Representation and progression among women with advanced degrees in science and medicine have significantly improved over the past 50 years. A recent report from the Association of American Medical Colleges indicates that despite women being in the minority, the number of female division/section chiefs, department chairs, and deans has increased overall by more than 50% in the past 10 years (https://www.aamc.org/members/gwims/statistics/; accessed April 2, 2012). This information and the election of 3 consecutive female AACC presidents and a new female AACC executive vice president caused us to reflect on the increasing global presence of female leaders in clinical chemistry and laboratory medicine. As female laboratory directors, mothers, and members of AACC's Society for Young Clinical Laboratorians group, we have the perception that our profession is a supportive environment and a well-suited career for young women today, but we wondered if it has always been that way. We posed a series of questions to a multigenerational panel of female clinical chemists, who relate their experiences as women in clinical chemistry and laboratory medicine over the past several decades.
How do you think the work climate has changed for women since you began your scientific career, and have you experienced any personal struggles because you are a female in clinical chemistry? What advice would you give young women starting out in the field of clinical chemistry?
Helen Free: At times I felt like a second-class citizen, not because I was female, but because I didn't have a PhD! I began my career during WWII, and I was needed because all the men were in the armed forces. I'm 89 and didn't realize there were gender discrepancies in clinical chemistry. I would advise those starting out in the field to go into your career with a positive attitude and work toward equality by your actions. If you're happy in your job, then let people know that you would like additional responsibilities, but remember that no job is perfect. There will always be good and bad days, and the trick is to enjoy the good days and learn from the bad days. If you find that you're not having fun at your job, quit and find something that is fulfilling.
Jocelyn Hicks: The work climate has improved dramatically, and I personally had very few struggles, although I have experienced salary discrepancies and rank discrimination. I am proud of my “firsts by a female,” including being elected as the youngest member (male or female) to be president of AACC and the only woman to be president of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) in its 60-year history. My advice to young females in the field is to be a colleague and a resource to the medical staff; learn why tests are ordered and how they are interpreted. For the first 7 years of my career, I went on morning rounds and learned a great deal. Listen to the laboratory staff, and be physically present in the laboratory on a daily basis if possible. Finally, read journals, and keep up with the science and medicine! I still read and follow the scientific literature, particularly Clinical Chemistry and the New England Journal of Medicine.
Marilyn Huestis: I do believe that the work climate has improved for women since I began my career, but the family structure, function, and society have also improved to support women in their careers. As a military wife, I moved frequently and had many different jobs where being a woman was neither an advantage nor limitation, but equal pay for equal work was not the norm. Today, the culture has changed, and men are taking an active role in child rearing and responsibility for the home, which is a wonderful new norm. I would advise young women to get the best education and training fellowship possible to prepare them for a leadership role in the laboratory. I would recommend attending AACC meetings whenever possible; I remember returning from meetings reinvigorated with new ideas and knowledge. I also met lifelong friends who shared their ideas, problems, and, most importantly, their support and guidance throughout the years. I believe it is critical to be assertive from the start of your professional career to gain recognition and be considered for additional professional opportunities. Find innovative ways to conduct research (my particular passion), publish, chair committees, mentor students, and contribute in the best ways that you can so that you have a fulfilling, rewarding career. If you don't love your work, change your position, employer, or vocation. And most importantly, don't feel like you have to do it all—take some time for yourself!
Rita Horvath: I personally have not noticed many significant changes in the work climate for women in the last 25 years. I began my career and worked for at least 15 years in Hungary, where a majority of the profession and about 80% of the clinical laboratory staff are female. At that time, most of the laboratory directors and leaders were men, but this has now changed. Interestingly, in the 60-year history of the Hungarian Society of Laboratory Medicine, I was the first woman to be president, but I am happy to say that the current president elect is also a woman, so the traditional leadership landscape is changing. The workplace has become more supportive and accommodating for women with small children and families, and the Hungarian social benefit system is generous in supporting maternity leave. I never experienced any major hurdles or struggles because I was a female and always felt treated as an equal partner. Undeniably, every individual comes across some “interesting characters” throughout their professional life, and the more prominent positions ultimately equal additional responsibilities and unavoidable conflicts.
My advice for any young individual is to establish a foundation for a good balance between work and private life. If you become frustrated or underperform in the workplace, it will have an impact on your private life, and vice versa. Your early years are the most productive since you generally have more ambition, ideas, and freedom without too many personal or family commitments. Do not waste those years! What you learn and achieve during that time will define and establish your career pathway. Find a position where you have great mentors and people to learn from, yet recognize the most learning comes from what you do yourself. Become engaged in clinical or scientific projects and accomplish them. Achievements in the workplace will give you positive energies that will pay off in your private life.
Corinne Fantz: There are many more opportunities for women in science today than there were several decades ago. I'm lucky to have found myself among colleagues who value the contributions of both women and men. I would advise anyone to strategize for the future by having goals and formulating a plan to achieve those goals. Find a mentor who is willing to help you navigate choices in your career. Often when these choices arise, it may be difficult to see that there isn't always a right or wrong answer, just choices. If things do not work out, be flexible enough to change what you don't like. Get out of the laboratory, and communicate with your clinician partners; it not only benefits your career but also benefits patients as you build new opportunities for learning, communication, and collaboration.
What lessons have you learned from other women in the field, and what do you feel has been the most significant achievement by the women who were practicing clinical chemistry before you?
Marilyn Huestis: I learned a great deal from the women who broke the barriers before me by observing how they conducted themselves, how they were respected leaders, and how they were able to advance and distinguish themselves in their careers. There are many significant achievements by female clinical chemists, including becoming department heads, professors, investigators, industry executives, public health officials, and directors of laboratories. They persevered and forced institutions to change rules based on excellent performance alone. I appreciated the passion they had for their work and that their accomplishments came only with hard work and talent. They are strong women and didn't try to be men in a man's world.
Rita Horvath: This is a difficult question to answer since all of my own predecessors and role models are men. However, I have encountered female professionals whom I truly admire and others whose career or life gave me some warnings of what I should not do. The positive and negative examples have taught me that setting realistic goals that can be achieved given one's current circumstance(s) is extremely important. I have seen very talented but frustrated, stressed, and ultimately very unhappy women with high aspirations who could not achieve their potential because they were unable to balance commitments to family and their work. The women and men whom I admire have found ways to be successful in both personal and professional matters, and I consider this the most significant achievement anyone can have.
Corinne Fantz: A woman I respect in the field once told me that prioritizing one's time is critical and to consider commitments only if they can be fulfilled and if they get you one step closer to your goals. Another valuable lesson I've learned is not to be a perfectionist. Things will occasionally go wrong, which are out of your control, and you shouldn't beat yourself up when this happens. The most significant achievement by the women before me was undoubtedly paving the way and raising the expectations for the next generation of women scientists: providing the seemingly limitless opportunities and pushing the boundaries of what people thought possible.
What sacrifices, if any, have you made throughout your career, and how have you overcome feelings of self-doubt or guilt related to balancing a career and a family?
Helen Free: I do not feel like I have had to make any sacrifices. I was blessed with a marriage to Al Free (I married the boss), who was a leader in clinical biochemistry, and we raised 6 successful children. We were fortunate to live in a community with a plethora of individuals in the area to help us at home. Our work enabled each of our children to travel internationally with us when they were old enough to appreciate it.
Jocelyn Hicks: I did not have any children by choice, because I thought that I could not be a good mother and be successful in a career. I realize now that it is possible … but too late! My greatest difficulty in balancing a career and family was caring for a very ill husband for many years and traveling to distant places for my career. My husband always encouraged me and was a wonderful supporter of me. On his deathbed he thanked me for being the most wonderful wife he could wish for—we were together for 40 years.
Marilyn Huestis: I would not use the word “sacrifices,” I would say “compromises.” My generation of women felt that in addition to excellent performance at work, you had to be the perfect mother at home. One of the biggest struggles for me personally was always feeling guilty—if I was home with a sick child, I felt guilty about work, and if I was working late, I felt guilty about missing dinner with the family. Today's working women appear to be much better at letting the guilt go, but still juggle mightily to keep the work/family balance appropriate—one reason I have so much respect for today's dynamic young women scientists. I missed time with my children, but I tried not to miss important times, and I hope they knew that they always came first.
Rita Horvath: All professionals make sacrifices on the home front, and I am no different. When there are new challenges, major positions, or projects presented, I always ask for my family's opinion as to whether I should accept or not—therefore it ends up being a shared decision, and we collectively share the burden (and guilt). In addition, I try to fulfill my responsibilities at home first and conduct any additional work late at night, when it interferes least with my family time. Although this can be physically exhausting at times, I luckily have a very supportive partner who nurtures my career and helps at home. The sense of guilt always tends to remain at home and at work, since you always think you should do more and better.
Corinne Fantz: To preserve the precious time I have with my family, the biggest sacrifice I make is to wake up early in the morning to accomplish my personal goals. As for overcoming feelings of self-doubt or guilt, I haven't found the answer. It is always tough to travel far from home only to return to a pile of work and a family who needs you, without feeling overwhelmed. Having a supportive spouse is invaluable in such situations.
What advances do you feel are still needed for women in clinical chemistry, and what excites you most about the future of women in clinical chemistry?
Jocelyn Hicks: More women need to study science at the doctoral level. I believe the world is open to women if they work hard and earn the respect of their peers. Additionally, I see opportunities and a need for leadership in untapped fields, such as geriatrics.
Marilyn Huestis: Women need equal pay for equal work. It is a poor statement about our society that we haven't conquered this simple equality standard. In my opinion, women have to work harder to be heard and to advance. Improvements in child care options, costs, and maternity/paternity leave need to be made, along with guaranteed positions if optional leave is selected. Many societies globally recognize the importance of women having the option to spend extended periods of time with a newborn.
I look forward to the day when gender isn't even a question—just who is the best person for the position. I am excited about the future of women and men in clinical chemistry. We have an interesting, desirable, and valuable profession that can really contribute to public health. With advances in genetics, entire new areas of clinical chemistry are opening to us. It is really an exciting time to be a clinical chemist and a woman.
Rita Horvath: In any profession, the most important commodity for females who wish to have a successful professional and family life is protected time and a supportive environment. With the advancements in informatics systems and communication technologies, many of the functions that previously could only be done face-to-face can be accomplished electronically, allowing for more flexibility to fulfill work commitments while offering a better work–life balance for individuals with a young family.
I would like to see more women scientists and leaders in clinical chemistry. Women are talented in communicating effectively, multitasking with efficiency, and skillful at organizing, all of which will be critical skills as the profession moves towards strengthening its consultative role. There are ample opportunities for major novel biomarker discoveries due to rapid technological advancements in the field, ultimately changing the way we diagnose, screen, treat, and monitor diseases. I have great hope that we will have many more Marie Curies, Rosalyn Yalows, and Elizabeth Blackburns in the years to come.
Corinne Fantz: I think there is a shortage of women leadership positions, such as chairs in pathology and heads of laboratory medicine, particularly those who find value in certified clinical chemists. However, thanks to women like my fellow panelists, I see a bright future for women in clinical chemistry. I'm most excited to be a part of it, and maybe in 10 years I can say I share more in common with Helen Free than just a birthday!
Author Contributions: All authors confirmed they have contributed to the intellectual content of this paper and have met the following 3 requirements: (a) significant contributions to the conception and design, acquisition of data, or analysis and interpretation of data; (b) drafting or revising the article for intellectual content; and (c) final approval of the published article.
Authors' Disclosures or Potential Conflicts of Interest: Upon manuscript submission, all authors completed the author disclosure form. Disclosures and/or potential conflicts of interest:
Employment or Leadership: S. Haymond, AACC; A.K. Saenger, Clinical Chemistry, AACC; H.M. Free, AACC; A.R. Horvath, European Federation of Clinical Chemistry and Laboratory Medicine.
Consultant or Advisory Role: A.R. Horvath, National Prescribing Service (Australia) and Becton Dickinson.
Stock Ownership: None declared.
Honoraria: None declared.
Research Funding: None declared.
Expert Testimony: None declared.
- Received for publication April 20, 2012.
- Accepted for publication April 24, 2012.
- © 2012 The American Association for Clinical Chemistry