Academic Psychiatry, 28:4, Winter 2004 http://ap.psychiatryonline.org 305 Women in Psychiatric Training Ann M. Bogan, M.D. Debra L. Safer, M.D. Drs. Bogan and Safer are with the Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, California. Address correspondence to Dr. Bogan, 550 Hamilton Avenue, Suite 208, Palo Alto, CA 94301; annbo- ganmd@gmail.com (E-mail). Copyright  2004 Academic Psychiatry. I n 1849, Elizabeth Blackwell became the first woman in the United States to graduate from medi- cal school (Geneva Medical College, later Hobart Col- lege, in New York) (1). January 2003 marked the 154th anniversary of Dr. Blackwell’s graduation. Over the intervening years, women have certainly become much more highly represented in medical schools na- tionwide. The number of female medical students has grown with a near constant acceleration since 1969. For example, in the 1949–1950 academic year only 7.2% of the total enrolled medical students in the United States were women. By the 2000–2001 aca- demic year, 44.6% were women (2). The increasing percentage of female medical stu- dents is a trend evident among female residents as well though the numbers, as would be expected, lag behind medical school enrollments by several years. In 2000, 38% of all residents were women. The per- centage is higher in psychiatry residency programs where, in 2000, women achieved statistical parity with men by comprising 49.8% of all psychiatric residents. The only medical specialties with higher percentages of women residents were dermatology, medical genetics, obstetrics and gynecology, and pe- diatrics (3). Though statistics can demonstrate the approach towards or achievement of numerical equality, they do not reveal information about whether the concerns particular to women medical students and residents are being addressed. It is quite possible that the dem- ographic shift has not been accompanied by a corre- sponding cultural shift. Unfortunately, there are little data on the particular issues facing women residents in psychiatry. Interestingly, more of the academicar- ticles on this subject were written in the 1970s and 1980s. More current writings on the topic appear in psychiatric newsletters. One might assume that in core aspects, women psychiatry residents’ concerns are similar to their female counterparts in other de- partments and of female physicians in general. Among the major concerns for female physicians are work-life balance and career opportunities (4). Be- cause of the limited literature available relating spe- cifically to women psychiatry residents, this article will include information from more general sources but will focus to the extent possible on the concerns of women psychiatry residents. BALANCING WORK AND FAMILY For female psychiatric residents, the issue of balanc- ing work and home resonates especially loudly when considering pregnancy. Typically, residency occurs during a woman’s prime child bearing years. It is therefore not surprising that a sizeable number of res- idents will become pregnant. Women psychiatry res- idents, like their medical counterparts, are affected by the regulations of the American Medical Associa- tion’s (AMA) maternity leave policy (H-420.967). This suggests that residency training programs grant a minimum of six weeks of maternity leave, with the understanding that no woman should be required to take a minimum leave (5). Furthermore, the AMA’s policy regarding maternity leave for residents (H- 420.987) encourages flexibility in manpower levels and scheduling to allow for coverage without creat- ing intolerable increases in residents’ work loads (6). In addition, as employers, training programs are reg- ulated by the Family and Medical Leave Act of 1993, a law requiring employers to grant 12 workweeks of unpaid leave during any 12-month period for medi- cal events, including pregnancy (7).