mutation in the admissions process? You bet there was. Was it a random mutation? Not on your life. The mutation was directed by the women’s movement. Each year during the seventies and the eighties, as more women were accepted, more women applied. Success begot success. Women applicants to medical schools numbered 2,800 in 1971 and rose to more than 17,000 last year.

What is the empirical evidence for the directed change in the admissions process? Affirmative action for men had held steady for two centuries until 1970. For each subsequent year, until the end of the 1970s, the percentage of women accepted exceeded the percentage of women in the pool by 2–3 percent. That edge is statistically significant given the large numbers.

Then a funny thing happened. The admissions edge for women disappeared in 1980, and it was replaced by a two to three preferment for men in the 1980s as the male pool got smaller. Without ever announcing it or acknowledging it, medical schools adopted affirmative action for men. Unless my memory fails me, those men were not dismissed as affirmative action admits. It is odd, isn’t it?

Some of you probably object to affirmative action. You will point out that its existence impugns every promotion of a woman by attributing such promotions to affirmative action rather than merit. Yes, some folks do say that. But what about all those men who become professors only because women are not considered? A diverse faculty is a superior faculty, because it is chosen from a larger pool.

My third point is that we are now engaged in a battle for academic norms that acknowledge the importance of family life as a legitimate value. Women physicians with children have been leading fuller lives than most of our male counterparts. Yes, the price has been heavy, but we have not been deterred. We have richer connections with our children and with our parents and, for that matter, with our husbands, when we have them, than men do with their children, their wives, and their parents. We make richer connections with our patients, because we are more in touch with feelings. To the extent we can reduce the endless hours, the competitive atmosphere, and the exclusive focus on personal achievement in academic medicine, we will have created a better world for men as well as for women.

The way scientific research is organized leads to systematic exploitation of trainees. An enormously competitive system forces principal investigators to work themselves and their fellows for long hours. It may surprise you to learn that among postdocs without children, women work more hours than men. Among those with children, women work many fewer. This situation erodes career progression. Citation half-life in the biosciences is short, making it difficult to take time off from work and return to the same career trajectory. Men and women alike need basic reform in the career structure. We need to increase fellowship stipends, to convert lengthy postdoc fellowships into faculty or staff positions, and to provide support for independent research careers at the end of postdoctoral training.

But we must face the fact that women professionals who bear children deal

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