Women physicians are underrepresented in film, a study led by oncologists finds

OK, name a movie doctor—fast!

Chances are, you are thinking of Robin Williams as Patch Adams in the eponymous flick or of Harrison Ford as Dr. Richard Kimble in “The Fugitive.”

“Why do we not know the female equivalent of Patch Adams?” asked Reshma Jagsi, the Lawrence W. Davis Professor and chair of the Department of Radiation Oncology at Emory University School of Medicine, and member of the Cancer Prevention and Control Research Program at Winship Cancer Institute of Emory University.

Jagsi is the senior author of a study published in Journal of the American Medical Association, which found that women comprised 18.6% of all physicians depicted in movies over three decades from 1990 to 2020. 

Comparatively, women comprise more than half of today’s medical students in the U.S. and more than one-third of practicing physicians. 

“St. Elmo’s Fire”—a formative film for Jagsi—depicts medical student Dale Biberman (Andy McDowell) as the love interest of another character. 

“She’s cast as this character who is the object of affection of one of the main characters in the cast,” Jagsi said. “It is striking that—she’s definitely beautiful, and put together, and there’s a reason she’s the object of his affection—but she’s also scripted in a very thin way, to some extent. 

“There’s certainly not the depth of Patch Adams.” 

Why does this matter?

Because role models we see on the screen engender dreams and create expectations. 

The problem these movies contribute to is known as “the authority gap,” said Caroline Heldman, executive director of The Representation Project, and chair of Gender, Women, and Sexuality Studies at Occidental College. 

This gap creates the impression that women are to be taken less seriously than men.

“Media has a profound effect on shaping who gets to be a possessor of knowledge in our culture,” she said. “When we ask young people in experimental settings about who a leader is, about who a scientist is, they will again and again, predominantly, identify white men.” 

Media plays a major role in shaping who has authority, Heldman said. 

“Whether it’s you’re going to the doctor’s office, the dentist’s office, whether or not it’s your professor standing in front of a classroom, or a teacher or who has the authority to run for public office, who’s seen as a legitimate possessor of knowledge is very much shaped by media,” she said. “Those ideas are shaped at a very young age.” 

Consider the two career-shaping influences cited by Bismarck Odei, first author of the JAMA study and assistant professor in the Department of Radiation Oncology at University of Utah and Huntsman Cancer Institute. One came from real life–his father. The other was the film depiction of the neurosurgeon Ben Carson, who he had seen depicted “Gifted Hands: The Ben Carson Story.”

“His experience of overcoming the challenges of growing up in a resource-limited setting to become a physician was inspiring and powerfully motivating,” he said. “It was, in effect, how my calling to medicine was issued and finalized.”  

Odei, who conducts gender equity research, started thinking about how impactful it was to see someone who looked like him as a physician—and partnered with Jagsi on the study. 

“The question was trying to examine if women physicians were being appropriately represented in movies, with the understanding that a poor representation may have dire implications on the general population’s perception of the role of women in medicine,” he said to The Cancer Letter. “If the window of perceived possibility is so diminished to just a level of about 18% probability of visibility, then you can see that movies are not really inspiring the younger generation to get a picture of what the professional trajectory of traditionally underrepresented groups can look like.”

The study found that among U.S. movies depicting physician characters, only 28% portrayed even one as a woman, with no change over time. Lead physician-characters were also predominantly white.

Representation in the media is particularly important, Heldman said. 

“Representation matters an awful lot in terms of shaping our values and what we imagine we could do in our lives,” Heldman said to The Cancer Letter. “Whether it’s who we love, or what careers we pursue, or whether we should pursue an advanced degree, or even where we should live or travel—from the most important life decisions down to the most mundane everyday life decisions.” 

Imposter syndrome

One would hope that representation of physicians in movies for younger audiences, those rated G and PG, might be better, Jagsi said. 

“Unfortunately, what we found was, if anything, it was worse in those movies,” Jagsi said. ““It’s important, because they’re forming their idea of who can and should be a doctor.” 

Twenty-one percent of movies evaluated in the study rated either G or PG included at least one woman physician character. The proportion of women physicians was higher—29%—in movies rated PG-13 or R.

Representation in movies for younger audiences is especially important, Jagsi said. 

“They might miss out on a career that they might find incredibly satisfying and contribute so much to, simply because they’re thinking either explicitly or implicitly, ‘Hey, I don’t fit the stereotype of what a person who does that should look like,’” Jagsi said. “And even if they weren’t going to pursue a career in medicine, now they’ve got an idea in their heads of who should be in medicine—and they’re certainly going to be patients.” 

Children ages seven to nine—ages within the G and PG audience—are impressionable.

“If we are fed a steady diet of only seeing certain people in certain positions, like leadership positions, or STEM or medicine, we get to thinking that’s normal,” Occidental’s Heldman said. “And once you have normalized something, it’s very difficult to undo that.” 

The lack of representation also contributes to something known as the “imposter syndrome,” Odei said. 

“This has been well documented for women and also for people of color who, because you’re seldom depicted in these roles—when they actually assume these roles in real life, they may have a sense that they do not belong,” he said. “Their patients may also erroneously feel that they are not in traditionally safe hands.”

Down the line, this lack of representation could lead to bias against physicians who are women or people of color, Jagsi said. 

“We hear all about the incivility that sometimes occurs in the healthcare setting,” she said. “Are we predisposing certain individuals to be on the receiving end of incivility, because now they don’t fit that vision of who should be in the doctor role?” 

“We’re just stuck in 1990”

Between 1990 and 2020, the period covered by the study, more women have become physicians.

The proportion of women doctors stood at 18.8% in 1992, 30.4% in 2010, and 36.3% in 2019. 

In contrast, the proportion of women depicted in film increased 2% each decade that the researchers overviewed, the study found. 

For women and also for people of color who, because you’re seldom depicted in these roles—when they actually assume these roles in real life, they may have a sense that they do not belong. Their patients may also erroneously feel that they are not in traditionally safe hands.

Bismarck Odei

“We know that the face of the medical profession has really changed dramatically since the early 1990s, and this study spanned three decades during which there was a true transformation of the face of the medical profession,” Jagsi said. “It turns out that in the movies, we’re just stuck in 1990.”

The study found that films with women writers were more likely to include at least one physician character who was a woman.

“Having an enterprise that is so male-dominated is limiting female voices in movies,” Odei said. “In terms of low representation of women physicians in movies, this is quite unfortunate because so much of what we see impacts what we believe is possible in our individual lives.” 

Jagsi agrees.

“When you have diversification of those who are writing movie scripts, you’ll be more likely to see women in those roles,” Jagsi said. “That gives me some hope that there is a lever for change, that in general, as we diversify all professions, that we may see some improvements.” 

“The purpose of research like this is to call out things that might not have been noticed. Now that we see it, we should be able to target it and change it.” 

The Scully effect

Beyond the quantitative research, Jagsi has made her own observations about women characters who are depicted in film: They lack complexity.

“The female physician characters just haven’t been given the depth of roles that the male physician characters have even been given,” she said. “That’s a qualitative observation beyond the quantitative underrepresentation.” 

In television, Heldman noted the power of the Scully effect. The character Dana Scully in “The X-Files” is the first woman protagonist who was in a STEM profession, she said.

“We know that a vast majority said that watching that show inspired them to pursue something in health sciences, or a career in STEM,” she said. “It also made them more confident that they could succeed in settings that are male dominated.” 

TV and film are influential because people watch them to relax, Heldman said. 

“Unconscious, and entertainment media in particular, get under our radar because we’re simply thinking we’re being entertained,” she said. “It gives us worlds that we generally don’t question… it’s still teaching those messages, but it’s actually doing so in a way that’s more effective because we don’t know we’re being taught.”

Increasing representation in film could change someone’s life, Odei said. 

“In a very real sense, [representation] can be very powerful and emancipating for people who have no role models,” he said. “These things are not just interesting, but they can really have implications on the professional trajectory of the future generation.” 

Calling out the problem now can benefit future generations, he said. 

“By being as precise as possible now, and by being able to zone in on the concepts that actually affect public consciousness, we can go a long way in being able to change the narratives for a lot of the young children currently trying to navigate their lives, and looking for clues and cues as to where they can fit and belong,” he said.