17th April 2025
This year for the first time there are more women on the GMC medical register than men. It’s taken a long time. Henry VIII’s 1540 charter for barber surgeons decreed, ‘no carpenter, smith, weaver or women shall practise surgery’. In 1860 the BMJ declared: “It is high time that this unnatural and preposterous attempt to establish a race of feminine doctors should be exploded.”
The profession was outraged because from the beginning of the 19th century women seeking medical training had been knocking on its closed doors. Among the few who found a way to slip inside was Margaret Ann Bulkley. Disguised as a man, she qualified in Edinburgh in 1812. For half a century, as army surgeon James Barry, she lived and worked throughout the empire as a man among men, always fighting to improve conditions for suffering people. In St Helena a court-marshal acquitted her of ‘conduct unbecoming to an officer and a gentleman’. Despite suspicions, it was only after her death that Dr Barry was found to be female and might have gone through a pregnancy.
Born in 1832 in Bristol to a liberal family which emigrated to America, Elizabeth Blackwell was repeatedly rejected by medical schools on the grounds either that women were intellectually inferior or because she would threaten the male hegemony. Eventually a medical school in Geneva, upper New York State, offered a sly evasion: they would admit her if the entire student body agreed. Every student voted in her favour – as a joke. So she joined 150 young men and qualified in 1849. With her sister Emily, who followed her into medicine, she fought for social reform throughout the American Civil War. She founded the New York Infirmary for Women and, when she returned to England, the London School of Medicine for Women.
Elizabeth Blackwell’s example and encouragement fostered the ambition of suffragist Elizabeth Garrett Anderson. Rejected by British medical schools, she qualified in Paris. Still unable to register in Britain, she discovered that the Worshipful Society of Apothecaries didn’t exclude women, a loophole they promptly closed after she passed their exams in 1865 to become England’s first qualified woman doctor. She campaigned for the 1876 ‘Enabling Act’ that finally allowed the licensing of female doctors and founded what became the Elizabeth Garrett Anderson Hospital, for women and staffed by women. It survives as a wing of University College Hospital.
These women and others may have come from privileged backgrounds but they spent much of their lives challenging orthodoxy, pioneering for the disadvantaged and marginalised as well as for women in medicine. By 1914 about 1000 women appeared on the medical register. The First World War opened the opportunity to fill the vacancies left by doctors serving at the front – until the men returned home.
The BMA does not come well out of the story of women in medicine. After Elizabeth Garrett Anderson managed to join the BMA in 1873 it promptly excluded women. Inside the tent, she led a campaign which reversed that decision in 1892. But for most of the following century medical schools were slow to admit students who didn’t play rugby. Women still needed great determination – and luck – to qualify.
One was Dame Janet Vaughan. Born in 1899, she qualified in London. In the slums she encountered some patients’ prejudice against a female doctor and saw how anaemia contributed to deadly poverty. Her subsequent work on anaemia won her a scholarship to research vitamin B12 deficiency at Harvard. Their medical school didn’t admit women as students till 1945. Nor would they let women do research on mice, so Vaughan used pigeons instead.
And later, as an experienced physician, she suffered the prejudice of medical colleagues who refused to speak to her. When they needed her advice they sent her notes. In 1938, foreseeing the outbreak of war and the need to store and transport large quantities of blood, she helped set up depots in four areas around London which held blood in modified milk bottles of her devising. The blood was despatched to areas hit by bombs in Walls ice-cream vans, mostly driven by women. One wore her pearls, another her fur coat. The depots were the start of modern blood banks.
“I am here” she said “trying to do science in hell.”
In 1945 Vaughan was recruited to go to Bergen-Belsen to research a safe strategy for refeeding starving people. She never forgot the stench. “I am here” she said “trying to do science in hell”. She was appointed principal of Somerville, her old Oxford college, where she promoted the education of women in science and supported the fledgling NHS. Still excited by unexplained phenomena, she continued with research which changed our understanding of blood and bone diseases and the effects of radiation. She was still writing academic papers in her 80s.
Another determined woman was Marianne Fillenz, born in Romania in 1924. At a catholic nursery she was promised that if she sang a song she would get a reward. None was forthcoming. She asked why not. The reply was that she would receive her reward in heaven. Marianne stalked out of the nursery and refused to return.
When she was 15 her Jewish family found a spare entry form for New Zealand and fled the Nazis. Within three years her English was fluent and she won a place at the notably misogynist Otago Medical School. Neurophysiology and philosophy fascinated her, and she came to Oxford to pursue a productive research career.
She met and married an Australian academic. He too was a mould-breaker; in the 1950s they were sharing equally the responsibilities of rearing three children. As a college fellow Marianne continued to challenge authority, accepting the students other admission tutors rejected on the grounds of their age or academic or social background. I was one of them. I will not forget her encouragement, her humour, her gatherings at which students past and present debated philosophy, politics, the arts. Thank you, Marianne.
So now women are in the majority. And now they have leadership positions, especially in general practice: the president and chair of the RCGP have often been female, and the chair and deputy chair of the GPC are both women. Other Royal Colleges are slower, but have schemes to support women as leaders. It will take time to reach equality at the top of the career ladders, but we’re getting there – two centuries since we had to be male impersonators.