In her excellent essay on women in medicine in the Autumn 2010 issue of Yale Medicine [“Improving the lot of women in medicine”], Jill Max seems to lament that “Even in pediatrics or psychiatry, where women have accounted for half the field for more than 25 years, they have accounted for only about 10 percent of department chairs during the past decade.” I read that to imply that everyone in academic medicine should strive to become a chair regardless of his or her primary interests or skills.

More than rarely, it has seemed to me that some faculty members advance beyond their original interests—and sometimes even their merits as an outstanding clinician or researcher—into running a department. That leads to a Rake’s Progress, as I like to call it, of going on to become a dean or worse. It may be unfair to gripe that women have not in larger numbers chosen the administrative route: they may have preferred the one-on-one of caring for patients. I am sure the satisfactions of patient care outlast those of any administrator, given the usually abbreviated term of the latter.

Howard M. Spiro, M.D.
Professor Emeritus of Medicine
New Haven, Conn.

I was frankly astounded. I finished the nicely balanced article “Improving the lot of women in medicine” in the Autumn 2010 issue, impressed by the persistence of this issue of undervaluing women in medicine. How can we have discussed it for so long and still be baffled for a solution? Then I went on to read the following article, “When medicine meets the business world,” which features four photographs of business/medicine leaders. All four are men! Could not one photo be found of the successful female leaders mentioned in the article? Maybe I should not feel so baffled. As Pogo (Walt Kelly) said, “We have met the enemy and he is us.”

Joseph Connors, M.D. ’73 
Vancouver, B.C.