by Nicole Fletcher
Department of History, University of Manitoba
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Women have long been a part of the history of healthcare in the Western world, taking on the roles of midwives, healers, and patients. [1] Once the modern profession of “doctor” began to coalesce, women were largely excluded from formal medical education and practice. This article focusses on the unique obstacles faced not by the first wave of women to achieve recognition as physicians in Canada, but by the second generation of women entering professional medicine. It examines the consequences of the impediments faced by these doctors. This analysis concentrates on the example of Dr. Elinor Black (1905–1982), a prominent Winnipeg obstetrician and gynecologist, who earned a plethora of firsts for women in Canadian medicine. Dr. Black’s experience will be contextualized within that of second-generation woman physicians, or those who trained in medical school and practised medicine in the first half of the 20th century. This study contributes to literature on this little studied group of women and shows that there were ongoing barriers for medical women, even after pioneering woman doctors had gained access to the profession.
Dr. Elinor Frances Elizabeth Black (1905–1982) at the time of her 1951 appointment as Professor and Chair, Department of Obstetrics and Gynaecology.
Source: University of Manitoba College of Medicine Archives
Dr. Black’s career is of interest due to its uncommonly successful nature. After earning her medical degree at the University of Manitoba in 1930, she went on to head a medical department at the University of Manitoba and run the Obstetrics and Gynecology department at the Winnipeg General Hospital, in addition to maintaining a private practice. Even though Dr. Black had a distinguished career and often paved the way for women in medicine, very little has been written about her. The most substantial work is Julie Vandervoort’s biography, Tell the Driver, published in 1992, which offers a detailed and interesting description of Dr. Black’s private and public life using Black’s own archives. This article expands on Vandervoort’s biography by considering Dr. Black in the context of generational differences between the waves of women entering the profession. Although prominent with many achievements to her credit, Dr. Black faced gender bias throughout her education and career. This affected her identity as a doctor and as a woman. [2]
Elinor Black’s fonds at the University of Manitoba, Faculty of Medicine Archives and contemporary articles from medical journals and the Winnipeg Free Press are used to investigate and analyze Dr. Black’s life, education, and career, via a feminist analysis of women in medicine. Black’s experience as a second-generation female practitioner, is framed here in comparison with the better-studied lives of the pioneering generation who graduated from Canadian and American medical schools in the 19th century. I draw on both Canadian and American historical literature regarding the experience of early women in medicine. Although medical women in each country had separate fights for equality, they enrolled in similar schools and faced some similar obstacles, such as a bias against women receiving higher education. [3]
The struggles of the first women to enter the medical profession in North America have been well documented in works including Veronica Strong-Boag’s article in A Not Unreasonable Claim, Mary Kinnear’s In Subordination, EllenMore’s Restoring the Balance, Mary Walsh’s Doctors Wanted, No Women Need Apply, Carlotta Hacker’s The Indomitable Lady Doctors, Cheryl Warsh’s Prescribed Norms, and Regina Morantz-Sanchez’s Sympathy and Science. [4] These studies divide the 19th-century feminist physicians into two groups: those arguing that women have a “special calling,” therefore offering a quality of patient care that men cannot; and those who maintained that women are not different from men and that they should assimilate into the male establishment of medical practice rather than highlighting gender differences.
The second-generation of woman physicians in Canada, women who were accepted into co-educational, orthodox medical schools and went on to practise medicine, have been overlooked in existing scholarship. There are currently no studies focussing on this interwar period.
After the first generation of woman physicians—those who entered the field before 1914—scholarship moves on to focus upon the impact of the second wave of feminism in the late 20th century upon women in medicine and health. This paper seeks to help remedy this void and draw attention to second-generation practitioners. The age of existing studies is also of note. Other than Warsh’s work from 2010, key studies on woman physicians in Canadian medicine were published from the late 1970s through the 1990s. In the last 25 years, it appears that scholars have abandoned the study of women in medicine. Much work waits to be done on Canadian women in medicine, including the impact of women entering medical practice and the persisting gender discrimination in medicine, in the hospital and the laboratory.
This article follows the life and career of Elinor Black. The first section introduces early woman doctors in Canada and medical schooling prior to the First World War, followed by a brief overview of Elinor Black’s early life and primary schooling. The next two sections discuss Black’s entrance into medical school and the barriers faced by women in the co-educational system. The conflict between gender norms and the expected traits of a doctor are explored in the following section. Lastly, the article considers the obstacles to woman doctors practising medicine and discusses Black’s successful career.
The Manitoba Medical College, seen in this 1914 photo, had moved to this site on Bannatyne Avenue eight years earlier from its original building a few blocks away on McDermot Avenue.
Source: University of Manitoba College of Medicine Archives
In Canada, one of three women could arguably be considered the first woman doctor. James Miranda Barry was the first woman to be identified. However, she presented herself as a man for her entire career and not until her death was her gender discovered. [5] She was appointed the Inspector-General of Hospitals for Upper and Lower Canada in 1857 and was the country’s chief military physician. [6] Perplexed officials buried her as a man, leaving her sex officially undiscovered. [7]
Emily Stowe (1831–1903) is the first woman doctor with official training to practise in Canada as a woman. Stowe earned her degree from the New York Medical College for Women in 1867 and returned home that year. In 1869, regulations were altered so doctors with degrees from American universities were permitted to practise medicine in Canada only if they attended one session of lectures at an Ontario medical school.[8] As medical schools in Canada did not admit women at that time, Stowe simply practised without a licence for thirteen years, refusing to take the exam when she was able in an effort to undermine the licensing body’s authority. [9]
Jennie Trout (1841–1921) claims another first for woman physicians in Canada. Like Stowe, Trout travelled to the United States for education, graduating from the Women’s Medical College in Pennsylvania in 1875. [10] Trout and Stowe were initially friends (although they had a falling-out later), who fought for medical education rights for Canadian women. [11] From 1870-1871, both were admitted to the University of Toronto to take the requisite session of medical schooling in Ontario on the stipulation that they make no complaints. [12] After passing her exam, Trout became the first woman licensed to practise medicine in Canada. [13]
All woman physicians who began practice in Canada before 1884 received their schooling outside of the country, usually in the United States, because no Canadian school admitted their sex. [14] Dissatisfied with their education and their treatment by Canadian schools, Stowe and Trout each pursued the creation of women’s medical schools. [15] Their efforts came to fruition with the founding of the Toronto Woman’s Medical College and the Women’s Medical School in Kingston, Ontario in 1883. However, by 1895, the two schools had amalgamated as the Women’s Medical College, and by 1909, both schools had closed as the University of Toronto began admitting women. [16] In Manitoba, the Manitoba Medical College was established in 1883 and women were allowed admission to the school three years later. [17] However, only two women graduated from the Manitoba Medical College prior to 1901 and the number did not begin to rise significantly until the interwar period. [18]
After women could earn degrees at some Canadian medical schools, many barriers remained in place. Maude Abbott (1869–1940), who became an internationally recognized cardiologist from Canada, was denied admission to McGill’s medical school based on her sex and instead earned her degree from Bishop’s College in 1894. [19] McGill did grant Abbott an honorary medical degree in 1910 although women were unable to attend the school until 1918. [20] This gender bias continued later in her career, when she was forced to retire in 1936. McGill refused to advance Abbott to Emeritus Professor, even though she had received numerous international honours, in an attempt to limit her historical importance. [21]
Table 1. University of Manitoba medical graduates, 1892–1971.
1892–1901
1902–1911
1912–1921
1922–1931
1932–1941
1942–1951
1952–1961
1962–1971
Male
177
242
256
410
478
534
644
517
Female
2
1
9
34
40
57
39
48
% Female
1.1
.04
3.4
7.6
7.7
9.6
5.7
8.4
Source: Mary Kinnear, In Subordination: Professional Women 1870–1970. Montreal: McGill-Queen’s University Press, 1995, page 177.
The first wave of woman physicians, those who entered the field before the First World War, paved the way in co-education and medical practice for the next generation. These women had fought for the right to education and viewed activism as an essential component to medicine, and many were involved in the suffragist movement. [22] The second generation, who entered medical practice in the interwar period, were admitted to medical schools but they faced quotas and a range of barriers. According to Warsh, the response of many was to emphasize professionalism and the progressive and objective tenets of science. [23] The second-generation doctors tended to reject the earlier feminism of pioneering woman physicians and tried to assimilate into a male-defined medical culture, rather than emphasizing their experiences as female practitioners, or shaping a distinctive female approach to medicine.
The Black family at Victoria Beach in 1923.
Source: University of Manitoba College of Medicine Archives
Elinor Frances Elizabeth Black was born in 1905 in Nelson, BC to Margaret and Francis (Frank) Black. [24] She was the youngest of four children after siblings Marjorie, Donald, and Charlotte. Margaret Black (née McIntosh) was from Boca, Nevada and was a graduate of California State Normal School. After graduation, she returned to Nevada and opened a school where she taught until her marriage to Frank Black in 1897. [25] Frank was a Scottish immigrant and graduated from Perth Academy. He moved to Canada in 1891 and joined the Bank of British Columbia. [26] Frank became a prominent businessman working as the district manager of P. Burns and Co. The family was financially well off, being able to afford a housekeeper and a summer home. [27]
Elinor’s early life involved significant relocation across Canada. In 1909, Frank Black was promoted to company treasurer of P. Burns and Co., a job that required the family to move to Calgary, where the company’s head office was situated. [28] The young Elinor’s interest in medicine was piqued in Calgary. Later in life, she credited two female school inspectors in Alberta, Dr. Lillias Crignan-McIntyre and Dr. Geraldine Oakley, with prompting her resolve to pursue medicine. [29] After a family summer trip across Canada in 1912, Margaret Black and the children moved to Edinburgh, Scotland to learn more about their Scottish heritage while Frank continued working in Calgary. The following year Margaret, Elinor, and Charlotte returned to Calgary while the two older siblings finished their Scottish education. [30] In 1917, Frank Black was appointed treasurer of Winnipeg’s United Grain Growers in Winnipeg. [31] The next year, at the age of 12, Elinor and the rest of her family joined Frank in Winnipeg. [32] In 1922, Frank was elected to the Manitoba Legislature and served as the Provincial Treasurer and the Minister of Telephones and Telegrams in the John Bracken administration until 1925. [33] Elinor attended Kelvin High school, a mile-and-a-half walk from her family’s Kennedy Street home. [34] Elinor was firmly settled in the city in which she would later study and practise medicine.
Elinor Black, 1920s, photo taken by Arthur Stoughton.
Source: University of Manitoba College of Medicine Archives
Elinor Black entered the University of Manitoba Medical College in 1924 against the wishes of her family. [35] Her brother, Donald, already in medical school, was most opposed, complaining, “women were a nuisance around the medical school.” [36] At the time of his sister’s admission, a mere 7.6% of University of Manitoba medical students were female (see Table 1) and medical women were regarded as anomalies. [37] Many families dissuaded daughters from entering professions which were still regarded as not respectable for their sex and preferred to reserve money for education for their sons. [38]
By this time, Dr. Edward Clarke’s previously influential theorieson education for women were largely disproven. In his popular 1873 book, Sex in Education or, A Fair Chance for Girls, Dr. Clarke’s claims focussed on biological factors as a reason for women refraining from higher education, maintaining that menstruation was debilitating and women could not physically handle education without risk of compromising their health and fertility. [39] The question now remained, not so much if women could be doctors but rather if they should be. [40] It was widely thought a waste for them to attend medical school where they would replace more valuable men, who would not depart the field upon marriage. [41] It was furthermore commonly assumed that women would become less feminine, and thus less desirable by potential husbands, if they became professionals, thereby upsetting the roles of men and women and traditional home life. [42]
Gaining admission to the University of Manitoba’s medical program was an accomplishment in itself. A major drawback to the closures of the separate women’s medical schools was that applicants to co-educational institutions almost always faced gendered admission quotas. [43] The University of Manitoba became the centre of controversy in 1944, when its quota system became public. In the University of Manitoba system, applicants were divided into four lists: one for “preferred” applicants (Anglo-Saxon, Icelandic, and French-Canadian), one for women, one for Jews, and one for “other origins” which included Ukrainians, Mennonites, Dutch, and Poles. [44] Each list was then sorted by the students’ grades. Three to five applicants were chosen from each of the three lists of less desirable applicants. The remainder of students were chosen from the “preferred” list. [45] Therefore, this quota system effectively limited admission to the medical school by ethnicity and sex, regardless of academic ability. Additionally, systems similar to this were in place “in every medical college on the continent.” [46]
Elinor F. E. Black, MD, 14 May 1930.
Source: University of Manitoba College of Medicine Archives
Dr. A. T. Mathers, dean of the faculty of medicine, justified the system by stating that criteria “went far beyond mere scholastic requirements...intelligence, scholarship, character and physical and ethical fitness and adequate financial resources are necessary.” [47] Dr. Mathers also defended the quota by stating, “...some of our hospitals refuse to accept women internes, and similar restrictions operate with regard to certain racial and technical groups.” [48] The College of Physicians and Surgeons went before the university’s Board of Governors in May 1944 affirming that ethnicity would not come into account during the selection of medical students; however, no mention of sex was made. The College did reiterate the importance of an internship year as “essential to the training of a man or woman prior to entering Medicine,” showing a reluctance to give up the limiting of women who entered medical school. [49]
The quota system was not officially instituted until 1932, eight years after Dr. Black started school, but female admission rates were already suspiciously low. One graduate stated, “We knew. [The faculty] took sixty men. Thirty girls applied and they took four: one Jewish, one French Canadian, and two Anglo-Saxons. It [the effective quota] was widely known.” [50] Another graduate commented that the admission reform of 1944 did not abolish the quota but increased numbers from four to ten percent. [51] The University of Manitoba was not alone in low admission rates for female medical students; these issues affected other Canadian universities as well. A University of Toronto graduate, Dr. May Cohen, recalled that there was a limit of 10% women in each class. [52]
After 1945, the percentage of woman graduates stayed well below 10% until the 1970s (see Table 1). On a national level, female medical school graduates rose from 6% in 1959 to 33% in 1981. [53] Available data do not show how many women applied or how many dropped out during the program, making it impossible to conclude whether a gender quota was in place or not.
Elinor Black was one of three women in the 1930 class in the Faculty of Medicine at the University of Manitoba.
Source: University of Manitoba College of Medicine Archives
Second-generation woman doctors were accepted into co-educational medical schools, receiving education in conjunction with their male peers. Without the support system of the earlier women’s colleges, female students were forced to conform to the male-dominated social structure. [54] They routinely encountered backlash and discrimination from male students and professors, often in the form of micro-inequalities. [55] These types of inequalities ranged greatly in form, but included being forgotten for training opportunities such as surgeries, and jokes made by lecturers about women. Micro-inequalities are slight and often cumulative, making them very difficult to combat; however, they are serious, leading to problems with professional and personal performance and self-esteem issues. [56] Such barriers may have encouraged women to prefer the more socially acceptable professions of nursing or teaching over medicine. [57]
Elinor Black’s experience confirmed prejudice. For example, one professor offered an impromptu lecture on birth control at his house, since the topic was illegal at the time and could not be discussed at the university. However, Black and her three female classmates were never notified. [58] Subsequently, as an instructor, she offered a similar private seminar to her female students. [59] Conditions did not quickly change. As late as the 1960s, two Manitoba graduates reported being told that women do not belong, getting bruised and shoved, and often being the last to be able to see the patients. [60] The Manitoba graduates also recount that while learning to perform rectal examinations on male patients, the male students would enter the exam room with the patient and close the door while the female students would prepare in the hall. The exam room door would open and the female students would silently rush in, perform the rectal exam, and leave, showing that women were still not fully accepted as doctors. [61] Some professors continued to try to intimidate women with sexist comments and lewd jokes. Elsewhere in Canada, the story was much the same.
At the University of Ottawa, a pathology professor scattered nude pictures throughout his lecture. These included a cartoon depicting a male doctor and female patient having intercourse with the caption “What to do while waiting for the doctor.” [62] Some of the female students objected to the content but the professor attempted to defend himself by stating that he was simply lightening the mood for his students since the class contained many gruesome images.
Even though the woman students received at best a chilly welcome, few complained. [63] Dr. Cohen later reflected, “...those of us who succeeded in getting through that barrier could only feel extremely grateful for our good fortune. We were not about to make waves and so accepted, without protest, sexist remarks, [and] our apparent invisibility when references to the class were directed only at males.” [64] Looking back, a 1950 University of Manitoba graduate stated:
I think we were naïve that we didn’t recognize some of the discrimination. We were just so delighted to be accepted. I remember one time – I’m sure now the girls would flare up and rage, but we didn’t, we just laughed along with the guys at some of the jokes, the female jokes – one lecture, the anatomy professor started off. The topic today, he said, is the female breast. And I want you to get a good grasp of the subject. Well, we just giggled long with the boys. We weren’t feminist enough to realize that some of these things shouldn’t be done, and were happening, and we ought not to take it, but we did. But you had to do it to get there. [65]
Such denial of harassment perpetuated the idea that nothing was wrong and that no changes needed to be made.
Part of the discrimination women faced sprang from the profession’s masculine culture. As a friend of Elinor Black commented, “Women were women and men were men. And doctors were men.” [66] In the late 1800s, medicine began to modernize with the introduction of laboratory science, prescriptions, and more structured schooling, doing away with the earlier apprenticeship system. Modern medicine’s increasingly scientific and systemized approach was gendered male, leaving no room for women who had been viewed as healers in the past. Doctors were expected to demonstrate detachment, objectivity, and authority, traits deemed masculine, whereas the ideal woman was passive, nurturing, and emotional. In order to be even minimally accepted, women had to downplay their female identity and ignore discrimination. [67]
Social norms, shared by most male doctors, accepted women in medicine only as nurses. Woman physicians and medical students often distanced themselves from nurses to affirm their higher status, even as nurses struggled to elevate their own standing as healthcare professionals. As a result, female nurses and woman doctors were often at odds. [68] Elinor Black, on the other hand, claimed to greatly esteem nurses, maintaining amicable and respectful relationships with many during her career. As an intern, she roomed with a maternity nurse, Annie Taylor, and the two became close friends. Later in life, Dr. Black undertook a world tour with the head nurse at the Winnipeg Clinic, Frances (Frank) Ward. [69] She also regularly spoke at nursing graduations and events. [70]
Yet, near the end of her career, Elinor Black claimed that after spending so much of her life surrounded by men, she did not get along well with women. She was not alone. After fitting in as a “medical man” during years of schooling, second-generation woman doctors reported difficulties identifying with other women. For example, Dorothy Mendenhall, a medical student at Johns Hopkins University in 1900, decided that while in medicine she would never object to anything a man did or said “[in her] presence if he would act or speak the same way to a man...” [71] As Warsh suggests, second-generation woman physicians experienced more gender role conflict compared to the female medical pioneers, identifying with the masculine version of medicine. [72]
Medical textbooks still supported gender norms of the day. The obstetrical and gynecological textbooks in use during Black’s years as medical student and teacher depicted women as weak and infantile, with the core personality traits of “...feminine narcissism, masochism and passivity.” Not only were all medical students and doctors referred to in textbooks as “he”, but also the widely used Obstetrics and Gynecology claimed that women were so highly emotional that previously “infertile women” would become pregnant after common diagnostic procedures. [73] Two 1950s textbooks instructed doctors to teach their patients how to fake an orgasm to please their husbands. [74] Another tex tdirects the future doctor to analyze the female patient’s personality through her appearance, dress, and walk. The medical establishment used textbooks like these for years; Obstetrics and Gynecology was widely used throughout North America until the 1980s. [75] Such representations could only make it more difficult for woman doctors to relate to their own sex
Medical texts were not the only problem. Students had to find internships to complete their degrees. In 1925, only 128 or 24% of the 524 U.S. hospitals offering American Medical Association-approved internships accepted women. By the 1940s, that number had risen only to 30%. [76] There is little reason to expect that the Canadian situation was any different, because in 1944 Dr. Mathers stated that some Winnipeg hospitals would still not accept woman interns. [77] The shortage of internships helped to sustain the argument used to limit female admissions into medical school. Those able to find internships discovered that hospitals were not prepared or willing to accommodate female doctors. In a 1973 survey American woman doctors described the lack of acceptance that would have been familiar to their northern counterparts:
Being “forgotten” is most prominent in surgery. Women med students are required to dress in the nurses’ dressing room and hence are often not informed by fellow male students and/or interns, residents of changes in surgical scheduling. Also the women students on surgery are consistently deprived of the discussion of the actual operation after the surgery, which frequently occurs between students and surgeon in the “doctors’ dressing room,” and therefore the men’s dressing room. We also encounter difficulty in the hospital in terms of finding a bed to sleep on overnight when we’re on call—the nurses kick us out of their quarters, and the doctors and students out of the “men’s” sleeping quarters. [78]
In Winnipeg, the Interns’ Quarters within the hospital were reserved for men; woman interns had to find nearby rooms. The Winnipeg General Hospital paid the rent for an apartment but no furniture was supplied. Luckily, in Elinor Black’s case, friends and family came to her aid, furnishing the rooms. Female interns also ate separately from men; free meals were provided at the Nurses’ Residence along with laundry service. [79] At other institutions, female interns were required to share both rooms and meals with the nurses. The interns’ extremely variable schedules often conflicted with those of nurses, causing friction between the groups and, sometimes, resulting in missed meals for the doctors. [80] Male interns faced none of these difficulties. The everyday lives of female interns were structured according to gender norms and segregation.
No matter their path, woman doctors were met with regular criticism and considered somewhat anomalous. According to William Osler, a Canadian physician and a founder of Johns Hopkins Hospital, “Humankind can be divided into three groups—men, women, and women physicians.” [81] As graduate physicians, women faced further obstacles such as limited numbers of staff positions in hospitals and medical school faculties, as well as barriers to membership in specialist societies. Consequently, most woman physicians worked longer than their male counterparts as general practitioners, therefore making less money than male specialists. [82] The recurring prejudice was summed up by Dr. R. H. Spencer, the medical director of the U.S. National Institute of Health, in a 1942 speech entitled, “Future of Women in Medicine,” in which he predicted a need for more women, although he foresaw them mainly as general practitioners, community health workers, and experts overwhelmingly only in women’s and children’s health, or those fields generally thought more suitable for women. [83]
Table 2. Percentage of married, gainfully occupied women, selected, Manitoba.
1931
1936
1941
1946
1951
1961
1971
Physicians
22
14
27
46
44
50
65
Nurses
4
2
4
11
29
52
64
Teachers
4
3
6
10
21
46
67
All professional occupations
4
3
4
9
20
41
n/a
All occupations
4
9
9
18
33
55
62
Source: Mary Kinnear, In Subordination: Professional Women 1870–1970. Montreal: McGill-Queen’s University Press, 1995, page 186.
One early argument against women in medicine was that family duties would curtail careers. In fact, an American study entitled “Survey of Women Physicians Graduating from Medical School, 1925–1940”, undertaken by the Association of American Medical Colleges, showed that 87.5% of participants were in active practice. It reported that 33% of women withdrew for an average of 4.5 years, usually to stay with children until they were school-aged. Only 10% of male physicians had withdrawn and in their case for an average of 2.1 years, generally for a physical disability. [84] The perception was that family would interfere with the medical career of women but in reality, it affected only a minority of female doctors, perhaps because some women chose not to marry. The assumption that women would not stay active in the profession affected Dr. Black herself, who concluded that men “can stand the pace [of medicine] longer.” [85] As late as 1979, Dr. Arnold Naimark, dean of the University of Manitoba medical faculty, admitted to hearing male doctors complain, “it’s a waste of place (to let female students enter the faculty) because women graduates won’t work the full equivalent of the male pattern.” [86]
Due to such prejudices, some women felt they had to choose between a medical career and a family. Dr. Black’s suitors reinforced this presumption. One serious suitor, Bernard Collins, asked “...do you ever think of getting married or are you too wrapt up in your profession? Because, for a girl, getting married practically means dropping your profession, doesn’t it?” [87] Collinseven suggested postponing their engagement for a year so that his prospective wife could get a taste of practising medicine before giving it up. In response, Dr. Black decided instead to never marry. A determined few who defied gender norms to a significant extent chose as Black did.
At the same time, it is interesting to note that, according to the 1931 census, 22% of Manitoban woman physicians were married, a rate much higher than that of other female professions (see Table 2). [88] They could rely on higher incomes and greater opportunities for work flexibility. Many woman physicians raised children, although according to a survey of Manitoba physicians it was a difficult balance. Like other women, woman doctors with children had a more difficult time balancing home and professional life as they were expected to handle a majority of the parental duties and the housework. [89] Until the 1960s, woman physicians continued to work after marriage in much higher numbers than other employed women. One doctor commented, “I have simply accepted the fact that we have to juggle many more responsibilities than most of our male peers.” [90] In a clear double standard, married doctors, especially those with children, were vulnerable to dismissal as insufficiently dedicated, while as professional women they were regarded as unappealing wives. [91]
Table 3. Percentage of women in Canadian academic medicine.
1984
1994
2004
Medical School Graduates*
36.8
44.3
53.4
Assistant professors**
31.6
41.1
40.4
Associate professors**
15.8
25.0
35.2
Full professors**
5.4
8.8
17.2
Deans***
0
0
5.9
Source:*“Canadian Medical Education Statistics 2011,” The Association of Faculties of Medicine of Canada, volume 33, 2011, page 34; **“Narrowing
the Gender Gap: Women Academics in Canadian Universities,” CAUT Equity Review, no. 2, March 2008, page 5; ***Mary C. Sheppard, “Women Are
Changing the Face of Medicine But Are Underrepresented in High-Level Positions,” CBC News, 7 March 2011, sec. Health.
Medical schools were also reluctant to hire women for the faculty. As late as the 1986-1987 academic year, only 13.8% of the full-time faculty members in Canadian medical schools were women. [92] In 1994, even as women made up 44.3% of medical school graduates, no deans of medicine were women (see Table 3). [93] In fact, there was not a woman dean of medicine in a Canadian school until 1999, when Dr. Noni MacDonald was appointed dean of the Dalhousie University medical school. [94]
In this challenging context, Elinor Black achieved great success professionally and gained numerous firsts for female physicians in Canada. After a six-month appointment as the house surgeon for the South London Hospital for Women in 1938, she gained membership in the Royal College of Obstetricians and Gynecologists. She was very proud of being the first Canadian woman and the first Winnipeg doctor to receive this honour. [95] Many decades later, in 1961, Dr. Black became the first woman president of the Society of Obstetricians and Gynecologists of Canada. [96]
Dr. Black also succeeded in the top ranks of academia. She started at the University of Manitoba as a demonstrator in the Gynecology Department in 1934. In 1935, she began demonstrating for the Obstetrics Department as well. [97] In 1937, she became a lecturer in Obstetrics and Gynecology, the only woman lecturer in a Canadian medical school at that time. Thirteen years later, Dr. Black was appointed Assistant Professor of Obstetrics and Gynecology. [98] In 1951, she was appointed head of these departments at the university and the Winnipeg General Hospital. Once again, she was the only woman to head a medical school department in Canada. [99]
Since gender discrimination was so pervasive during this period, what made Elinor Black successful? First, she was fortunate to have several supporters and benefactors who helped her financially. Dr. Black belonged to a middle-class family with resources to send both daughters and son to post-secondary education (despite her brother’s hostility). Dr. Black’s sister Charlotte went on to have a successful academic career, becoming the head of Home Economics at the University of British Columbia. [100] When her family lacked money to lend Dr. Black, she could count on family friends to provide support, most importantly to start her private practice in the midst of the Depression. [101] Her father’s sister, Jeannie, later helped arrange and pay for Dr. Black’s post-graduate training in England. [102] Dr. Black also remained unencumbered by marriage, children, and caregiving. Living alone with few responsibilities, she could devote herself to a private practice, classes at the University of Manitoba, and work at the Winnipeg General Hospital.
When she retired from her post at the University of Manitoba in 1964, Black was replaced by a full-time, male physician. He received secretarial and technician support and a substantially better salary. While Dr. Black earned an annual $5,400 per year from the Obstetrics and Gynecology Department, about a fifth of her total income, one male applicant for the job would accept no less than $20,000. [103] Not surprisingly, it took four years for the University of Manitoba to hire a replacement. It would be another 21 years before another woman would head a department in the medical school. [104]
1. Ellen Singer More, Restoring the Balance: Women Physicians and the Profession of Medicine, 1850–1995, Cambridge, MA: Harvard University Press, 1999, page 3.
2. Studies which include a brief mention of Dr. Elinor Black are, Mary Kinnear, In Subordination: Professional Women 1870–1970, McGill-Queen’s University Press, 1995, pages 61, 68-69, Margaret Nitychoruk and Lindsay Nicoile, “A Brief History of Women in Medicine in Manitoba,” Prairie Medical Journal 64, no. 1 (1994), page 9, and Cheryl Lynn Krasnick Warsh, Prescribed Norms: Women and Health in Canada and the United States Since 1800, Toronto: University of Toronto Press, 2010, pages 194, 218.
3. Dr. Edward Clarke, discussed later in this paper, was a Harvard professor whose theories against women receiving higher education were made popular in Canada and the United States in the late 1800s.
4. Margaret Nitychoruk and Lindsay Nicoile, “A Brief History of Womenin Medicine in Manitoba,” Prairie Medical Journal 64, no. 1 (1994), page 6.
5. Cheryl Lynn Krasnick Warsh, Prescribed Norms: Women and Health in Canada and the United States Since 1800, Toronto: University of Toronto Press, 2010, page 222. It is also possible that Barry was intersexual.
6. Carlotta Hacker, "The Indomitable Lady Doctors", Canadian Lives 29, Halifax: Goodread Biographies, 1984, page 3.
7. Ibid., page 3.
8. Nitychoruk and Nicolle, “A Brief History of Women in Medicine in Manitoba,” page 7.
9. Warsh, Prescribed Norms, 218-219. Stowe was granted a medical licence in 1880 based on her experience.
10. Nitychoruk and Nicolle, “A Brief History of Women in Medicine in Manitoba,” page 7.
11. Carlotta Hacker, “Jennie Trout: An Indomitable Lady Doctor Whose History Was Lost For a Half-Century,” Canadian Medical Association Journal 110, no. 7 (1974), page 843
12. Ibid., page 841.
13. Nitychoruk and Nicolle, “A Brief History of Women in Medicine in Manitoba,” page 7.
14. Veronica Strong-Boag, “Canada’s Women Doctors: Feminism Constrained,” in A Not Unreasonable Claim: Women and Reform in Canada, 1880s-1920s, ed. Linda Kealey, Toronto: The Women’s Press, 1979, page 112.
15. Ibid., pages 114-115.
16. Warsh, Prescribed Norms, page 180. See Strong-Boag’s, “Canada’s Women Doctors: Feminism Constrained” and Warsh’s Prescribed Norms, for more information on the influence and closure of women’s medical schools.
17. J. M. Bumsted, The University of Manitoba: An Illustrated History, University of Manitoba Press, 2001, pages 2, 8.
18. Mary Kinnear, In Subordination: Professional Women 1870-1970, McGill-Queen’s University Press, 1995, page 59.
19. Barbara Brookes, “An Illness in the Family: Dr. Maude Abbott and Her Sister, Alice Abbott,” Canadian Bulletin of Medical History 28, no. 1 (2011), page 174
20. Brookes, “An Illness in the Family,” page 172.
21. Ibid.,” page 186.
22. Warsh, Prescribed Norms, page 190.
23. Ibid., page 191.
24. University of Manitoba Faculty of Medicine Student Survey, 1935, Box 1, Folder 1, CV/Biography/Bibliography 1952–1970, Elinor Black Fonds, Faculty of Medicine Archives, University of Manitoba.
25. “Guide to the Margaret Elizabeth McIntosh Black Collection,” Online Archive of California, 2009, http://www.oac.cdlib.org/findaid/ark:/13030/kt5z09q9wh/
26. J. M. Bumsted, Dictionary of Manitoba Biography, Canadian Electronic Library. Books Collection, University of Manitoba Press, 1999, page 25
27. Julie Vandervoort, Tell the Driver: A Biography of Elinor F.E. Black, M.D., University of Manitoba Press, 1992, page 5.
28. Ibid., page 5.
29. Ibid., page 12.
30. Ibid., page 7.
31. Bumsted, Dictionary of Manitoba Biography, page 25.
32. Ibid., page 24.
33. “MLA Biographies - Deceased,” The Legislative Assembly of Manitoba,4 August 2009, http://www.gov.mb.ca/legislature/members/mla_bio_deceased.html#B0
34. Bumsted, Dictionary of Manitoba Biography, page 24.
35. Biography, Box 1, Folder 1, CV/Biography/Bibliography 1952–1970, Elinor Black Fonds, Faculty of Medicine Archives, University of Manitoba.
36. “I’m not a ‘lady’ doctor... just a doctor,” Winnipeg Tribune, 17 September 1979, Black, Elinor Frances Elizabeth 1905–1982, 21.9, CA UMASC Mss Sc 37 (A.78-32, A.81-17) Elinor Black Fonds, Faculty of Medicine Archives, University of Manitoba.
37. Deborah Gorham, “‘No Longer an Invisible Minority’: Women Physicians and Medical Practice in Late Twentieth-Century North America,” in Caring and Curing: Historical Perspectives on Women and Healing in Canada, eds. Dianne Dodd and Deborah Gorham. Canadian Electronic Library. Books Collection, University of Ottawa Press, 1994, page 187.
38. Nitychoruk and Nicolle, “A Brief History of Women in Medicine in Manitoba,” page 8.
39. Regina Markell Morantz-Sanchez, Sympathy and Science: Women Physicians in American Medicine, New York: Oxford University Press, 1985, page 54.
40. Regina Markell Morantz-Sanchez, “The Female Student Has Arrived: The Rise of the Women’s Medical Movement,” in Send Us A Lady Physician: Women Doctors in America, 1835-1920, ed. Ruth J. Abram, New York: Norton, 1985, page 65.
41. Kinnear, In Subordination, page 68.
42. Morantz-Sanchez, “The Female Student Has Arrived,” pages 63–64.
43. Warsh, Prescribed Norms, page 185.
44. “University Heads Deny Race Charge,” Winnipeg Free Press, 16 March 1944, final edition, sec. Vol. 50 No. 145, pages 1, 9.
45. Ibid., page 9
46. Ibid.
47. Ibid.
48. Ibid.
49. Kinnear, In Subordination, pages 64–65.
50. Ibid., page 64.
51. Ibid., page 65.
52. Gorham, “No Longer an Invisible Minority,” page 186.
53. Ibid., page 184.
54. Warsh, Prescribed Norms, page 187.
55. At Massachusetts Institute of Technology Mary Rowe coined the term, micro-inequalities. Rowe’s work led to MIT’s having one of the first anti-harassment policies in the United States.
56. More, Restoring the Balance, page 230.
57. Warsh, Prescribed Norms, page 213.
58. Vandervoort, Tell the Driver, page 43.
59. Kinnear, In Subordination, pages 68–69.
60. Pat Jackson and Sylvia Negrych, “Medicine: The Female Point of View,” University of Manitoba Medical Journal 3, no. 2 (1961), pages 15–16.
61. Jackson and Negrych, “Medicine: The Female Point of View,” page 16.
62. Warsh, Prescribed Norms, page 217.
63. Gorham, “No Longer an Invisible Minority,” page 187.
64. Ibid., page 186.
65. Kinnear, In Subordination, page 75.
66. Vandervoort, Tell the Driver, page 35.
67. Gorham, “No Longer an Invisible Minority,” pages 188–189.
68. Warsh, Prescribed Norms, page 218.
69. Frances Ward and Elinor Black may have been involved in a romantic relationship. Black’s biographer believes that she may have been a lesbian. However, this paper does not deal with Black’s sexuality.
70. Presentations to Nurses, 1947–1968, Box 2, Folder 1, Elinor Black Fonds, Faculty of Medicine Archives, University of Manitoba.
71. Morantz-Sanchez, Sympathy and Science, pages 114–117.
72. Warsh, Prescribed Norms, page 193.
73. Kay Weiss, “What Medical Students Learn About Women,” Off Our Backs 5, no. 4 (1975), page 24.
74. Diana Scully and Pauline Bart, “A Funny Thing Happened on the Way to the Orifice: Women in Gynaecology Textbooks,” American Journal of Sociology 78, no. 4 (1973), page 1046, doi:10.1086/225420.
75. Gorham, “No Longer an Invisible Minority,” page 207.
76. Warsh, Prescribed Norms, page 217.
77. “University Heads Deny Race Charge,” page 9.
78. More, Restoring the Balance, page 190.
79. Elinor Black, “Not So Long Ago,” University of Manitoba Medical Journal 45, no. 2 (1975), page 55.
80. Kinnear, In Subordination, page 69.
81. Warsh, Prescribed Norms, page 175.
82. More, Restoring the Balance, page 98.
83. Ibid., pages 186–187.
84. More, Restoring the Balance, page 190.
85. “City Doctor First Woman Elected Fellow Of College,” 1949, Box 2, Folder 6, Correspondence with Francis Mollison Black and other family, 1952–1970, Elinor Black Fonds, Faculty of Medicine Archives, University of Manitoba.
86. “I’m not a ‘lady’ doctor... just a doctor,” Winnipeg Tribune 17 September 1979, Elinor Black Fonds, Faculty of Medicine Archives, University of Manitoba.
87. Letter from Bernard Collins to Elinor Black, 1932, Box 2, Folder 7, Correspondence – “boy friends” 1926–1977, Elinor Black Fonds, Faculty of Medicine Archives, University of Manitoba.
88. Kinnear, In Subordination, page 186.
89. Ibid., page 71.
90. Ibid., page 72.
91. Warsh, Prescribed Norms, page 207.
92. Gorham, “No Longer an Invisible Minority,” page 185.
93. Stacy J. Williams, Laura Pecenco, and Mary Blair-Loy, Medical Professions: The Status of Women and Men, Center for Research on Gender in the Professions, University of California San Diego, 2013.
94. Nancy Robb, “Canada Has Its First Female Dean — 170 Years After First Medical School Opened,” Canadian Medical Association Journal160, no. 7 (6 April 1999), page 1042.
95. Nitychoruk and Nicolle, “A Brief History of Women in Medicine in Manitoba,” 9 and “Dr. Elinor Black Wins High Diploma in London,” Winnipeg Free Press, 4 February 1938.
96. Ibid., page 9.
97. University of Manitoba College of Medicine Student Card, Box 1, Folder 1, CV/Biography/Bibliography, 1952–1970, Elinor Black Fonds, Faculty of Medicine Archives, University of Manitoba.
98. “Winnipeg Honours Go To Doctor Elinor Black,” Winnipeg Free Press 29 December 1951, , Box 2, Folder 6, Correspondence – Francis Mollison Black (father) & other family – 1912–1942, Elinor Black Fonds, Faculty of Medicine Archives, University of Manitoba.
99. A. W. Anderson, “Obituaries,” Canadian Medical Association 126 (1 April 1982), page 869.
100. “Charlotte Black fonds,” University of British Columbia, http://resolve.library.ubc.ca/cgi-bin/catsearch?bid=3149784
101. Elinor Black, The Professor and His Wife manuscript, p. 21, Box 2, Folder 4, The Professor and His Wife, Elinor Black Fonds, Faculty of Medicine Archives, University of Manitoba.
102. Vandervoort, Tell the Driver, page 51.
103. Ibid., page 251.
104. Gordon Goldsborough, “Memorable Manitobans: Agnes J. ‘Aggie’ Bishop (1938-2014).” Manitoba Historical Society, 31 May 2014. http://www.mhs.mb.ca/docs/people/bishop_aj.shtml. Dr. Agnes Bishop became Head of the Department of Pediatrics in 1985.
105. “City Doctor First Woman Elected Fellow Of College,” 1949, Box 2, Folder 6, Correspondence with Francis Mollison Black and other family, 1952–1970, Elinor Black Fonds, Faculty of Medicine Archives, University of Manitoba.
106. “I’m not a ‘lady’ doctor... just a doctor”, Winnipeg Tribune.
107. Letter from Elinor Black to Alex Andison, 1976, Box 6, Folde r 6, Correspondence with Alex and Molly Andison, Elinor Black Fonds, Faculty of Medicine Archives, University of Manitoba.
See also:
Memorable Manitobans: Elinor Frances Elizabeth Black (1905-1982)
We thank Clara Bachmann for assistance in preparing the online version of this article.
We thank S. Goldsborough for assistance in preparing the online version of this article.
Page revised: 12 August 2020
