COMMENTARY

Women in Medicine: Career Advice From Leading Female Physicians

Cheryl Pegus, MD, MPH; Hansa Bhargava, MD; Julie Silver, MD

Disclosures

July 21, 2017

In May, Medscape hosted a Facebook Live session to discuss issues unique to female physicians as they advance through their careers.Here are highlights from that discussion. Don't forget to follow us on Facebook to participate in future Facebook chats.

Hansa Bhargava, MD: Hi. I am Dr Hansa Bhargava, senior medical correspondent for Medscape. Today, we will be talking about women in medicine on Facebook Live. Thank you for joining us.

I am very excited about our guests who are joining us today. We have Dr Cheryl Pegus from NYU and Dr Julie Silver from Harvard Medical School. I would love for you all to introduce yourselves and tell us a little bit about yourselves.

Cheryl Pegus, MD, MPH: Hi. I am Cheryl Pegus. I am a cardiologist. I work primarily in innovation and some start-up companies besides having an academic role. I have two children; they are both off to college. [I'm] happy to be with you today.

Julie Silver, MD: Hi. I am Julie Silver. I am a physiatrist, a doctor that specializes in physical medicine and rehabilitation, at Harvard Medical School. I am on the staff at three Harvard hospitals: Spaulding Rehabilitation Hospital, Massachusetts General Hospital, and Brigham and Women's Hospital. I have three children as well. I have a teenager; I have a junior in college; and I have a son who is going to medical school. My two youngest are girls, and then I have a son. [It's] great to be here, thank you.

Dr Bhargava: Thanks for joining us, both of you. I am really excited about this topic. Women in medicine—we definitely face a lot of the same issues as men, but we have a different set of issues as well that we face.

Let me jump right in and say that about one half of our medical school graduates right now are women. If you look at how many of them are at the high levels of academia, such as division chiefs, [it's] 24%; 16% [of] medical school deans; [and] 15% of department chairs.[1] There seems to be a little bit of disparity. I was wondering what your thoughts are on those numbers, and why the disparity exists.

Dr Silver: I will start out just saying [that] first of all, I am so glad Medscape is having this [discussion]. It is such an important conversation to be having. I am in academic medicine. I became the associate chair of my department a couple of years ago. I started looking at our very diverse faculty. I counted the faculty, and more than 60% of the people in our department are from underrepresented groups.

The majority of the people whom I am supporting in my department at Harvard Medical School are from underrepresented groups, which means that there is a lot of work to do in supporting them—to help them to publish; to help them to advance in their careers; to help them win recognition awards; to help them close the gap in healthcare disparities.

As I was looking at that, I started to get really interested in what we as a medical community could be doing better together, all of us: men, women, the gender spectrum, all specialties, all hands on deck. That is really why I am here today talking about these issues.

Cheryl, what do you think about this?

Dr Pegus: There are a couple of points that we should look at. We should say and acknowledge, "Yes, there is work to be done." I think there are some concrete things that we know work for everyone—men and women.

Having mentors is really important. Understanding what you want your career path to be and what is necessary for promotion is important. Also, being able to look outside—I think sometimes women feel that to set up [their] mentoring committee or group, [they] may want to look for other women. [But] there are men who are just as supportive. Your mentoring committee, and frankly the people [to whom] you look to assist you, should include a breadth of people who are interested in the work that you are doing, who have expertise in it, and who are willing to support you through the process.

Dr Bhargava: I totally agree; we had spoken about some studies around this as well. Would you mind telling us about your very interesting study?[2]

Dr Silver: At medical schools, the chairs of departments have gotten a lot of flak for not promoting their women or their ethnic minorities. It has been, "The chairs are not doing enough, the chairs are not doing enough, the chairs are not doing enough." When I became an associate chair, I started feeling like, "Wow, we are doing an awful lot, but there are some closed gates here."

I started to look over at the medical specialty society side of things. We send all of our medical students and our residents over there to the specialty societies. We say, "You join this society; you get your papers published; you give talks; you do these different things. That is how you build your CV, and then you take it back to the medical school side. That is how you get promoted. You have to get a bunch of things from the medical society to get promoted at the medical school."

As I looked at that, I realized that data were not really being captured on the medical society side. We have pay gaps on the medical school side. We have promotion gaps on the medical school side. We have tons of data on the medical school side, and very little on the medical society side. I also realized [that] we at the medical school were paying the medical societies to send our people over. We are paying for this privilege.

I decided to use a specific study as a tipping point. That study was looking at recognition awards. The reason [that] my team and I (four men and four women, including the male chair of our department at Harvard Medical School, Ross Zafonte) looked at recognition awards as a tipping point [was] because you have to do a certain number of things in order to get recognized. You have to publish papers. You have to give talks. You have to do these different things.[2]

It is not really about just women getting more awards. It is about, how are women navigating the specialty society? What we found was [that] they were getting fewer recognition awards than their numbers in the society. We also found [that] they were more likely to get awards in groups and least likely to get an award that was very prestigious, especially if there was a lecture and a speaking part. That is where they were the least likely. This was the first study of its kind.[2]

Our message to medical specialty societies is to look at your data and be transparent. It is not just membership, which is diversity; it is inclusion. It is, how are people progressing? Are they task force and committee chairs? Are they the presidents? Are they getting recognition awards? Are they getting speaking assignments? Are the plenary speakers? All of these different things.

How to Get Promoted

Dr Bhargava: I think that is a really important point. Cheryl, I think you were talking about how the awards are important, but also being part of committees is important. Just like when you apply to medical school, most people—and I was just looking at some numbers—have either done volunteer work or they have done research, or they have published, or all of the above. Similarly, there are probably some boxes you have to check. We do not know what boxes to check.

Dr Pegus: I agree. I think it varies by specialty. I will tell you that in cardiology, I think there is a lot of work done in this area. There has been some meaningful progress. I will say [that] for a lot of us, we work hard during the day, just with what we are doing. We chose these fields or these subspecialties because we are passionate about [them].

I really encourage everyone to get involved with their [specialty] society. I have worked with the American Heart Association for quite a while. I am on the board of the Association of Black Cardiologists and the chair-elect, first woman coming in. I think it is my passion. It is also what I enjoy. I am around people who have the same interests. I am building out my network as well of people nationally, which is really important.

I get asked a lot to write letters of recommendation for people at institutions. How do you meet those people who are necessary to help you for your portfolio?

The other thing I want to stress is [that] we do not spend time when you start your training saying, "These are all the requirements you need to have for your promotion." There needs to be an easy app of "Here are the requirements for associate; here are the requirements for assistant; here are the requirements for professor." We could all follow that.

It is hidden. You may get it one-on-one, and maybe because there are more men who are professors and there are people who are working in their lab or doing research, I think women can simply ask to have men as some of their mentors. I think understanding their process (because women tend to wait until they know all of the information), getting the process out, is really important. Getting out there and asking the questions. I just met the two of you, and we started asking each other questions about our careers, about how we are helping with our families. I think that comfort level that we are all in the same boat and we can assist each other really needs to occur.

My hope is [that] as the younger generation uses social media a lot more and asks each other all of these different questions, in healthcare in particular, that will happen. There is a lot of stress. Frankly, we see it particularly in women as they look at their careers and lives. We have all gone through the same thing. I think we have got to get comfortable with "Hey, how can we help?" We are here to help. It does not look good for those of us who have climbed, and we have not brought along a lot with us. You should feel comfortable that we want that to occur.

What Women Bring to the Table

Dr Bhargava: The issue also is that women actually bring a lot to the table. For example, we just started a women's network at WebMD and Medscape. The question that was brought up to me was, why is this important? Not in a bad way—I think it is a fair question.

Why is it important? It is because we bring diversity to the table. The returns on investment (ROIs) for a lot of businesses are higher with women leadership. We bring a different view to the table.

Interestingly, there was a study in JAMA that was published in December, which you probably are aware of, looking at mortality and readmission rates with women physicians versus men physicians. The women physicians had better outcomes.

Dr Pegus: And better patient satisfaction.

Dr Bhargava: This is why diversity is a good thing, because it brings a broader outlook to everything. I think communication is extremely important. We will get back to the asking question, because that is another thing [that] I think we as women definitely need to promote ourselves with—asking for the information, asking for the promotion, asking for what you want, being confident enough to ask for it.

Dr Pegus: And asking for help. It is okay to ask for help. Sometimes you have to buy some help so that you can manage everything else. It is okay.

Clarifying Promotion Requirements

Dr Bhargava: We are on Facebook Live. We are talking about women in medicine, a great topic. There has been a lot of chatter about that on social media. We are just so excited to be here with two great experts.

I am going to go to Facebook Live. Kelly is [saying that] promotion requirements are rarely clear.

Dr Silver: True; it is sort of like a hidden thing. It is not only promotion requirements. We have talked a lot about academia, but also out in the real world in practice. When we introduced ourselves, I did not know this, but I am an innovator too. I founded a start-up company. This idea that we have to sort of follow this pattern, and here is our box and we have to stay in it, is really not true.

There are women who are innovators and all kinds of interesting things. I love the question, how can men help? We certainly need allies. I will say that in my department and in my work, one thing I am trying to move the conversation away from is helpers—basically saying that diversity and inclusion is a core leadership competency, and that all leaders, whether they are men or women, need to develop this as a leadership competency and not consider themselves as helping. The more we position [the issue] as "we need helpers" versus as a core leadership competency, and every leader has to be engaged in best practices, looking at the data and this discussion, I think that is a game changer.

Dr Pegus: I always say [that] the way you make this relevant to everyone is [to] say, how does it improve the business of what we do? Women participating in healthcare and participating in research has made a huge difference. We have seen it in some of the studies. We see it everywhere, from legislation to different ways that we are looking at innovation and how tech should include women, particularly as you look at healthcare.

The business case exists. I think sometimes we think everyone must know this. The fact of the matter is that they do not. I have worked in the insurance world; I have worked in retail health. I have always recognized my responsibility of being the one to bring it to the table, but bring it to the table in saying, "I have noticed that there are more women who see physicians in the outpatient practice. Have we done our surveys in understanding how we are meeting their needs?" They are asking for more female physicians. How are we doing that? Press Ganey scores are higher. You make it a business case for why you are doing it. I think that is really important.

The second question about promotional requirements—every academic institution actually has [them]. It is usually written in a very dense document. What I did when I was running a division at [New York University] is create something online that allowed you to kind of type in where you were. It would tell you the things you needed to do over the next 18 months.

I mentioned that there should be an app. Maybe it is [something] we take from this. It is generalized across the country. It is not really that specific to each institution. I do think there are some things that we should do and make available. I may take that as a homework project for myself.

Dr Bhargava: I agree with you. I think until we get there, be assertive and ask—never be afraid to ask and communicate with the people whom you look up to or you aspire to be with.

Dr Silver: Even if it is not an academic promotion (or even if it is), how do you do a start-up company?

Dr Bhargava: Yes, absolutely.

Dr Silver: Or how do you run a practice? I think that the Facebook groups and social media are great venues for that. I see a lot on the [Facebook] Physician Moms group. I see a lot of people asking questions about practice-related things and how to build things. I am actually really interested in all of the different things. I find myself getting caught up in it. I have to say, I have to stop reading this. It is pretty interesting to hear all the advice.

The Importance of Networking

Dr Bhargava: We have another question coming in on Facebook Live. Linda asks—and this is a great question—"We all are aware of Sheryl Sandberg's book, Lean In, and her analogies. I am sure that we are aware of analogies that we know personally. How do men and women promote themselves differently?"

Dr Pegus: I have a couple of comments. The importance of networking should not be underestimated. There is this great book called Never Eat Alone. It reminds you that people have to feel connected to you and get to know you. You have to spend some time doing that.

I have this thing where at least twice a month, I am meeting with someone whom I do not know. It could be at Starbucks. It could be somewhere else. It is allowing me to hear their story, share mine. Or I am attending a conference that I have not ever attended before. Last week, I did a wellness conference because I am very interested in physician wellness. I met all of these different women entrepreneurs. I met people who are investing in that space and came back with a network that I probably never would have known. It did not cost me anything. It is an hour or 2 hours.

I do think [that] if we think our jobs are [that] we come in, we see patients, [and] we are finished at 5:00, or we work in a corporation and we finish at 5:00, most men do not see it that way. It may be a man is thinking, "My wife is home watching the kids." I think it is okay to say [that] one day, twice a month, we will have the nanny stay until 7:00 PM because this is important for my career. I think structuring things that way is really important.

I think also, we have got to recognize that there are online communities and forums to participate in. LinkedIn provides a really nice platform for reaching out, asking questions. I have a lot of people who reach out through that who are asking really important questions, looking for direct help. Maybe they have looked through my network, and they are like, "Hey, can you help me with this?" I will ask them a question, and they are off and running.

I think stepping back [is important]. I say to everyone, take 2 hours of the week and spend it on yourself—one of them on a massage, the other on your career.

Dr Bhargava: That is great advice. I do think connections are very important. I am going to ask you, Julie, about Sasha's question here. Sasha asks us, "If there is one thing that you could tell junior women in medicine, what advice would you give them?"

Dr Silver: I was thinking about the whole "lean in" [movement]. When I was younger, I would lean in more. I felt like I got kind of beat up. That hurt a lot. I realized I carried that around with me too much. It hurt me too much to do that. I developed my own little philosophy called "lean around and up." I do not lean in so much and get all beat up. Instead, I lean around and then up.

I have this one rule about "no." The only "no" that I will listen to is the "no" that comes with "If you do this, you will be fired." I have never heard that "no." Never once have I heard that "no." I figure if I am doing good work and no one ever tells me, "You cannot do that, or you will be fired," then I am okay to do anything—really, anything—because I am doing good work. That is the advice I think I would give Sasha.

Dr Bhargava: I did want to refer back to the "lean in" philosophy. It is interesting, because I have a [personal] story. I had just joined WebMD and Medscape, and I was attending a meeting. I felt like I was junior and had to sit back, and [I] decided to go to this big meeting and sit along the edges of the room. The leader of the meeting actually looked over and said, "Hansa, come and join us at the table." I have to tell you, it was really interesting how my perspective changed just by physically moving over—I felt like I was involved. I participated in the discussion. It is just so important. I would add to your advice, do not be afraid to sit at the table.

Dr Silver: Yes, sit at the table—exactly.

Choosing a Specialty

Dr Bhargava: Thank you for your question, Jay. Jay asks us, "Are there certain specialties that attract women? Should other specialties do more?" The reason I am looking at Cheryl is because there has been movement of more women in a lot of specialties, but unfortunately, cardiology has been stagnant. Could you speak to that, Cheryl?

Dr Pegus: There are definitely specialties that attract more women. We know some of them: primary care, family medicine, pediatrics, and ob/gyn. Cardiology has been a challenge. I would say [that] cardiology and orthopedics are the two that have been very challenging.

Part of it, I think, is that—I will speak from what I hear from colleagues—it is a competitive fellowship. The numbers of people getting them tend to be very few and in between. It requires not just great performance during your training as a resident; it also requires that maybe you have done a research project in a lab, or you have got a network of people you have worked with, or you are active in the American Heart Association or American College of Cardiology.

This comes back to the promotion piece, but actually moving it earlier: How do you get into the right fellowships as a woman, particularly the hard-to-reach [fellowships]? I think that road map is not clear as well, because there are so few women cardiologists at each of these institutions. Making sure that they are providing that network and mentoring is really important.

I remember I finished my cardiology fellowship in 1995 at New York Hospital-Cornell. I had been the first African-American woman to become a cardiologist there. Four or 5 years later, there was another woman. In that time, they did not know who to reach out to, and they reached out to me to go back and counsel the woman. For me, I felt two things: First, really, there have not been more? And second, I own it. You reached out to me. My job is to help her get through.

Her name is Dr Icilma Fergus. She went on to be the president of the Association of Black Cardiologists, practicing at Mount Sinai. I do think for each one of us who has been lucky, if you only bring one along, that is still something that you do. We have to do it. Make it [so] that is not scary to reach out to ask us those questions, or to feel that we will not help; that we will. We have to.

I think it is a responsibility that we all take on with a being in a trailblazing area. Hopefully, my children will not [have to do this]. But recognize that it is a role, and you have to make time for it. Some of it I do think is putting this on paper a bit and making it more accessible. It takes no time to text back to someone if [he or she asks] you a question. It really does not. I waste a lot of time a week doing way too many things on Netflix, so I know I have the time.

Work-Life Balance

Dr Bhargava: The life-work balance is an issue as well. I am going to ask Julie. Our Facebook question is, "What impact does life-work balance have on choosing a specialty, and also moving ahead in that specialty?"

Dr Silver: That is a great question. There is a career trajectory as you have kids. When they are little, it is different from when they are sort of middle-school age versus when they are a little bit older. One of the things I think I really figured out is that when you are in school and you do so well in school and you get into med school, you are just this high achiever. You just cannot do it all perfectly well.

One thing I really focused on when my kids were little was trying to integrate them into my life. If I was going to exercise, I would take them on a walk with me. I would actually take them to do television shows. I would take them when I gave talks. I would just sort of integrate them in as much as I could—not completely, but trying to really get them engaged.

As they got older, they got more active with their own friends and different things. I founded the start-up company and did some other things to kind of change what I was doing, so [that] I had a little more control. I was not structured from 8:00 in the morning until whatever at night. That helped me too. A little flexibility in my schedule went a long way.

Leadership Can Lead to Happiness

Dr Bhargava: I think you hit a really interesting point. The [Medscape] Women in Medicine report was interesting, because we asked women in leadership positions whether they were happy with their career and their life. We asked women who were not in leadership positions the same question. Guess what? I am sure you know this.

Dr Pegus: Women in leadership are happy.

Dr Bhargava: The women who were leaders were happier. They were happier. That was so interesting, I actually did a commentary on it. Basically, the message was that sometimes when you go for that leadership position, you actually have a little bit more control over things so that you can actually balance it.

Dr Silver: Yes, that is a component of burnout. One component of burnout has to do with autonomy—autonomy at work. When you do not promote people and when they cannot climb the ladder, they do not have as much control. That really feeds into burnout. Leadership positions can actually help mitigate some of the burnout symptoms, depending on why people are burned out. It is really important, because leaders do have a lot more autonomy. They can say, "My child is playing soccer from 3:00 to 4:30."

Dr Pegus: I also think it is asking the questions and putting these things on the table, maybe sometimes earlier. If today in medicine you are in practice, be you at an academic center or you are out on your own, you are looking at such things as relative value units (RVUs); yes, we are still a fee for service. We have not moved over to the Merit-based Incentive Payment System (MIPS) yet. You are looking at RVU totals. You are also looking at Press Ganey scores. If you are in a risk contract, you are looking at how good the outcomes are and the clinical outcomes.

I think for women, this offers an opportunity to not be looked at for just the hours, but actually for productivity. Frankly, we are moving more to a productivity environment. It makes you able to have transparency. Why are there pay differentials? If everyone meets the same RVU target, then everyone should be paid the same. There is a lot more transparency available to us now because of the data available.

It really allows us, I think, to have women more at the table and to be more successful. I have definitely seen [that] for our own things that we do; we are getting better numbers because they know the path. If you love something, you are passionate about it, and we tell you how to get to the next level, people are just doing it. It does not feel like work. You feel like you own it. There is some autonomy. You also feel that you are all playing the same game on the same team. No one is doing it differently. I think that is really important.

The only other thing that I would mention around this is that I do think that overall, we do not raise these issues in the workplace or at institutions enough. In corporate America, it gets raised in the human resources (HR) department. They are the ones who are responsible for diversity. In academic centers, maybe it is the mentoring committee, as opposed to this is what we all look for in our lives. This is how it happens. Why is it not part of discussing the business?

I sat on the board of the American Heart Association. We say "Cardiovascular disease is worse in these communities. We need physicians who are working in those communities to participate." If we believe that there is a disparity in the care of women in health, we actually need them sitting at the board so [that] we can solve it.

If you begin to look at it as having the people who have the expertise and experience to assist you, it makes someone say, "Okay, it is not just the right thing to do from a public health perspective. It is actually the right thing to do to continue to be profitable in your community and to continue to see growth." I think those are the conversations we need to have more. This is not just a nice thing to do; this is something that actually assists everyone. I really think moving it into that arena works.

Dr Silver: That is so important, what [Dr Pegus] said. The conversation so often is based on, how do we support the workforce? Or how do we support patient disparities? People do not see them as the same exact thing. If you cannot support the diverse workforce, then you cannot do all the things with the question.

Dr Pegus: That has been proven. There have been way too many studies.

Dr Silver: Every conversation has to be those two things, hand in hand.

Why It's Okay to Work Part-Time

Dr Bhargava: There are going to be some people who are listening to our discussions and saying, "Maybe I do not want to be a leader. Maybe I just want to work and go home to my children." I would ask both of you very career-minded women who also have children (and I do as well), what would you say to that?

Dr Pegus: I would say good for you. I think you have to do what is right for you. I did one of these career paths; [I] went from practice, became a national medical director at Aetna, CMO at Walgreens, went back to an academic center, and now do a lot of start-ups. I do it because it is all healthcare, and I know how each of them improves the communities that I care about.

I also know [that] I grow each time. I am humbled by how much I still do not know about healthcare. That has worked for me, which means to me [that] I will be working until I am 90 in my motorized wheelchair, and you are sending me around. I can make it work, because that is what I want to do.

I think women who feel pressure feel that there is some guilt associated with wanting to work 3 days a week (by the way, you can work 3 days a week and still have 3500 RVUs—just saying. Call me, I can tell you). I just think you should because it is one of the best careers for women. This is one of those careers that with your skill set, you can work as long as you want, however you want, in any industry in healthcare you want. There is a demand. At the end of the day, no one should forget there are not enough physicians.

We are all contributing. Telehealth is coming. You do not see as much of it yet, but being able to do e-visits allows you to [achieve] some work-life balance for some of the physicians who are doing it. By the way, women and men both love it.

The other thing that we do not talk about is [that] many men feel like it is too many hours working in medicine as well. We sometimes make this a women's issue, but it is not.

Dr Bhargava: Sometimes, that is contributing to physician burnout.

Dr Pegus: There is a lot of work to do. It is learning your electronic medical record (EMR). It is learning about all of the new risk payments.

Dr Bhargava: There is a lot of pressure, absolutely.

Dr Pegus: It is managing all of the new scores that you are responsible for, and data. We need to acknowledge that this is a lot. We have not yet built out the right infrastructure to have people come to work and [say], "This is a great day." At the end of the day, sometimes it is stressful. People have to figure that out and accept it.

Dr Bhargava: I agree with you. Stress is a real issue for physician burnout. We know that is another big topic. We have seasons in our lives. There is a season for us to have children. I think those women should be applauded about deciding to do that at that time in their life.

My bigger question for all of us is that those women also need to be supported, just like we are talking about leaders being supported. How can we as a society actually support that? Do you have any thoughts on that, Julie?

Dr Silver: I do. It's interesting, because my sister is a doctor. She is a pediatrician. We took different career paths. She is more in the vein of the part-time, although she has ramped up as her kids have gotten older—clinical only. She works for Kaiser, not in academia; she does not want to give any talks, she does not want to write any papers.

The thing that we share, other than being sisters and being great friends and all of that camaraderie, is a calling for medicine. That calling is the same. It really does not matter whether you are putting in 100 hours or 5 hours, or are taking time off and going back to it. That calling, that really wanting to help people at their most vulnerable, is something that has been very tied to burnout. Bringing people back to the real calling—Why did you go into medicine? What do you want to do?—is super-important, I think. It really goes to how we value everybody in the workforce, everybody.

Dr Bhargava: Including the physicians.

Dr Silver: Yes, everybody—including the physicians.

Dr Bhargava: And the nurses, and the healthcare providers. I think it is very hard to push up those RVUs if you do not have the morale and the energy to do it.

Dr Pegus: Your question about if someone wants to work part-time—I have done this, and I know many people who have had to manage practices do it. You can bring in two people to share one full-time position.

You can have the hours be extended until 8:00 PM, 2 days a week, so that the other days are off. By the way, if we look at why we do this, patients are asking for this. There are many ways to structure this so that it gives you everything you want, to make sure that you are able to pay your staff and provide the services and also retain talent.

Dr Bhargava: I do want to go back to your message, because both of you are saying the same message: Ultimately, whether you want to be a leader or you want to work part-time and put your family life first, ask for it. Ask for it. That is what it is. Ask, and you shall receive.

I am going to go to a Facebook question here. The question is, "What are ways [in which] women can get involved in societies as a medical student, and not necessarily just as junior faculty?"

How to Get Involved in Medical Societies

Dr Silver: I love social media for getting connected. I was talking to some of the folks on social media who have connected with me [and] who are medical students right before this. I hope they are actually watching now. They were both men and women that are medical students who reached out to me just as you said, sort of networking, and said, I am starting; I want to get engaged; and so on. I love that. It is a really great way. That does not necessarily bring you to the society level, joining the society. But it starts to get you connected with people.

Twitter is a great place to be. I would keep it very professional. There is this hashtag, #DearFutureMD; #DearFutureMD are all of these older doctors giving the younger folks some advice. One of the bits of advice, and you were talking about this earlier, is how do you find those mentors and those people? @WomenSurgeons is the handle. "If you do not see any women who are surgeons, come talk to us, because we are here." You can look at #ILookLikeASurgeon on Twitter. Heather Logghe and Heather Furnas are great. Follow them. They are fantastic. Lots of people are on social media connecting. That gets you to the society level.

Dr Bhargava: That is a great suggestion. That is wonderful.

Dr Pegus: There are student-level organizations. There is the Student National Medical Association; the American Heart Association has a student society. So does the American College of Physicians. You can go in, look for medical students at their site, [and] register to get emails right away. A lot of medical students cannot attend conferences because they tend to be expensive; all of the societies provide scholarships. It is really a good way if you have an interest in any of the specialties; they all have student societies. They are online. They have hard learning programs. Some of them have great podcasts and blogs. There really are a lot of ways to become involved. You definitely can do it.

Dr Silver: Using more than one strategy often works too. You are reaching out at different times.

Dr Bhargava: Thank you very much for joining us. Great discussion. We had great experts here: Dr Cheryl Pegus and Dr Julie Silver. Thank you both for joining us. Hopefully, you took some great points away from this. I know I did. We will see you next time.

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