Introduction
Methods
Study design and setting
Participant selection
Data collection
Semi-structured interview
Outcomes and primary data analysis
Results
Subject characteristics
Main results
Themes | Illustrative quotations |
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Women leaders made an intentional decision to pursue opportunities to influence emergency medicine. | |
Made strategic decisions and took risks | I think people in emergency medicine, we are not very good at saying, “You need me to do that?” I mean, we are really bad at walking past a crisis and not responding to it. So, I guess I learned first of all, transparency—being fair and being transparent are about the most important things about a leader. I think that the first couple of years you have to develop your confidence in your clinical area and get your boards through. I think the skill set that helped me the most was being open to possibility. I did not say no to things. I think you miss out on opportunities. I think being open to possibility is an important skill set. |
Are women leaders necessary? | I think one of the most important things is the critical mass. We need more women in leadership roles because that will make this a continued process without it being a battle to keep us there. Gender balance in leadership brings a more diverse and innovative range of ideas. |
Do women leaders need to be like men? | The women who are coming up I think are still having the same baggage that we did years ago: I am not good enough. This is the imposter thing that people talk about. I mean, we have that, we all have that big-time but women have it bigger than men. Most women are less competitive, because I think women are socialized more to work in groups, which is why they are better collaborators. I do not think male mentors would talk to anyone about their dress, even though I have seen women hurt themselves in a professional environment by the way they presented themselves. When a woman is offered a good position, she might say ‘Oh, I am not ready yet, I have to study, I have to do a number of things first to do an excellent job from day one and I do not yet know how to do it.’ A lot of men would say, ‘That sounds like a cool challenge and I’ll try it’. |
Gender bias | I think that women need to be aware that there is still gender bias. It may not be overt, it may not be as wide spread as it was but there is still gender bias. And when we as women assume that there is none we are doing a disservice to other women. I think women need to be aware that there is still a bias out there and take that into account when they make decisions. |
Women sought out natural mentors and sponsors to facilitate career development. | |
Are mentors necessary? | Mentors provide clear visioning about what people want for themselves. And it has to be real. Not what they should do, but what they really want to do. |
Find mentors for content development and career advancement | Someone pointed out to me that one person cannot be your be all to end all whether it’s in marriage or your children or in choosing mentors. And that what you should do if you are smart is find someone to help you, who can help you with something specific that you need. I did broaden out who I asked for advice about certain things. One mentor may not be broad enough to cover all of your interests. Any doctor, leader, or teacher can act as informal mentors if we only observe and learn from what they are doing. |
Sponsorship | Part of it is that we are not encouraged, we as women are not encouraging other women to get involved. You know there were people that had to sort of hit me over the side of the head to say you are ready. Move, go for it. The problem is we have a human affinity to sponsor people who are like us. I really was not looking for a leadership role, and yet I was requested by my program director and peers in my class… he very much encouraged me and offered his ongoing services to talk me through if I came to some bumps in the road that were challenging. Women cannot sit back and wait to be recognized. Women need to share their drives and goals with the right people who can help them succeed. It is not enough to work really hard and wonder why you are not recognized for it. |
Establish supportive connections | I do think the networking is important, because men do networking much better. Women interested in leadership, a chair or a Dean, need a network. We need to get together; we need to spread the word that there is support out there. |
Women leaders intentionally planned their out of work life to support their leadership role. | |
Work/Life issues | Adaptations and accommodations we make around childbearing and family are very important, but the best thing you can do for a woman in that process is to tell her that you really believe in her ambition. We need to keep supporting them in feeling good about being super capable. |
An important work focus was to help others achieve excellence. | |
Identify and reinforce leadership potential | Do not be afraid to surround yourself with people who are better than you are. Because if you provide the right environment for them, they will grow, and you will grow with them. They will bring you their best, and you will be learning from them. Consciously look for leadership talent that you see. And start it early. I think that means starting with medical students. I think that means residency. You look for that early on. Who has that kind of leadership potential and start actually putting the idea in their heads? So, I might meet with one of my senior residents and just say you know I have noticed that you really have a skill set for leading people through. Have you ever thought about becoming a chair some day? Nobody’s talked to them about it, they have never thought about it. Put that little bit of seed of interest in their head and see what happens. I think we also must allow people to find their own way, and how to do it. I have always been very supportive and taken advantage of programs like that but I did not define myself by those programs. The idea is to be a human being and citizen and not use gender as your defining feature. |
Theme 1: women leaders made an intentional decision to pursue opportunities to influence emergency medicine
The earlier people can identify who they are and what they want out of life and a career, the clearer their vision will be. And once you have a clear vision, then the way you react to opportunities and invitations can be more deliberate. In the absence of a clear career vision, people can get overwhelmed and distracted by the opportunities available to them.
In the 80’s, books came out about how women need to be like men and now we have swung full pendulum to ‘women need to be women’. The answer is somewhere in between…women need to maintain their identities as women but still work in a field predominantly led by men. I think the first thing that women need to do is know who they are; know themselves.
I found that I had to take on masculine traits to be effective or at least to feel like it. … younger women do not see role models that they can relate to. For many of the first women to be in leadership positions, they usually must take on the attributes of the majority, who are men.
My role model cared enormously about patients; the patient came first and everything else came second.
Theme 2: female leaders sought out natural mentors and sponsors to facilitate career development
You must find institutions that are thoughtful about women and value the role that gender diversity brings to the work place and are willing to champion putting women into some of these roles. Obviously, women leaders can do that as well and we need to be very thoughtful about supporting each other through these searches. I cannot tell you how many women I told “Look! Go apply for this job and put me down as a reference.”
Mentoring comes from someone who has experience about something that you do not, where you can learn from them and they can guide you.
Theme 3: leaders intentionally planned their out of work life to support their work
I would never suggest that a woman not give the time and attention needed to her home and to her family. Women are still doing most of their housework and most of their child care. I really caution women not to use home and family obligations as an excuse not to take on the challenges of leadership. Yes, it is challenging but I think when women hide behind domestic duties, they are not acknowledging the real challenge of leadership.
Theme 4: an important focus for their work was to help others achieve excellence
I particularly seek out women and say, ‘I think you are ready to run for the board.’ I am so grateful for two people having done that for me. I would never have run for that first role if they had not pushed me.
When I became chair, I was no longer interested in my own career; I was interested in the careers of others. My success was only going to happen if other people were successful.
I can still remember one person saying to me that it was my job to learn my boss’s job. It was also my job to teach my job to the person who would one day take my job.
Women who have scratched and clawed their way to the top on their own, and now just feel like “the rest of you are just wimps” because you did not do it, are doing us a disservice. What we need to do is bring each other along. We have a harder role than the men do to get there.
You mature as a leader through incremental leadership experiences, starting with little things and then grow through a career...encourage female faculty to seek leadership roles to the committee level, task force level or clerkship level and more senior faculty need to foster and encourage it. They need to get into leadership roles outside of the department to expand perspectives a bit.
We sponsored institutional, permanent funding for programs that brought women together. Women coming up are still having the same baggage, especially the imposter thing. We all have that big-time but women have it bigger than men.
It’s a real struggle as a leader to keep it in balance. Maybe the question is not: “How do we get women to want to take on something that’s inherently counter healthy?” but instead: “How can we rewrite the roles so that a sensible person would want to do it?” … Maybe the answer is we need to change the role of a leader to something that’s attractive to smart and sensible people.
We need the critical mass. We need more women in leadership roles because that will make this a continued process without being a battle to keep us there. We need to educate current women leaders to learn how to bring those behind them up in a planned and deliberate way. That removes some of that unconscious bias because once people look over and see a woman there it reminds them, we must help each other.