September 29, 2017
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‘A banner year’: Women leaders established in ophthalmology

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Lisa Nijm

Women in the ophthalmology world should set career goals, seek out mentors to help them achieve those goals, and take advantage of networking and training opportunities in order to advance female leadership in the field, according to Lisa Nijm, MD, JD, an Illinois-based ophthalmologist member on the Women in Ophthalmology board of directors who also chaired the WIO annual meeting this year.

“It’s certainly been a banner year for women leaders in ophthalmology,” she said, mentioning female leaders of WIO, American Glaucoma Society, American Society of Cataract and Refractive Surgery and American Academy of Ophthalmology. “But our work has just begun.” The percentage of women department chairs, full professors, researchers, speakers and practice owners has not yet caught up to the number of women entering the field, which is something female ophthalmologists can work to improve.

“Ophthalmology residency programs are approaching 40% to 50% female residents, but there has been a lag within the profession. It is still taking time to reflect this change in demographics in prominent roles in academics, research, private practice and industry,” Nijm said.

Providing opportunities for women to master leadership skills, participate in speaker panels and hone business skills is important, but female ophthalmologists should also seek out mentors — both female and male — who can help them develop their respective career paths and work to identify and achieve their personal career goals.

“When you identify your goals, be it becoming a department chair, the owner of a private practice or serving on a national speaker bureau, find a mentor who can help you develop a concrete plan to achieve those goals. The insight and experience of a good mentor is invaluable in navigating the best pathway to success and can be particularly helpful when you encounter challenges along the way.” Nijm said.

This sentiment echoed what was recently suggested for women in medicine during an AMA webinar in honor of Women in Medicine Month.

Women in Medicine Month

Vineet Arora, MD, MAPP, kicked off the webinar by asking, where are the women in medicine who are leading? Though roughly half of applicants to medical school are women, only one in five women make full professor and just 16% rise to the level of dean of a medical school, she explained. This “leaky pipeline” fails women in medicine at that level, but that does not mean women in medicine are invisible or not leading. One-third of associate deans are women, but we do not hear about them, Arora said.

Julie K. Silver, MD, went on to show that women are underrepresented in benchmark areas of academia such as award recipients of medical societies. The American Academy of Dermatology, Arora said, touts nearly half of practicing physicians as being women as well as faculty, yet one of their prestigious awards has only been given to women 8.3% of the time. In invitations to grand rounds, women are less likely to give those at other institutions and are less likely to be named visiting professors, Arora showed.

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Coaches, sponsors

Arora attributed at least some of this to a discomfort among women – even women physicians – with self-promotion. In many cases, a physician must be sponsored for recognition like grand rounds and association awards and, in many cases, the best way to get that sponsorship is to ask for it.

“Many of us can find mentors in our workspace. It’s harder to find coaches and sponsors,” she said. “A coach is short-term interaction to help with targeted feedback and problem-solving. ... You need a sponsor to ... use their influence in their field to support their mentee to gain visibility.”

Coaches can help women work through job negotiations and sponsors can put names forward for Grand Rounds or society awards.

And once there, once recognized by an institution, women must also recognize the passive ways their roles can be minimized, Arora said. Specifically, she showed data in which women are introduced as “doctor” less often than their male peers. Though women introducers were on parity between the sexes, men introducing women called them doctor only 50% of the time while they did so for men being introduced 72% of the time.

“This could be a more subtle form of bias and you might think it’s not much,” Arora said. But it adds to the image of a doctor as a man. “Women are not perceived of not only as doctors but as leaders. ... We will see bias and we need to stand up in defense of our colleagues.”

Maternal, internal discrimination

Arora showed that this is compounded by “maternal discrimination” in the workplace where four out of five physician women reported discrimination and one-third reported discrimination based on being a mother. Pay discordance, consideration for promotion, disrespect by support staff and exclusion from administrative decisions were all heavily impacted by maternal discrimination, she showed. Additionally, women who reported maternal discrimination had 74% higher rate of burnout.

Lastly, Arora pointed to internal threats to women’s success – stereotype threat, the likeability penalty and imposter syndrome as well as women not supporting one another through Queen Bee syndrome – can further reinforce the lack of visible women leadership in medicine.

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She cited medical school observation data where men scored 1.5 levels higher than women, which is equivalent to 4 months of additional training. The only correlation being the difference in sex, leading the researchers to hypothesize that this could be due to stereotype threat. Other research looking at critiques of medical residents’ performance showed mixed messages to women addressing their levels of confidence, assertiveness and aggressiveness.

Even the women quoted in her presentation, Arora said, often responded to her with statements playing down their leadership roles, yet they all very much lead from where they stand.

“The truth is that we are and we have to accept that and fight the internal voice in our head and go out and lead,” Arora said. “We all have to overcome this to lead.”

Amplification of women voices

She suggested women take on a role of amplification for one another. If each woman consistently gives credit to other women for the strides they’ve made, the research they’ve done or the stance they’ve taken, that amplification will be heard and cuts off the chance for someone else to take the credit. Instead, women are often seen to be each other’s worst enemies, with women bullies directing much of their antagonism toward other women.

“We have enough battles to fight that we have to work together and here’s this genius strategy we can operate on,” Arora said. “It’s important we step out from hiding and say, ‘I’m here and I’m ready to lead.’”

And, to do so, Arora says to women in medicine: “Find your posse.”

She belongs to Physician Moms, a Facebook group for physicians who are also mothers, and she said, “Social media has made it easier to find your posse.” These women along with those in the workplace and women in societies can act as a sounding board for physicians, allowing for confirmation and amplification of women in medicine.

Each woman in medicine should craft her own legacy statement, stand by it and find her support system to make it happen, Arora concluded. In this, you should create your image as a leader and set the goals that you want to achieve.

“This legacy statement centers you to think about what’s your compelling future and inspires you to change your present,” she said. “Think about your legacy because you are writing it every day.” – by Katrina Altersitz and Rebecca L. Forand

Disclosure: No products or companies are mentioned that would require financial disclosure.