ased in part on a chapter for the upcoming book The American Society of Anesthesiologists: A Century of Challenges and Progress, this article looks back at the situation for women physicians when ASA began and then leaps forward 100 years to the present, to 2005.

Then (1905):
There were few women physicians when ASA began in 1905 as what was then the Long Island Society of Anesthetists (LISA). There had been progress, however, from a lone woman doctor in 1849 (Elizabeth Blackwell, M.D.) to 8,201 women doctors in 1905. Because they had usually trained at a women’s medical college (few regular medical schools accepted women students), did their hospital work at a women’s hospital, usually cared for only women and children and were often not accepted by local medical societies, women doctors of that time were usually isolated from mainstream medicine.

Physician Anesthetist Mary Botsford, M.D., 1923.

Physician anesthetist Alma Vedin, M.D., 1922. She was the first woman ASA officer.

No photo of Dr. Schirmer could be found. She was the first woman ASA member. This is her signature on the list of Charter Members of LISA.

Only a few physicians were interested in anesthesia as a specialty in 1905. Several hospitals had appointed physician anesthetists to try to solve the problem of excessive anesthesia mortality. At least two women physicians were known to be practicing anesthesia in 1905: Mary Botsford, M.D., of San Francisco, California, and Emilie Schirmer, M.D., of Brooklyn, New York. (Isabella Herb, M.D., of Chicago, Illinois, had started her anesthesia practice in 1894 but left in 1904 for pathology, where she stayed for five years.) Dr. Botsford (M.D. in 1896 from the University of California) had been appointed anesthetist at the Children’s Hospital of San Francisco (a hospital founded by and for women physicians) in 1898; it was not possible to learn where Dr. Schirmer (M.D. in 1899 from Cornell University; this was the first Cornell class that included women) did anesthesia. Because it was difficult to make a living doing only anesthesia then, physicians interested in anesthesia usually had other practices, and this was the case with these two. Dr. Botsford had a general office practice in addition to her anesthesia work, and Dr. Schirmer did pathology along with her anesthesia practice. The image of a woman doctor in 1905 was as an unattractive, unmarried spinster. The true picture was very different. Dr. Botsford had been married to another physician and had no children but lived with and supported a niece and the niece’s child. Dr. Schirmer was married to another physician and had two children. A live-in servant was her support at home.

Dr. Botsford never joined the LISA-ASA organizations due to, first, geographic issues (it was hard then to travel across the country to meetings) and second, she was committed to the anesthesia organizations of Francis H. McMechan, M.D., which competed with the East Coast-based LISA. Dr. Schirmer was located in Brooklyn and was the only woman present at the first general meeting of LISA. So she should be considered the first woman member of ASA. She is listed as member 11 in the typed list of ASA members; no photograph of her could be found. Few medical societies allowed women members then, so LISA was unusual. Perhaps women were included because there were so few people practicing anesthesia.

It was about five more years until there was another woman applicant to the New York Society of Anesthetists (NYSA), the organization having changed its name in 1912. This was Alma Vedin, M.D., of New York City (M.D. in 1899 from Women’s Medical College of the New York Infirmary, a women’s medical college). She began anesthesia practice in 1907 and was the anesthetist for the New York Infirmary for Women and Children, a women’s hospital. Dr. Vedin was elected to the LISA Executive Committee in 1918 and was vice-president in 1920-22. She can be considered the first female officer of ASA.

The situation for women physicians slowly improved after 1905, and by 1910, women physicians thought they were in a “golden age.” A striking drop in opportunities for education and training and in the total number of women physicians and percent of women in the physician population began after 1910. This drop lasted for 50 years, until 1960. Surprisingly, during this time of even fewer women physicians, women physicians filled a need for manpower in anesthesia practice. Although they were only 4.4 percent to 5 percent of the physician population (1920-48), women were 11 percent to 13 percent of national anesthesia society members, a marker for being a professional anesthetist. This was most likely due to their lack of other practice opportunities and their acceptance by surgeons.

Now (2005):
The presence of women in medicine and anesthesiology has changed dramatically! The number of women physicians increased strikingly after 1960, without the women’s medical institutions needed at the turn of the century [Graph 1]. This increase means more women are available to enter specialties. This increase is reflected in a numeric increase in women anesthesiologists. The percent of women physicians entering anesthesiology is actually falling, however [Graph 2]. Other specialties such as surgery are now available to women, and women doctors are choosing them in preference to anesthesiology. This could be important in the future manpower supply for anesthesiology. Anesthesiology remains, though, the sixth most popular specialty for women, a rank it has held since 1980.

More women also are entering medical societies. If opportunities to become leaders are indeed equal now, there should be an increase in women officers of societies. See Graph 3 for recent data on women in ASA leadership positions. One possible cause for lack of women leaders is women’s family responsibilities, which give them less time to participate in medical societies. This effect would be equivalent for all women in all the various societies. An excellent measure of success in leadership would be achieving the presidency of an organization, so the major specialty organizations were surveyed about recent women presidents. It was surprising to learn that all the major specialty societies in 2004, except for surgeons, have either a woman president, a woman immediate past-president or an incoming woman president [Table 1]. ASA has had only one woman president, Betty P. Stephenson, M.D., in 1999.

The reasons for the “steady state” of women in ASA leadership positions, except for committee chairs, have not been explored, although they have been discussed informally. Remarkable changes have occurred for women in anesthesia since 1905, but there are still more issues to examine and discuss.

Selma Harrison Calmes, M.D., is Chief of Special Projects, Medical Administration, Olive View-UCLA Medical Center, and Clinical Professor of Anesthesiology, UCLA Medical Center, Sylmar, California.