Tuesday, July 29, 2008

Women in medicine panel presentation: notes

For those who were unable to attend the women in medicine panel presentation on July 12 (and you missed a good one!), brief notes taken by panel moderator Sandra Assasnik are now available:

On Saturday, July 12th at the Multnomah County Central Library four very different and amazing women physicians shared their stories for the “Careers in Medicine Panel Discussion” in celebration of the Changing Face of Medicine, National Library of Medicine exhibition. Kim Chi-Vu, MD, plastic surgeon in private practice, Flora Fazeli, MD, internist for Kaiser Permanente, April Sweeney, MD, psychiatric resident at OHSU, and Stephanie J. Murphy, associate professor in the Anesthesiology and Peri-Operative Medicine (APOM) Department at OHSU and director of APOM Core Animal Laboratories all shared their stories about their careers in medicine. Sandra Assasnik, Office of Program Development and Outreach Program Manager, facilitated the discussion.

Dr. Flora Fazeli completed high school in Iran. She had to ask permission from all of her family members to pursue her education in Belgium. All her family members asked her why she was doing this. However, she was lucky, she had her mother’s support and eventually the family approved of her moving to Belgium at the age of 19. This presented new challenges to Fazeli, besides learning two new languages, French and Flemish, she had to learn how to base behaviors in another culture. She completed medical school in Belgium and a residency in radiology. She moved to the United States with her husband and engaged in research at OHSU, focusing her attentions on Alzheimer’s disease and Parkinson’s disease. In 1996, she had a beautiful baby girl and took time off to raise her. However, she desired to return to medical practice and in 2006, she completed residency at OHSU in internal medicine.
Dr. Fazeli said that she is often times mistaken by patients for the nurse. It has been more challenging to have a family. She said that people in the medical field have to work harder to have a family. To those considering a career in medicine, Dr. Fazeli said, “Don’t hesitate. If you want to be a doctor, you are capable of everything. It is a long path, but you can do it.”

Dr. Kim-Chi Vu was also born overseas, in Vietnam but moved with her family to the United States. After living in Knoxville, TN, she moved to Oregon with her family. Dr. Vu was a very active young woman and wanted to engage in sports, but her parents made her study instead. Despite some adolescent rebelling, she was able to receive high grades and was accepted at the University of Portland. She had no idea that she would eventually go into medicine, but her experiences as a volunteer candy striper and at a nursing home guided her into the field.
For Dr. Vu, English was a struggle to contend with. Because it was often hard for her to communicate, she gestured a lot. She said she didn’t have friends or attend parties because she just studied. She was the next to the youngest of 7 siblings and the only thing she knew was that she had to go to school. She was influenced by her parents because they challenged her, but ultimately, Dr. Vu found that she pushed herself the most. She did whatever it took to go to college. The first year she applied for medical school she did not get in; so, she worked for a year. After she was accepted to medical school, she was discouraged from surgery until she met a woman role model and mentor who was a colorectal surgeon at OHSU. Dr. Vu knew that if her mentor could become a surgeon, that she could become a surgeon too.
During general surgery residency, Dr. Vu was told not to have children until she was finished. However, during her plastic surgery residency, she had a baby. Breast feeding was probably one of the biggest challenges. She had a great attending resident who was supportive. Vu offered this advice to the audience: “Face your obstacles. Make the best out of it.” Both Fazeli and Vu seemed in agreement that you can’t let your children pay for your career in medicine.” With Fazeli, it meant taking time off to spend with her daughter, and for Vu it meant sending her children to child care. Both Fazeli and Vu agreed that having a child after residency during a career, is often even more difficult than having a child during residency.
Dr. Vu closed by offering these suggestions: “You must like it [a medical profession]! Whatever specialty you go into, you will find your path. You must be honest with yourself. Choose what you enjoy, the gratification will come. Others will be affected [negatively] if you are not happy. Take some time off. Admissions looks at you as a whole person. A well-rounded person will be a better person.”

Dr. Stephanie Murphy finished college and stumbled upon veterinary school “late in life”. She attended the University of Pennsylvania veterinary school, the oldest in the nation and simultaneously received graduate training in biochemistry at the University of Pennsylvania medical school. In the medical school, she was the only American and only one of two females. She specialized in anesthesia and neurology at the veterinary school where the class was fairly well divided between men and women. After completing these studies Dr. Murphy went on to accept a faculty position at Johns Hopkins University, and then OHSU.
Dr. Murphy received a lot of support from her parents. They reinforced the idea that she had no limits on what she could accomplish in life. In school, girls often were persuaded to study French rather than the sciences. Because of her talent in French, she was heavily pressured to choose French. Because of her mother’s support, Dr. Murphy ended up being able to study both French and biology.
Dr. Murphy shared many interesting stories about her training. On one occasion, she became acutely aware that even though her behavior was similar to her male peers' when engaging in discussions and asking questions, she was perceived negatively, as aggressive. In order to provide support to other women and slow down the high rate of turnover of women at the Penn State program, she was instrumental in developing a peer mentor program. This was a program that provided needed reassurance and helped to reduce the drop-out rate of women in the program.
Dr. Murphy is her father's primary care giver. She had sound advice for managing a busy career at 2 to 3 sites and taking care of an elderly parent, one of her suggestions was to make sure that you block time in your calendar. Give yourself a cushion for driving time. Also, make sure you block out time for a hobby or other interest and commit to that. She suggested “having an activity that is unrelated to work and make it a priority and to protect that time.” She purchased tickets to the theatre in order to keep a balance in her life. It helped her to recharge her batteries. She also suggested making long and short-term goals, being free to modify them, “it is okay to move the finish line.”

Dr. April Sweeney, self-described as the "baby" of the panel is in her second year of a 4-year psychiatric residency program at OHSU. Dr. Sweeney was born and raised in New Jersey in an Irish-Italian American family. Because of Dr. Sweeney's father's illness, she developed an interest in the brain and the nervous system. She went to Rutgers University and took both biology and anthropology classes. With this background, she applied to medical school and went to Newark, NJ, medical school. As a student, she and other women formed a coed medical group and brought in a number of speakers. This was a helpful support to Dr. Sweeney and other women who did not have female role models or female mentors in medicine.
Dr. Sweeney ended up working with underserved populations in Newark and realized that psychiatric patients are often the most vulnerable of the underserved. She likes psychiatry because so much territory is waiting to be discovered, including unknown etiologies and unknown reasons why treatments work. It also is fulfilling career considering her interest in treating people like her father. However, there were several times that Dr Sweeney debated whether or not to actually pursue psychiatry because of safety issues. April is on call frequently. She too suggested keeping balance in life. While you are on call, and being a doctor, it "squashes being whatever else you are." She said it is helpful to make time to be with partners and friends. Being in the medical profession is not a "normal life." Keeping hobbies is hard, especially if you have a hobby that must be scheduled. Dating too is difficult. Dating outside the medical profession is challenging as well. Dr. Sweeney's advice is "you must love it [a medical career]….You must get along with people." She went on to say that this career may be difficult for introverts. "Go slow, if you leave, you will go back and you will have life experience outside of a library."

Despite challenges, all the speakers said that there are advantages of being women in medicine. Some of these include:
  • As an associate professor, you may have more opportunities than men.
  • Patients like female plastic surgeons because women seem to be able to listen and empathize better.
  • Females screen for things that male colleagues don't do as well as they should, for example sexual assault screening.
  • Everyone agreed that you have to have a sense of humor to get through difficulties and it is important to have someone to talk to.
Final words of wisdom were shared. Dr. Vu said "if you work hard, your staff will appreciate it." Dr. Murphy said that in the last 5 to 10 years, researchers have paid attention to the differences that gender makes. "Finally, [researchers are] thinking about gender differences….This work will improve our patients' care." Dr. Sweeney said that she wants to work with the chronically mentally ill and to change the way that they are treated. Dr. Fazeli concluded by saying that medicine has had different faces. There are differences in the history of treatment, of clinical research, and today there is a combination of both, communicating with the patient along with research. And in this process, it becomes even more important to understand the patients' backgrounds.

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