Letter to a Young Female Physician: Thoughts on Life and Work

by Suzanne Koven

"A warm and wry epistle, the endless and near-perfect email you wish your mother, your mentor and your therapist would sit down and type out together." ―Laura Kolbe, Wall Street Journal In 2017, Dr. Suzanne Koven published an essay describing the challenges faced by female physicians, including her own personal struggle with "imposter syndrome"―a long-held secret belief that she was not smart enough or good enough to be a “real” doctor. Accessed by thousands of readers around the world, Koven’s “Letter to a Young Female Physician” has evolved into a deeply felt reflection on her career in medicine. Koven tells candid and illuminating stories about her pregnancy during a grueling residency in the AIDS era; the illnesses of her child and aging parents during which her roles as a doctor, mother, and daughter converged, and sometimes collided; the sexism, pay inequity, and harassment that women in medicine encounter; and the twilight of her career during the COVID-19 pandemic. As she traces the arc of her life, Koven finds inspiration in literature and faces the near-universal challenges of burnout, body image, and balancing work with marriage and parenthood. Shining with warmth, clarity, and wisdom, Letter to a Young Female Physician reveals a woman forging her authentic identity in a modern landscape that is as overwhelming and confusing as it is exhilarating in its possibilities. Koven offers an indelible account, by turns humorous and profound, from a doctor, mother, wife, daughter, teacher, and writer who sheds light on our desire to find meaning, and on a way to be our own imperfect selves in the world.

Genres: Medicine, Medical, Memoir, Nonfiction, Audiobook, Health, Biography

320 pages, Paperback

First published May 4, 2021

About the author

Suzanne Koven is a primary care doctor and writer in residence at Massachusetts General Hospital in Boston. She is also on the faculty at Harvard Medical School. Her writing has appeared in The Boston Globe, The New England Journal of Medicine, The Los Angeles Review of Books, Psychology Today, and many other publications. Her memoir, Letter to a Young Female Physician: Notes from a Medical Life, will be published by W.W. Norton & Co. on May 4, 2021.

Reviews

[Max · Rating 2 out of 5]

When I stumbled upon this book on the shelf at the library, my heart did a little pitter-patter as I thought I had found something meant just for me. As a member of the target audience of the book (a young female physician myself), I found this book to be rather lackluster. Perhaps it was the author's stereotypical wealthy upbringing (surgeon father, lawyer mother, Black housekeeper), the significant amount of pages dedicated to struggles with body image, or the overall classist vibe, I just didn't finish this book feeling inspired or rejuvenated or with any other takeaways I had initially anticipated. I'm not really sure who the target audience is, but I would not recommend it to young female physicians.

[Schizanthus Nerd · Rating 4 out of 5]

Your training and sense of purpose will serve you well. Your humanity will serve your patients even better.

Although each essay in this book can be read separately, together they paint a picture of Suzanne Koven’s life, from her childhood recollections of her father’s orthopedic practice and always choosing to be the doctor during childhood games of Careers to her own residency and eventually her work as a doctor. Throughout, the reader witnesses Suzanne struggling to maintain a work-life balance, parenting her children, caring for her ageing parents and figuring out how to be the best doctor she can be for her patients.

I find my patients much more interesting than their diseases.

Although I was introduced to a number of the author’s patients, albeit de-identified and with some details changed, there were times I was holding out for a resolution that failed to come. I wanted to know what became of these people whose stories I was just becoming invested in.

For some reason I also became invested in the story of the white pine trees, where the infection of one may result in the infection of its neighbours. My biggest frustration with this book was not learning whether the two pine trees survived or not. Why do I care so much about this? Perhaps it was because of what those trees symbolised to the author. Regardless, I felt cheated by not knowing their fate.

My favourite parts of this book involved the author’s relationship with her mother and how it changed throughout her life.

The reflections on what it is that makes a good doctor would be particularly valuable for newly trained doctors, who are finding their feet in a world where having empathy for their patients can prove just as important as knowledge of their medical conditions.

Students worry about knowing enough. Patients worry about them caring enough.

Content warnings include ableism, attempted suicide, eating disorders, racism, sexism and sexual harassment.

Thank you so much to NetGalley and W. W. Norton & Company for granting my wish to read this book. I’m rounding up from 3.5 stars.

Blog - https://schizanthusnerd.com

[Kathryn in FL · Rating 4 out of 5]

Suzanne Koven is someone I would like to be my doctor if she didn't live 1500 miles away. She is also a gifted writer providing reflections on her time in medical school and as a teen in the 1960's as well as life today as a respected physician. Much of the focus of the book that I enjoyed most was being a female professional where your gender separates you from the ol' boy's club.

We are told that Suzanne always wanted to be a doctor, even as a child, when playing games, she chose to be a doctor in her favorite game. She believes her interest stemmed from observing and assisting her own father, an orthopaedic physician. He allowed her to assist in cast removals and she was hooked on the business of healing. However, even becoming a doctor didn't seem to engender a deeper connection to him. Likewise, she talks about the changes in her relationship to her mother as well, particularly as they have aged.

There is much written about the imposter syndrome and about balancing marriage, parenting and work life, while still having a sense of self and a unique identity. As a woman, who worked in the business field, there were things I definitely related to in the book. I think many others, who work outside the home will find they experience similar feelings to Suzanne.

As the title suggests, her writing is specifically targeting women who are developing professionally in the medical community. My sister had begun medical school only to drop out and become a nurse a couple years after Ms. Koven completed college. I remember my sister expressing very similar frustrations as mentioned in this book. Overall, the book was much more focused on medicine and the community dynamics and I suggest those considering this field to read this to see if it is something they are willing to face. Of course, Ms. Koven is quick to point out that today there are actually more women students in the classroom than men (although it is isn't that far from 50-50). I see that as such a positive for the future of medical care and standards, personally speaking.

Don't for a minute think that Koven isn't venting or antagonistic. She never comes across as whining these essays. She presented her concerns considering the dynamics that shaped situations in the past, as well as the present. Her upbeat personality shines on each page. While some of the topics were not in my wheelhouse, I definitely learned things I hadn't considered and I appreciate her honesty.

I recommend it to any female considering a career in medicine.

Thank you to the author, publisher and goodreads for a free copy of this book, in return for my honest opinion.

[Terri (BooklyMatters) · Rating 5 out of 5]

“I find my patients much more interesting than their diseases”.

And I find this physician much much more interesting than her profession❤️

This is a book about stories. The stories we tell ourselves about where we come from, who we are, and what we need to be “real”, to be true to that tiny kernel of truth each of us is searching for deep inside.

In this poignant memoir, Dr. Suzanne Koven, a Harvard faculty internist, opens up wide and tells us her story. Or rather, stories.

Starting with her childhood, Dr Koven tackles full on her push me-pull you relationship with her mother, a story-teller and feminist role model in her own right, who retrained as a lawyer late in life, battled her own demons and refused to settle for “nonsense” in any capacity.

The authors treatment of her relationship with her physician father is much more complex. Circling, always circling, her coverage here is wispy, sparse - we get the sense of a relationship hovering, fluttering on the perimeter of her life; lacking definition, comfort and safety always just out of reach.

Growing up, then, it was perhaps no surprise that Dr. Koven, early on her journey of self-discovery, leaves her studies in English and Literature to “find herself” as a physician.

It’s fascinating (and in many parts, heartbreaking) to hear about her journey, - as a female medical student and then physician in the 80’s, Dr Koven struggles with identity issues, centering on what we now know of as “imposter” syndrome. Never feeling good enough, not nearly as good as everyone else (read “male” here, but the syndrome isn’t necessarily gendered ) through all the medical knowledge and skills needed, impossible hours, patient trauma and gut-wrenching responsibilities. Balancing it all with motherhood, family illness, menopause, and inevitably the horrifying losses that come with parental decline.

We ache for Dr. Koven through it all, feeling with her as she reveals insights painstakingly gained that lead her to a final story we cannot help but cheer for.

“The experience of the body is never only about the body.”

In illness or in health, our lives become our stories, - how we tell them and the power they hold to define, defeat, or release us.

And on the flip side - hearing others stories transforms us; providing empathic connection and insights that reveal new meaning, aiding us as diagnosticians, as physicians, and ultimately, expanding our lives as people.

Coming back full circle to her first love - the magic of story-telling, language and reading - Dr. Koven comes to realize a new beginning for herself, and a final phase to a more fulfilling medical practice. One that allows her to teach others, integrating both the art and the science of medicine, acknowledging and cherishing both the “male”and the “femaleness” in each of us.

I loved this book. There are so many insights crammed in here, so much to think about, that I suspect I will be reading this one again very soon.

A big thank you to Edelweiss, the publisher, and the author for an advance review copy of this book. All thoughts presented are my own.

[maura · Rating 4 out of 5]

lovely, insightful, and feminist. what more could you ask for.

[Gillian Danielson · Rating 1 out of 5]

This may be harsh… but it seems the author just wanted to write a book about herself? I was hoping it would be advice, information, food for thought, etc about being a *female* in healthcare/as a physician. However, it’s mostly just her talking about herself throughout her career without lessons to learn or big take aways.

[Reb · Rating 3 out of 5]

actual rating: 2.5/5

i really liked (most of) this book. dr suzanne koven shares a lot of thoughtful reflections on the practice of medicine. i wish that there was more of this in the book, actually. instead, it leans a bit more "memoir" than i would like, and i feel that many of the chapters where she delved more into her personal life (mental health, family life, etc.) were less interesting, less well-described, less powerful. for my own interest, i wished that she connected these things to medicine more clearly. so, overall, the book was less relatable and reassuring than i had hoped for, as a young female physician myself.

with that being said, i thought her "letter to a young female physician", published in NEJM and transcribed at the start of the novel, was so lovely and meaningful. i want to get it printed out to keep at my desk or something.

some interesting themes/concepts to remember:
- family history is not just about hereditary diseases, but also the way we experience illness in our own families and how that shapes our experience as a patient
- ...and similarly, as a doctor, your upbringing (i.e. your family’s perspective on health) influences the way you practice medicine
- the dilemma of wanting to delve into patients' emotional/psychological/social problems, knowing that it could improve their care, but you often simply don’t have the time for it, and how difficult and emotionally taxing that is to navigate
- reading and understanding literature helps us to understand people, and by extension helps us to become better doctors
- and the MOST relatable quote in which dr koven describes the feeling of going through residency training, "i envied dogs i saw in the street, because they could lay down when they chose." so painfully accurate.


the parts i didn't like:
- the interspersed chapters about the author's struggles with body image and dieting. her perspective seemed very dated, which is fair given that she went through these things several decades ago, but didn't resonate with me as much given how differently we conceptualize body image issues in the modern day. also, i personally don't feel like my own body images issues connect to my career in medicine at all, and so i didn't relate to her exploration of this connection - it felt a bit jarring.
- she also takes a couple chapters to explore some of her mental health struggles, but does so in such a vague and confusing way that it felt a bit intangible.


came back to drop my rating to 2.5, because less than 1 month later i feel like i've already forgotten EVERYTHING about this book...

[Amaia ✡ · Rating 4 out of 5]

A thoughtful, sensible and intelligent essay and medical memoir, observant and analytical of the subtle and faceted dilemmas of a conscious physician, heart-warming but also brutally honest, this is the letter I should have read in my early years of medical training, or maybe even before I took this path. I found myself in many of this memoir’s instances, and the idea that literature makes us better doctors is something I find comfort in for many years.
Feminism aside—as this is not my cup of tea—, this book is wonderful and highly recommended.
4.5*

[Maureen Grigsby · Rating 4 out of 5]

I would actually give this one a 3.5. I usually really like a medical memoir, but this one just didn’t do it for me.

[Camille Hanna · Rating 3 out of 5]

What a brilliant woman you are, Suzanne. I shouldn’t be surprised at this point that so many physicians love literature, and yet it still shocks me. I love people who equally value logic and creativity & are uniquely proficient in both. Dr. Koven is one of these rarities.

The first two thirds of the book were slow. But maybe that’s because I wasn’t really in the mood to read a memoir right now. The last third was spectacular, however. Her insights about the supreme importance of doctors making their patients feel heard & valued was astounding. Great insights about what is most important to focus on if you want to be a good physician one day.

[Paisley Steadman · Rating 4 out of 5]

I really enjoyed this book! I’m not sure what I was expecting, but I’m happy I read it. There was a lot in it that felt real and definitely relatable. Imposter phenomenon, anyone? Glad I read it so early in my medical education as it gave me a lot to think about.

[CatReader · Rating 3 out of 5]

Suzanne Koven is a primary care doctor and writer; her 2021 memoir Letter to a Female Physician, titled after her 2017 New England Journal of Medicine editorial, starts off promisingly by offering advice to young women entering the medical field today. However, the advice largely ends after the introduction, and the rest of the book is Koven's memoir detailing her own and at times mundane struggles that are hardly unique to female physicians. She writes extensively about struggles with her weight, with her parents growing old and dying, with raising kids, with establishing a comfort level at work, navigating impostor syndrome, etc. She also writes with the perspective of someone who's been financially comfortable her whole life, from growing up with an orthopedic surgeon for a father and a lawyer for a mother (in a household that employed hired help), and marrying a fellow doctor, and so she seems to lack the perspective of many of her patients whose financial situations are markedly different. There are a few essays specific to the medical profession, but not much addressing the topics I'd thought she'd write about, like sexism, racism, classism, etc. that persist in medicine to this day, navigating extremely challenging and high-stakes patient care scenarios and dealing (often alone) with the psychological after-effects, etc., burnout and suicidal ideation, etc. This isn't to say that one needs to have experienced all/most of the above to write a good memoir aimed at young doctors -- but one thing that my own medical education taught me was to get out of my own head and put myself in my patients' perspectives, so that my worldview consisted of more than just my own lived experiences.

Further reading: female physician memoirs I'd recommend
The Beauty in Breaking by Michele Harper, MD
Final Exam: A Surgeon's Reflections on Mortality by Pauline Chen, MD
Solo practice: A woman surgeon's story by Elizabeth Morgan, MD
When We Do Harm: A Doctor Confronts Medical Error by Danielle Ofri, MD

Book 228 for 2025
Book 2154 cumulatively

[Biblio Files (takingadayoff) · Rating 5 out of 5]

I don't know why I'm attracted to these books by doctors about being a doctor. Atul Gawande, Oliver Sacks, Lewis Thomas, Henry Marsh, all are doctors who are excellent writers. But there aren't many books by women physicians even though at least half the medical students in America these days are women. Enter Suzanne Koven's Letter to a Young Female Physician -- I pounced on it even though I am neither young nor a doctor. She writes elegantly about being a doctor, a student, a daughter of a surgeon, a daughter of a mother whose health is failing, a teacher of doctors, and ultimately, it's all about the human side of being a doctor. Much of doctoring is algorithmic, evaluating symptoms, test results, eliminating diagnoses, treating conditions, but there is a side of doctoring that, at least now, can't be done by AI. Koven demonstrates the value of talking with patients and learning the limitations of medicine. It's a thoughtful and often humorous book.

[Claire Ruben · Rating 3 out of 5]

I usually stay away from memoirs, but this one seemed a bit too apt. While at times I found Dr. Koven's reminiscing a bit dry (perhaps this is due to my general memoir aversion), I resonated with so many of her thoughts on training in the medical field. I think this book gave me some perspective on the fact that many of the issues I currently face (namely imposter syndrome) as a young trainee won't necessarily go away, but that there is a way to navigate these thoughts and feelings and channel them into a productive career as a physician.

[Sarah Mudra · Rating 1 out of 5]

Dull, disjointed & largely superficial. Terribly hard to get through (though I presume I’m the target audience—young, female, soon-to-be physician).

[Caroline Nowatkowski · Rating 5 out of 5]

“… there are countless articles in the lay media about how reading increases empathy, decreases burnout, or even makes you a nicer person. These may be true, but for me, reading -now that I truly am a reader- has a more effect: it effaces the boundaries between me and my colleagues, between me and my patients, and also between me and my many selves. When I’m doing it right, reading makes me feel whole, more fully human, able, if only for a few moments, to scythe my field with joy.” Referencing Levin in Anna Karenina


Agh! This book was SO good like highkey going on my top 3 books list. The way that Dr. Koven writes is beautiful and poetic and just agh so great. I loved her perspective and the way that she weaves the narrative with including factual information about the medical field and female. I so relate with some of the things she writes about & the way she describes them like imposter syndrome & her love of reading. I fear that I will be reading this book again and again as I pursue this career and progress along the journey.

[Allison Turner · Rating 3 out of 5]

This was a good book. I liked her personal stories, but I was hoping I’d be able to relate to it a bit more. It was very physician-focused, and didn’t really apply to other healthcare professionals. I was also hoping for more on the topic of being a woman in healthcare. Overall good, but it wasn’t really written for me as the reader/audience.

[layan ليان (on hiatus) · Rating 2 out of 5]

first quarter of the book genuinely intrigued me and invoked many emotions and thoughts, then I don’t know what happened.

Rtc

[Sydney · Rating 3 out of 5]

3.5 stars

[Dorothy · Rating 5 out of 5]

I loved this. The writing felt really raw and honest, and I marked so many pages/quotes that I'd love to re-visit over and over again.

[Livia Frost]

Interesting reflections on the complexity of caring for family members as someone with a healthcare background, the mixed emotions when retiring as a physician with lots of patients, and what women might uniquely provide to the field of medicine.

[Mackenzie · Rating 5 out of 5]

So so good!🩺🥼🩵

[Jim Higgins · Rating 5 out of 5]

Yes, it’s about doctoring, but also about literature and the aging of parents and many other things. Highly recommended.

[Chloe · Rating 3 out of 5]

And in the same Rilkean spirit I will name my book Letters to a Young Chinese American Premed Girl who is super sick and fighting for her life who just finished reading this in bed and thought it was pretty inspiring but could have gone a bit deeper

[Ariana · Rating 5 out of 5]

As a new grad PA that will be working soon I found this book very informative and also comforting. It’s nice to know that even experienced clinicians like the author aren’t 100% sure of themselves either.

[Olivia Rohret · Rating 1 out of 5]

I entered this book expecting to receive advice that would serve me as a future female physician, but it ended up being essentially a memoir about a the author’s time in training and working as a physician. I wouldn’t have minded this if there had been some profound insights or takeaways throughout, but it was very matter of fact. I do not struggle with empathy and thus did not find myself relating to any of the author’s “struggles”. Maybe I expected too much and I’m being too critical of another woman, but this book falls flat for me.

[Kirsty · Rating 2 out of 5]

I had relatively high hopes for this medical memoir, which sounded like it was built on a strong and worthy foundation. However, once I got past the initial chapter, I felt a little disappointed. The book, as it goes on, becomes incredibly twee and quite repetitive, particularly about the author's many attempts at losing weight through fad diets and therapy. Yes, it's a memoir, but I felt as though a lot of this content had just been randomly placed together, and there was not really any flow from one chapter to the next. An odd mismatch of a book.

[Katie · Rating 5 out of 5]

I really enjoyed this book and I'm so glad I read it. I don't think that every doctor would, and I don't even think that every female doctor would resonate with it. But being me, "a doctor and a reader," like the author, I felt every chapter in my bones. I don't know that reading it would help you understand me better, because I don't think reading it helped me understand me better, but I know that reading it helped me feel less alone. And sometimes that's all you need.

[Aashka · Rating 3 out of 5]

As a young female trainee in medicine, I found this memoir filled with bits of wisdom on sexism, imposter syndrome, life, death, and the art of medicine. At times it felt disjointed and perhaps would be better read as a set of essays. The author also lacked a commentary on her perspective being that of a white, privileged, women in medicine.

[mariana kebaso · Rating 2 out of 5]

very underwhelmed by this book. the chapters reek of white feminism, slight racism, and overall a doctor complaining about her job and her family? it was hard for me to finish but I did. would not recommend at all.