Harsh Medicine
Why Women Can't Get Ahead in Science and Healthcare
by Jennifer Rubin Grandis, MD
Published by Johns Hopkins University Press – July 7, 2026
Harsh Medicine
Why Women Can't Get Ahead in Science and Healthcare
by Jennifer Rubin Grandis, MD
Published by Johns Hopkins University Press – June 2026
Why do women continue to face systemic barriers in medicine and science—despite decades of progress?
In Harsh Medicine, Dr. Jennifer R. Grandis draws on decades of experience as a physician-scientist, mentor, and leader to expose how deeply gender bias is embedded in the structures of academic medicine and scientific research. Through rigorous analysis, real-world case studies, and personal insight, the book reveals how policies, funding systems, promotion practices, and cultural norms continue to disadvantage women at every stage of their careers.
Rather than focusing on individual resilience alone, Harsh Medicine challenges institutions to confront the structural inequities that shape who advances—and who is left behind.
This book is both a diagnosis and a call to action.
What Harsh Medicine Explores
- How being a woman or minority in science and healthcare impacts one’s ability to move up the corporate ladder and effectively manage teams and budgets because of systemic issues;
- Male experiences working in science & healthcare are different from women’s. However, men who witness wrongs struggle to feel powerful enough to right those injustices. Additionally, when they are in power, they have a hard time seeing the inequities in their own domain;
- The universality of the female experience in the corporate world. Harsh Medicine focuses on science and healthcare, but the struggles of these women are found in almost all industries;
- These gender biases hurt us all: not just the women who are denied advancement; the entire industry is weakened when a variety of voices and ideas cannot be heard and explored;
- Harsh Medicine does not just report on wrongdoing: it is filled with actionable solutions that center on frank, open, and respectful conversations about what is happening, and offering interventions that can benefit entire teams and how they work together.
“How many surgeons can we afford to waste? How many researchers and physicians? On every level in medicine and science, harassment and discrimination block women’s ability to do our jobs and thus affect both the quality of scientific discovery and the care we deliver to our patients.“
What Harsh Medicine Explores
- How being a woman or minority in science and healthcare impacts one’s ability to move up the corporate ladder and effectively manage teams and budgets because of systemic issues;
- Male experiences working in science & healthcare are different from women’s. However, men who witness wrongs struggle to feel powerful enough to right those injustices. Additionally, when they are in power, they have a hard time seeing the inequities in their own domain;
- The universality of the female experience in the corporate world. Harsh Medicine focuses on science and healthcare, but the struggles of these women are found in almost all industries;
- These gender biases hurt us all: not just the women who are denied advancement; the entire industry is weakened when a variety of voices and ideas cannot be heard and explored;
- Harsh Medicine does not just report on wrongdoing: it is filled with actionable solutions that center on frank, open, and respectful conversations about what is happening, and offering interventions that can benefit entire teams and how they work together.
“How many surgeons can we afford to waste? How many researchers and physicians? On every level in medicine and science, harassment and discrimination block women’s ability to do our jobs and thus affect both the quality of scientific discovery and the care we deliver to our patients.”
Who This Book Is For
Physicians, scientists, and trainees
Academic and healthcare leaders
Policy makers and research administrators
Readers interested in gender equity and leadership
Anyone invested in the future of medicine and science
Advance Praise & Reviews
“Harsh Medicine lays bare what so many clinicians from marginalized communities already know: the system often promises credit and support, but does not deliver. Dr. Grandis names these inequities with clarity and courage, and we need that honesty if we are going to eradicate them, together.”
—Uché Blackstock, MD, author of Legacy: A Black Physician Reckons with Racism in Medicine
“In Harsh Medicine, Grandis walks a difficult tightrope with grace: channeling righteous anger, born of personal experience and countless stories of gender-based discrimination, while delivering a clear-eyed analysis of both the problems and their potential solutions. It illuminates not only the toll these inequities take on the women who endure them, but also the damage they inflict on academic medicine itself. A timely and valuable contribution to our understanding of what must change–and how.”
—Robert M. Wachter, MD, author of A Giant Leap: How AI is Transforming Healthcare and What That Means for Our Future
“Women now make up 57% of all applicants to U.S. medical schools and 55 percent of their graduates. Even in a specialty like otolaryngology in which 18% of practitioners are women, the proportion is growing. So what could be the problem? A lot, it turns out. As a practicing ear, nose and throat surgeon and medical researcher, Jennifer Grandis travelled the country to interview practicing women and men doctors and scientists. This is a book reveals a hidden world of disrespect for women, gone “underground,” and the harshness of that. If you think gender bias in medicine is a matter of history, read this book.”
—Arlie Russell Hochschild, author of Stolen Pride, Loss, Shame and the Rise of the Right.
About the Author
Jennifer R. Grandis is a physician-scientist whose research focuses on cancer biology and the impact of gender on career development in medicine and science. She has held leadership roles in academic medicine and is widely recognized for her work on equity, mentorship, and institutional change.
About the Author
Jennifer R. Grandis is a physician-scientist whose research focuses on cancer biology and the impact of gender on career development in medicine and science. She has held leadership roles in academic medicine and is widely recognized for her work on equity, mentorship, and institutional change.
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