Women in medicine: a conversation with my daughter about lessons learned

A few weeks ago, I became a full professor of medicine. The grand moment happened 28 years after graduating from medical school. The week after the promotion letter, my daughter’s MCAT results were in, and she was hitting submit on medical school applications. Fun fact, I had her at age 28, my chief resident year.

In her quest to understand the application process and career trajectories in medicine, my daughter had spent quite a few hours on the American Academy of Medical Colleges (AAMC) website. The site has tons of information, including data on faculty rank, medical students, and medical school applicants going back decades and broken down by demographics, region, and other measures. From the AAMC 2018- 2019 data, she saw what I already knew. For the last few years, there were roughly equal numbers of female and male medical school graduates, and women made up 57 percent of all instructors in medical schools. What struck her were the gender differences in senior faculty in academic medical centers: Women made up 39 percent of associate professors and only 26 percent of professors. As a young Black woman, she was most startled by the fact that of all women faculty in academic medicine, only 5% were Black.

She wondered why there were more male professors and department chairs despite the fact that there were more women instructors in medical schools?” She wanted to know why the gender disparities existed and understood many of the reasons cut across industry lines. More importantly, she wanted to know what I had learned in my 28 years of post-medical school. What advice would I give to my younger self?

In addition to working hard and working smart, below are eight things I told her I wished I knew early in my academic career:

1. Define your career path: find your niche and stay focused. Define your research, teaching interests, and stay focused. Avoid getting side-tracked by projects that do not align with your interests and goals. Have an accountability partner. Update your resume often, and keep your department chair in the loop. Celebrate your accomplishments and don’t be shy about discussing them. Graceful self-promotion is an art.

2. Seek out opportunities for career development. Attend workshops on career development, research and mentoring, grant writing, developing leadership skills. Seek out these opportunities early. Access opportunities through your faculty affairs department. Let your chair know you are open to sponsored opportunities. With the expansion of virtual engagements, there will likely be more opportunities to participate in these events.

3. Understand the rules and requirements for promotion in your institution. Having the rules clearly defined helps you plan. Every institution has these laid out and accessible to all. Meet with your chair regularly (sometimes you have to initiate these) to discuss your career plans and to ensure you are on track. I once heard that “if your work is not aligned with the organization’s mission, it’s a hobby.” Busy and hard-working does not equate with being on track for promotion. With research collaborations, be clear about authorship and responsibilities at the start of each project. Do not make assumptions.

4. Create time to network and expand your circle. Go to professional meetings and interact and engage actively with colleagues. Take time to exchange emails, follow up, and find mentors and sponsors who may not be in your institution. These are people that can offer career advice, write letters for promotion, invite you to speak at grand rounds, review journal submissions, or grants, all of which are important in academic medicine. Collaborate with people outside your institution. Accept invitations to speak within and outside your institution.

5. Be strategic and protective of your time. This is a critical one because a lot of women may find it hard to say, “No.” Many are on hospital committees and take on administrative responsibilities that do not count towards their promotion. Learn to say no to things that do not align with your overall goals. Remember, “No” is a full sentence.

6. Accept leadership opportunities. When you get an offer to lead a team, head a section, or chair a committee, please say yes if it aligns with your interests. Don’t pass because you don’t “feel ready for it.” You got the offer because someone thought you could do the job. Say yes and negotiate for the support you need in that role. Support could be administrative help, additional training, mentoring.

7. Ask for help. The reality is that many women carry the bulk of the work at home. Understand that asking for help is a sign of strength, not weakness. Ask for help within your personal network to help with your home life/responsibilities. Ask for help with your schedule at work if you need more time at home. Negotiate for yourself. You cannot do it all, and you need support to balance things.

8. Peers, mentors, sponsors, coaches. Women tend to be more collaborative, and having a peer network is helpful. Mentors are important to support and advise us, but we need sponsors. Sponsors value your work, and have the power and influence to give you opportunities to lecture, support your research, advocate for you, and promote your career. Engaging the services of a coach (who may or may not be in medicine) is beneficial for some, especially as we take on leadership or administrative roles.

To my daughter and the next generation of aspiring women physicians, I hope that in the years to come, we will see the numbers of women in the higher ranks more reflective of those starting in the field. I hope that soon enough, the odds of women, especially Black women like myself, eventually reaching the top of our careers, is higher. My promise, as a newly minted professor, is to continue to support and empower women faculty in medicine.