150 Years of Women in Medicine: The Legacy of Jennie Trout

In this episode of Canadian Time Machine, we mark 150 years since Jennie Trout became the first woman licensed to practice medicine in Canada—a breakthrough that helped open the doors of the profession to women across the country. We hear from historian Heather Stanley about Trout’s fight for education and equality, and from Dr. Ramneek Dosanjh, a physician and advocate for equity in healthcare, on the legacy of her achievement. Together, they trace how one woman’s determination helped shape 150 years of progress in Canadian medicine.

Listen to the episode:

Angela Misri: In 1875 Jennie Trout became the first woman licensed to practice medicine in Canada at a time when women couldn’t even vote, when universities barred them from lecture halls, and when the very idea of a woman doctor was considered laughable, Jennie Trout refused to back down. She studied in the United States because no Canadian medical school would take her, she returned home and opened a clinic in Toronto for women who had nowhere else to turn, and she spent her career fighting for women’s access to education, to care and to opportunity. Jennie Trout’s story is one of defiance and determination, but it’s also a question, what happens after the door finally opens?

Angela Misri: Welcome to Canadian Time Machine, a podcast that explores key milestones in our country’s history. I’m Angela Misri. A century and a half after Jennie Trout became an MD, women are no longer barred from the halls of medicine. But the barriers haven’t disappeared. They’ve simply changed shape, and that’s where Dr Ramneek Dosanjh comes in.

Ramneek Dosanjh: I’m Dr Ramneek Dosanjh. I am located in Vancouver, British Columbia, and I am a mother to three daughters. I am a family doctor and hospitalist, and I would like to believe that I am an agent for change and disruption.

Angela Misri: Dr Dosanjh is a family physician, hospitalist and a child and youth mental health advocate in British Columbia. But her journey into medicine didn’t start in a boardroom or a hospital ward. It began with a calling she felt from a very young age.

Ramneek Dosanjh: I was 12 years old, I started to volunteer at the local hospital. At 12, I was a candy striper, and got to witness how physicians were interacting with patients and the community, and I fell in love with it, and I always felt that it was a calling. From a young age, I wanted to help people despite how difficult it could be, and I was the first in my entire ancestral lineage, there is never from what we know in our villages, from Punjab in India, no woman physician. My mother didn’t even get to go to university. I felt I have to liberate my family with education and this experience, and if I had this opportunity, I’m a first generation Canadian born to immigrant settlers, and it’s been just a fascinating unfolding, especially with the participation in medical education and being able to practice.

Angela Misri: Even with that passion, the road ahead wasn’t simple. Her father had hopes that she’d become a cutthroat businesswoman, and early in her career, she realized that decision makers did not necessarily represent those they were making decisions

Ramneek Dosanjh: I mean, it started for me many years ago, where I just raised my voice in a meeting where they were discussing recruitment and retention and succession planning of family doctors. And I listened to this meeting, but the average age around the table, not to be ageist, but was well over 60, and I just was curious, and in the conversation, I said, you know, it’s interesting that you’re making decisions for people that you may not even be in the practice of medicine at that time, but where are the students or the medical students, or the residents, or the voices of who needs to be here telling you how they Want to practice. I think that we need to create a culture of health care where our providers are healthy healthy physicians or healthy doctors create healthy patients. And if we’re not looking after ourselves and self care and self awareness, then we will continue to perpetuate the bias in medicine and the mismanagement of our patients, and when we know better, we can do better. We can help. The overall impact on Canadian society.

Angela Misri: Support and mentorship mattered, but for Dr. Dosanjh, the bigger challenge came from navigating systemic barriers that have been in place since back when Dr. Jennie Trout was practicing medicine.

Ramneek Dosanjh: This struggle of understanding what it was to be a woman in medicine, particularly, and the sexism and the misogyny, the patriarchy and the layers of it, it was later on, during my leadership career where I really felt the weight of lack of representation, and I had many people reach out to me, including learners, including fellow colleagues, and saying how proud they were of me, or how they felt represented, I didn’t really understand the enormity of really what that meant. In 2022 Dr Jasmine was the first Punjabi woman in history to be president of doctors of BC, a provincial. Association that advocates for physicians, patients and a better health care system. She is also the 92nd president of the Federation of medical women of Canada. And I had said to them, I don’t know if I’m your president or if I could be worthy of this position. Let me give my keynote first and see if this would be of interest. I spoke of gender equity. I talk about health care equity and racial equity. I used many of my favorite people throughout my presentation of Toni Morrison and bell hooks and June Jordan, and talking about a lot of the civil rights movements and how the intersectionality of what we do matters, and deliberate intention using intersectional frameworks is what would improve our healthcare outcomes, and even for women in medicine, the representation wasn’t as diverse as I had hoped in over 100 years. But again, comparing it across the nation, it looked similar. And one of the sayings I have is that the status quo must go and we chanted, and everyone rose to their feet, and some on their chairs and rattled the tables, and they committed at that day. And I thought, this is exactly the place where I need to be, and this is a direction I need to move in, because we definitely need to mobilize and motivate those women in medicine.

Angela Misri: It was in these leadership positions that she began to understand just how powerful representation can be.

Ramneek Dosanjh: We have been a almost 102 year old organization and built on the back of these women Trailblazer physicians that really took charge and allowed for us to be able to be in the space where we’ve got more women in medicine graduating than ever before, but yet some of the top leadership positions or Dean positions, or decision making or power decision making, roles are definitely not equitable. We know that women physicians don’t get as much or time as male colleagues. We know that some of the tasks that women physicians are faced are not as what their our physician colleagues are getting, and it happens on so many levels, as well as the level of sexual harassment or opportunities. And more often than not, our male colleagues are looking for male replacements, not not generally, looking for female women of color to replace them, or look at the ladders and how that diversity of representation actually echoes the sentiment of the patients that we’re representing. And diverse leadership in medicine doesn’t just help female doctors navigate their careers, it’s also crucial in helping us get better at treating all bodies and all intersectionalities. For many years, we’ve seen this, the discrimination or the bias within the research, and we extrapolate that, and we apply that to every body in the world. But that’s inaccurate. That’s not this lived experience. That doesn’t bring in the intersectionality piece, which is so important when we’re looking at patients, when we’re looking at data, when we’re looking at deliverable treatments or innovations or advancement in medicine, because right now, we’re painting everyone with the same brush stroke on this canvas, and that’s inaccurate.

Angela Misri: We’ve come a long way since 1875, but Dr Dosanjh thinks we could be doing more.

Ramneek Dosanjh: I feel that we need to be light years ahead of where we are, because we’re primed for disruption. And that being said is I do know that and appreciate the incrementalism that’s happened, and for us to get to a point of graduating more female physicians in medicine than ever before, and historically, that wasn’t the case. So yes, I applaud the efforts of everyone opening those doors. But have we gone far enough? No, the answer is no, because we have not achieved the goals of health care equity, which also include the pillars of gender equity and racial equity. So until we’re there, we really haven’t done our job. But I do believe that we are entering this evolution of awareness and culture change.

Angela Misri: Dr Dosanjh believes we can’t move closer to equity without learning from those who’ve been historically left out of medicine.

Ramneek Dosanjh: I have learned so much over the recent my recent years through my indigenous elders and my indigenous colleagues, my black colleagues, because the level at which their pain is represented and their dry. For their purpose is on another level and but palpable, and when I look at them, I revere their patients and celebrate how far they’ve come in their journeys, because that is what makes me want to have a relentless devotion to healthcare equity is watching these incredible leaders, despite all of the hurdles and the roadblocks, they continue with a gritty, tenacious passion to try to implement change. But they can’t go alone. We need to show up.

Angela Misri: And if Jennie Trout were here today, Dr Dosanjh would want her to know:

Ramneek Dosanjh: Without you, there would be no me, and without you, there would be no leverage, and without you taking that opportunity to break down that wall, we wouldn’t have evolved as beautifully as we have. I don’t believe that any sector should be homogenous. I think we should be sprinkling diasporas and having our collective wisdom to really triumph and make a difference in the lives of others, but also in the lives of ourselves. We get one life, one shot. No point in being angry about it. If you’re angry, take that into action. Do something positive with it. Don’t just watch the world go by. You know, every little action can make a difference.

Angela Misri: Dr. Dosanjh’s journey shows how Jennie Trout’s legacy still resonates today. The doors she opened 150 years ago continue to shape lives, inspire leaders and push medicine towards equity and inclusion. But what kinds of challenges did Jennie herself face? What did it actually mean for a woman to step into a medical classroom in the 1870s to help us understand how far we’ve come in the field of Canadian medicine? We’re joined by Heather, Stanley, Associate Professor at the University of Lethbridge, and past chair of the Canadian committee on women’s history. Hi Heather, thanks for being here.

Heather Stanley: Hi, happy to be here.

Angela Misri: Okay, Heather, can you take us back to the world Jennie Trout was stepping into? What did medicine and medical education look like for women in Canada in the 19th century?

Heather Stanley: Well, in terms of medical education, it didn’t really exist. Jennie and her other contemporaries who wanted to study medicine, most often had to go to the United States because there were no colleges that would accept women in Canada. So what we see is women like Jennie going down to the United States. She goes to Pennsylvania to get their training, and then they come back up to Canada to practice. But there’s lots of barriers, and that’s why Jennie is such an interesting sort of famous first because women’s education didn’t really allow them some of the important factors that they needed to get into to medical school, even if there had been one you needed to have Latin, for example, to get into medical school, and that was not commonly taught to young women as part of their education. And in fact, for a lot of families, except for the very wealthy, and also families who, for other reasons, believe that education for women was important. Education for women was often seen as sort of an optional extra something that was nice if you could get it, but it was definitely not prioritized. And so for women to get that high level of education, to get into medical school was actually really difficult.

Angela Misri: What do we know about Jennie Trout herself? What motivated her to pursue medicine at a time when women were largely excluded from the profession?

Heather Stanley: We don’t know a huge amount about Jennie Trout. We definitely need some updated biographies of her. We know that she, at some point, had a nervous sort of disorder. And again, that’s a blanket term that could cover a lot of different things, and she underwent some electrical therapy. And again, that’s another very vague term that could cover a whole bunch of different therapies. This is at a time when electricity is just starting to be sort of new and exciting, and we see it being used in medicine a lot, particularly to cure mental disorders. And so she goes and takes this treatment, she says it cures her, and then she decides she’s going to dedicate her life not just to medicine, but that particular like stream of treatment, which we would see as kind of fringe today, but she very much believed that it helped her. And again, we’re not exactly sure what happened, but change happened so slowly and incrementally in people’s minds. We don’t really know what were the conversations around their kitchen table that made her feel like this was a possibility. We know that Emily Stowe, who is a contemporary of Jennie Trout, ends up being a part of the suffrage movement. So. Obviously she had, like, a political bent when we talk about, you know, education for women being considered, quote, unquote, a luxury, good higher education going to down to the states, that is something that you need disposable income to do. And so, yeah, she does do it after she’s married, and he supports her in that, which makes him unusual, too. But Jennie kind of is really she wants to create medical education, and then she wants to treat women like her, and that’s sort of what pushed her.

Angela Misri: So it’s like a whole bunch of factors that come together. She has this therapy she had helps her. She gets triggered by it, and she’s like, I want to do something in this. It’s really interesting the journey that she took to get to this. So what are the obstacles, other than we’ve talked about, I can’t believe we’re talking about it, but we talked about the Latin, we talked about the financial issues. We talked about the fact that they have culturally and and just societally. It was out of step to go down to the states and go get an education in medicine. What other obstacles did she face in medical school, like when she got there, and how did she manage them?

Heather Stanley: So we know that medical schools were not particularly happy to have women in their ranks. And this is a really crucial time for medicine and medical doctors. The Victorian era, which we’re sort of in the midst of, is the time when Victorian medical doctors are really consolidating their profession. They’ve done a ton of work to move from sort of what was seen as almost like a trade, because they worked with their hands, to one that is something that gentlemen pursue. That is, you know, you train in the university for you train in the hospital for most of them, not all. See women as as sort of creating a situation that threatens that, because if women can do it, then is it going to be a respectable profession? Is it going to be an educated profession? And so we see this, for example, when we talk about doctors and nurses at the time, they’re quite happy with this new idea of hospital nurse who they see as subordinate to them, very feminine, fitting in with that sort of Victorian idea of the caring female. So they are actively hostile, and so are the instructors. They play pranks on them. They try to shock them. They try to make them faint by showing them, you know, cadavers and stuff like that. And this is quite common throughout medical schools. But also we see this in other areas too. We see this in like when women start entering the legal profession. We see this hostility with some of those famous firsts as well. And one of the things that both Emily Stowe and Jennie Trout have to do in order to become licensed medical doctors is they have to complete one section of training in Canada, even though they’ve been fully trained in the United States, and they have to pass the Canadian matriculation exams. And this is a huge barrier, because, again, the United States, which was has been a little bit more liberal in places about allowing women into higher education. A lot of the established universities in Canada are not interested in that, and so they have to come up, back up, and go to a school here, and we know that they harass them. They yelled at them. Instructors refused to teach them or give them the same materials. They really put as many barriers in as possible in front of these women, because they saw it as devaluing their profession to have women practice it.

Angela Misri: There’s almost a five year difference between when Trout finishes and when stove finishes. It’s almost five years where she’s literally the only one, like the Canadian doctor, that is a woman. What kind of ripple effect. Did that have these, these two women basically battling every single it’s like the eldest sister in a family. That’s how I’m looking at it. Like you have to do everything you’re the first person to date, and have to fight everything through/

Heather Stanley: Yes, well, and I mean, still refuses after all of the abuse. She was like, I’m not going to sit the matriculation exam. I’m practicing without a license, and you can’t stop me. Damn the reason Jennie, and it’s interesting, because the two personalities there are in step for a lot of their trajectory towards becoming the first woman doctor. But I get the idea that Stowe is a little bit more militant, and Jennie, again, possibly because she is motivated, because she wants to have this particular therapy available to women just quietly sits the matriculation exams and becomes the first woman doctor without a huge amount of fanfare. So she’s the first licensed female doctor in Canada. So the ripple effect, again, it’s really hard to understand the changes that happen in people’s heads, and I do think your analogy of the eldest daughter is is a good one, because it is so much easier to do something that somebody has already done, even if it’s only one person, Jennie Trout and then eventually Stowe joins her after some estrangement between the two of them actually make really concrete changes that make it easier for women to get education in Canada. But. Plan together to open a woman’s College Hospital and basically create a separate stream of education for women. And this is really interesting, because they go through all of that taunting and pranks and all of that, and their solution is we are going to remove women and have women’s education be separate. And I think a lot of it has to do with the fact that they had endured so much vitriol from their male co students and their professors. And so they are originally going to set it up at U of T, but sto for is involved in other things, and she’s kind of stalling. And so Jennie Trout goes to Queens, and then Stowe sets up one at U of T, and they kind of run parallel to each other, which is problematic because of all the barriers, there’s not very many students. And eventually, then they they merge together. And then she also helps set up the women’s dispensary. What this is, is it gives a place for women to practice, because now they can train in Canada, and they can practice in Canada in this women’s dispensary, which opens in 1898 that allows women to take on leadership roles within a hospital. They can learn administration. They can do practical training. But the downside of that is that by separating themselves out, they basically create a parallel system. And that reinforces the idea that, yeah, sure, some women can become doctors, but they should only be treating women and children. And we see it being folded into this very Victorian ideal of femininity and womanhood, which is that sure you should be a doctor, because you’ll be gentler with children’s patients, and you’ll be gentler with, you know, women’s complaints, which are very embarrassing for a male doctor to have to to treat. And so basically, it sidelines a lot of women’s doctors in only practicing women’s and children’s medicine, and so it’s a double edged sword.

Angela Misri: Yeah, and when you look at the struggles that those women, the first women who did this, the first women who are setting it up, you know, getting out of medicine and focusing on, like, educating other women and opening up the practices to women who get educated in this, what do you see any parallels between between then and now, for the barriers for women?

Heather Stanley: Well, I think a lot of barriers are still things that women physicians are dealing with. I mean, one of the concerns I have when we talk about famous firsts is this idea that that women, white, female, famous firsts have a lot of privilege that often comes at the expense of other women, racialized women, ethnic women, women who are poor and so Yes, Jennie Trout wanted to treat these women at low cost and opened up those doors, but she was also using Those women to learn on. And I feel like there’s a lot of labour that of women that goes on behind the scenes. If you are going to be one of these famous firsts, you probably have someone cleaning your house who is, you know, financially and socially, doesn’t have that same capital to be able to be a famous first and so I feel like it’s really important that we talk about this, particularly because we see these women like Emily Stowe being tied to the suffrage movement, which here in Canada has some pretty, you know, problematical associations with things like eugenics and no so Jennie Trout, because she kind of, she sets up all This stuff and then she retreats. It retreats and has her practice and just works. She’s not as problematical as some of this, but I think we do have to recognize it’s amazing what they did, and I’m glad they did what they did with the resources that they had, but just recognizing that not everybody has those resources.

Angela Misri: Interestingly, I did look this up. The first female physician from India studied at the same Pennsylvania University in 1886 so it was happening. It was happening slowly in different parts of the world, but that Pennsylvania Hospital churned out some big names, right? Like, that’s actually kind of a big deal.

Heather Stanley: That is really interesting. And I wonder, what about that Pennsylvania Hospital opened those doors.

Angela Misri: Thank you so much for talking to us today, Heather.

Heather Stanley:Thank you so much for having me.

Angela Misri:Thank you for listening to Canadian Time Machine. This podcast receives funding from the Government of Canada and is created by The Walrus Lab. This episode was produced by Jasmine Rach and edited by Nathara Imenes. Amanda Cupido is the executive producer. For more stories about historic Canadian milestones and the English and French transcripts of this episode, visit the walrus.ca/canadianHeritage. There’s also a French counterpart to this podcast called Voyages dans l’histoire canadienne. So if you’re bilingual and you want to listen to more, you can find that wherever you get your podcasts.