I entered medical school just after medical school matriculation among women and men equalized, which has been the case since 2003. Still, the majority of women in academic medicine remain in the lowest ranks, are paid between $0.72 and $0.96 per $1 paid to men across different departments and specialties, and women still make up only 18% of all department chairs.
In the 16 years since I first entered medical school, the medical community has analyzed and unpacked the various forces at play in the gender inequities that persist in academic medicine, which certainly intensified in the aftermath of #MeToo. Though I had many leadership positions in medical school, several at the urging of an amazing woman mentor, I didn’t even consider divisional, departmental and institutional leadership as a career path in my first years out of training because it seemed out of reach. It wasn’t until I had a woman boss to whom I reported directly.
She was a phenomenal leader and I found myself excited about, rather than intimidated by, leadership opportunities as they arose. I didn’t know how important that visibility was for me until I had it - I had stopped noticing that I was often the only woman in the room and that the leaders of my previous divisions, departments and institutions were largely male. I took note of how she navigated challenging obstacles and how the dynamic of the whole group changed when its leadership ‘looked different’.
The focus of the first module at Oxford was on workplace culture and leadership and coaching styles. A personal realization for me has been to recognize there are still deep underpinnings in medical culture of, ‘I had it hard. It will be hard for you too in this profession. Toughen up or get out.’ When I have discussed this with other women colleagues, it has often been more senior women who were most prone to this attitude within our respective training and early careers.
I certainly acknowledge the strength and resiliency of the trailblazing women in medicine who were alone in their medical school classes, training programs and then as faculty of their divisions and departments. They had honed a necessary severity - indeed, a survival instinct - that I recognize was engendered by larger misogyny and paternalism pervasive in medicine at the time. While this messaging to subsequent generations may have been harsh and alienating, it was rooted in experience. I certainly don’t want to accuse those who came before me, but instead reflect and learn.
I’m the first to admit that I haven’t always gotten it right as a leader, a mentor and colleague. As a larger conversation about physician wellness has started in the context of an educational paradigm shift of the growth mindset, younger faculty and trainees have made proposals to essentially make our jobs less miserable. When my first instinctive response has been, ‘it was hard for me, it should be hard for you,’ I have tried to have the humility to dissect my reaction to preserve what is necessary to prepare trainees for the realities of how hard a career in medicine is while eliminating what is unnecessary and counterproductive.
I have also benefited tremendously from microaggression training; it has been empowering to have vocabulary and frameworks to describe my own experiences, to debrief and learn from the experiences of others, but also to recognize that we’re all human and can grow when our own biases may lead to behaviors that border or cross a line.
My hope is that this introspection and analysis allows me to continue to grow as a leader. It has been incredible to see my students and residents successfully secure spots in competitive training programs, present their work regionally and nationally, and go on to distinguish themselves as medical educators and community leaders. I am committed to seeing more women in leadership positions in healthcare as I strongly believe that diversity brings out innovation, creativity and sensitivity essential for future success.
The MSc in Global Healthcare Leadership cohort may be the most diverse group with whom I’ve had the honor and privilege to share a learning experience. In the last six months, we have tackled ‘wicked problems’ from different angles and perspectives, heard how leaders in other sectors of healthcare approach similar challenges, and learned lessons from other countries and economies. I’ve pushed myself out of my comfort zone, advocated for my profession, questioned certain assumptions and grown from the experience.
There is also a silver lining from Covid-19 underpinning the experience. I rose into my current leadership position in the context of coordinating the personnel and onboarding necessary during surge after surge on the front lines. While I found the operational management (surprisingly) rewarding, my hospital was in crisis mode for months on end, and it felt like we would never emerge out of this global pandemic.
When I arrived at Oxford and the cohort met in a room for the first time, I realized that I had barely met new people in person over the last two years. To debate and converse with those with differing political leanings, industry priorities and world views has been incredible, especially in a time when silos and echo chambers are becoming harder and harder to navigate.
I am thankful to have come out of Covid-19 with an experience that has allowed me to connect and bond with a global community, to see the lessons learned evolve into healthcare innovation and to see my own professional growth take root.