — those who jumped over the lower courts and the Supreme Court to own their own slam-dunk courts: 

• Elizabeth Fleischman — Started her own X-ray lab in San Francisco 1896. It was used widely in the Spanish American war to locate bullets in wounded soldiers coming from the Philippines. 
• Florence Stoney, MD — First woman radiologist in the UK in 1898.
• Marie Curie, PhD — Nobel Prize in physics in 1903 and in chemistry in 1911. First woman Gold Medal recipient in the ACR in 1931. One of two first women Gold Medal recipients in the RSNA in 1922.
• Maud Slye, MD — One of first women Gold Medal recipients in the RSNA along with Marie Curie in 1922. 
• Lucy Frank Squire, MD — First female radiology resident at Massachusetts General Hospital in 1940. Author of the textbook Fundamentals of Radiology, which is still referenced today.
• Alice Ettinger, MD — Established the first radiology residency program in 1945. Became the first woman radiology department chair at Tufts University in 1959.
• Rosalyn S. Yalow, PhD, FACR — Awarded the Nobel Prize in medicine in 1977. Developed radioassays.
• Carol M. Rumack, MD, FACR — Founded and served as the first president of AAWR in 1981.
• Kay H. Vydareny, MD, FACR — First elected woman ACR Council Speaker in 1993.
• Helen C. Redmond, MD — First woman president of the RSNA in 1995.
• Geraldine McGinty, MD, MBA, FACR — First woman BOC chair of the ACR in 2018. (See an article in this month’s ACR Bulletin about her being a 2024 ACR Gold Medal recipient.)
• Dana H. Smetherman, MD, MPH, MBA, FACR — First woman CEO of the ACR, set to take the helm in July 2024.

The radiology world, like the real world in the movie, is not Barbieland.

Historically, women in radiology, like those in most STEM professions, have been vastly underrepresented in number and in leadership positions. 

In 1970, 5.3% of radiologists were female. This rose to 14% by 1995, at which time 25% of radiology residents were women. This suggested optimism toward improvement in numbers of women radiologists, according to a study in the AJR.

But from 1981 to 2020, the percentage of women medical residents rose from 23% to 46% of all residents, while women radiology residents rose from 21% to only 26% — minimal improvement in almost 40 years, an April 2023 article in RNSA News reported.

Furthermore, “Women represent only 13% of all radiology practice leaders, including managing partner, chair, vice chair and executive committee members,” a second RSNA News article said. The number of female academic radiology department chairs has risen slightly from 17% in 2019, to 23% in 2022, according to a Tomography paper.

The ACR is 100 years old. The College has awarded its highest honor, the Gold Medal, to 206 recipients through 2023. Fourteen of those were women, 7%. The first female chair of the BOC was in 2018, 95 years after founding of the College. 

The RSNA is 104 years old and has awarded three Gold Medals a year since 1919. Twenty-one of those gold medals were received by women, 7%. The first woman president of the RSNA was in 1995, more than 75 years after the founding of RSNA.

What about the ACR now? How do we look? In the top leadership, 32% of the BOC as well as two of our last three board chairs are women. Additionally, 36% of the CSC are women. Of all ACR membership, 38% of medical school members, 29% of RFS, 29% of YPS, 23% of practicing attendings and 13% of retired members are women. Radiology is still clearly a Kendom!

What are we doing and what can we do to move the needle? A great first step was the establishment of the ACR Commission on Women and Diversity in 2012, wonderfully first chaired by Katarzyna J. Macura, MD, PhD, FACR, who received an ACR Gold Medal in 2022. One highly successful program instituted by the Commission and led passionately by Michele H. Johnson, MD, FACR is the PIER Internship (Pipeline Initiative for the Enrichment of Radiology) to introduce URMs and first-year medical students to radiology. A recent initiative pairs a PIER student with a faculty mentor to write short biographies of the RSNA women Gold Medal recipients, thereby introducing our Barbies to the current generation of medical students. A similar series was previously published in Clinical Imaging on the ACR women Gold Medal recipients.

Another huge step was the passage by the ACR Council in 2022 of the 12-week paid family/medical leave resolution, after the tireless work of Elizabeth K. Arleo, MD, FACR, and other AAWR leaders. The AMA House of Delegates later adopted the Council resolution language. 

Lastly, women need exposure. To know radiology is to love radiology. But one must meet our specialty to know us. Early introduction in medical school and required core curriculum courses in imaging DX and RX are crucial to encourage women to choose a career in the specialty that is most fundamental to decision-making and treatment for our patients.