Thursday, November 20, 2014

2014 AWS Conference Breakout Session - Mentoring & Career Advancement

by Nancy L. Gantt, MD, FACS

Our packed table energetically discussed mentoring, sponsorship and career advancement. The discussion highlighted challenges some of the members were having at their own institutions.
We spent a lot of time talking about the difference between mentorship and sponsorship, and why both are necessary for academic success. Dr. Emina Huang provided her insights about the difference between those two roles and how to find a sponsor. She noted that sponsorship is different than mentoring - the former helps with providing opportunities and exposure; the latter helps you with the steps to get there.

The discussion about Mentorship highlighted the following points:
  1. Mentorship is valuable in all aspects of your professional AND personal life.
  2. You will likely need more than one mentor, as a single person may not be able to meet all your needs. 
  3. Selecting a Mentor will be facilitated if you approach someone that you have worked well with, as your values have to be similar.
  4. A mentor, or sponsor, can be someone outside your home institution.
  5. If you are being stymied in your career progression by your Mentor because of their insistence to "follow specific channels" you may need to creatively develop a plan to include your current Mentor and a potential sponsor figure to further your career.

Members were directed to the Career Development Resource on the AWS website: “Strategies for Building an Effective Mentoring Relationship”.

In closing - you can have it all - just not all at the same time. Mentors and sponsors can help you achieve personal and professional success.

The Year of Mentorship

by Betsy Tuttle-Newhall, MD, FACS

As we start a new year of eConnections, and continuation of the mission of the Association of Women Surgeons (AWS) Foundation, the members of the Foundation Board want to dedicate this year of fundraising in honor of Mentors and the Concept of Mentorship.  The overall mission of the AWS Foundation is to provide opportunities for the educational and professional growth of women in Surgery. Many of the signature programs of the AWS are supported by the Foundation including the Kim Ephgrave Visiting Professor program as well as several national awards including the Nina Starr Brunwald Award, Olga Jonassan Distinguished Member Award, Honorary Member Award, Hilary Sanfey Outstanding Resident Award and the Patricia Numann Medical Student Award. The Foundation also supports the Resident and Poster Competition at the Annual AWS meeting to encourage and facilitate interaction between students and residents training in Surgery. The Foundation was started in 1996, and has provided many of the AWS members ways to heighten their visibility and created advancement opportunities. The Foundation and its board have been and continue to be the “mentor” organization for the AWS.

What is mentor? What is mentorship? And why is this important? A mentor is defined as a “wise and trusted teacher, an influential sponsor or supporter”. Many of us during our careers have benefited from people who have taught us, encouraged us and supported us during specific or all phases of our careers. Mentors are often responsible for bringing Surgery to our attention when we are students. They are also responsible for teaching trainees, especially in Surgery, those lessons that are not described in a text or journal article- lessons in such things as rules of surgical culture, compassion, professionalism, communication skills, and ethics.   They also knowingly or unknowingly teach us about personal matters, and self-preservation or lack thereof. Mentors are responsible for teaching us, often lessons that are transferred across generations.

"Mentoring is to support and encourage people to manage their own learning in order that they may maximize their potential, develop their skills, improve their performance and become the person they want to be." Eric Parsloe, the Oxford School of Coaching & Mentoring

There are many ways to mentor- formally via programs in your institution or via society programs such as the American College of Surgeons, or informally, by establishing a relationship to support a trainee or trainees in professional or educational matters. Mentorship relationships can involve formally assigning a faculty member to a trainee, and setting up a schedule for meetings, for adequate time to discuss issues. As for the trainee, there are many themes in a mentor-mentee relationship. These can include issues of the mentor being the professional role model, being compassionate and supportive, acting as a critic or a career counselor. Mentees often need specific goals for their relationships with mentors and they need to appreciate that their goals and expectations must be kept in the context of their training program and their expected level of professional performance.
There are many difficulties in establishing a successful mentor and mentee relationship. The most prevalent barrier to this relationship is lack of time. Mentors are often overcommitted with busy clinical or academic schedules, and trainees have their own time limitations with training hour restrictions and mandatory lectures and labs. Scheduling time in advance and scheduling those meetings at regular intervals can help make these meetings a priority for everyone involved. Secondly, there are often a limited number of faculty members who are interested or qualified to be a mentor. In the current era of declining re-imbursements and lack of funding for educational activities, faculty members are pressured to produce clinically and academically, limiting their time for non-reimbursed or credited activities. Similarly, issues of different generational priorities, gender and cultural differences in the available mentors can adversely affect the establishment of the relationships between the trainee and the mentor. While more and more women, gay and lesbians as well as international trainees are currently training in surgery, the diversity of the academic faculty has not kept up with the diversity of the training population. It is imperative that available mentors are sensitive to issues in the diverse population of trainees that are different than their own, and that issues are evolving over time to ensure that any mentor can have a mentorship relationship with any trainee. Often, it is not one person that is a mentor to a developing surgeon but a group of people over years, that train, influence and support the trainee. It does take a village to raise a child, and I would argue a well-trained surgeon as well.

As an example, for many years, early in my career, I was one of the only women I knew, interested and eventually training in Surgery. Women in Surgery were few and far between in the Southern part of the United States at that time. During my third year medical student rotation, I happened to be on service with teams of all male residents, and all male attendings. I spent a lot of time with several individuals that were professional role models for me including Chuck Harr, MD, Curt Mosteller, MD and Gary Craddock, MD. There was one woman trainee when I was student- Ginger Chiantella, MD and I thought she was marvelous. There were more over time including Catherine Share, MD who had a great influence on me as well.  I also started a life-long friendship with one of the Surgical Attendings, Dr. Jesse Meredith, the “old dad”. When I was student, I would often round with “Old dad” at night, where he would tell me stories, and teach me about what was important to Surgeons- patients ( “who always come first”), compassion (“you can never have enough”), integrity and work ethic. When I was a fourth year student, I did not match in Surgery for post graduate training out of medical school mostly due to my own lack of insight into how the system worked at that time, but also due in part to the attitudes of the program directors and some of the surgeons I interviewed with. I often heard in interviews that as a woman, I did not have the “stamina to train “as a surgeon. I was also accused by some of trying to “take a man’s position”. Despite, the disappointing turn of events, I eventually found my way to Boston to train with the help of many faculty along the way including the Dean of Students at Wake Forest, Patricia Adams, MD who at the time was a transplant nephrologist who would go on to become the first woman President of the United Network of Organ Sharing, a Pediatric cardiac surgeon at West Virginia University, Robert Gustafson, MD and of course, Dr. Meredith. I have never forgotten their support and frankly, their ability to judge my performance not my gender. Training in Boston opened many doors for me with the help of all of the Surgical Faculty at The Children’s Hospital of Boston (especially Drs. Hardy Hendren, Jay Schnitzler, Jay Wilson, and Bob Shamburger). Drs. Al Bothe and Glenn Steele gave me a chance to train at the Deaconess and Dr. Roger Jenkins told me I could do anything I wanted to but to try transplant. It was Dixie Mills, MD that reminded me that there are still issues for women in Surgery, and Susan Pories, MD who taught me a lot about grace under pressure.

As I have progressed over my career, I have had many challenges, and while there has been a significant increase in the number of women training in Surgery, the number of senior women in Surgery in leadership positions academically has not kept pace for many reasons. At the completion of my training in Boston, I eventually completed a Transplant Surgery fellowship at Duke University Medical Center. I was the first woman fellow in Surgery at Duke, and the first woman attending in General Surgery to be pregnant and have children. Without the support of my chairman Dr. Robert Anderson and my Division Chief and friend, R Randall Bollinger, MD it would have been impossible for me to continue my career and have my children. My mentor and fellowship director, Dr. Pierre A. Clavien, now Professor and Chief of the Department of Surgery in Zurich Switzerland, taught me many things clinically, as well as teaching me how to be academically productive and know “how” to support and mentor junior faculty.  

I never had a formal relationship with any agendas working with these people who were and are my mentors, but I learned by listening and watching, occasionally asking for guidance and support. I still call the “old dad” often who is now 90 to discuss issues of management and development as he has more common sense than anyone I know. As for mentors in how to progress in academic rank, time management and my career, I have the members of the AWS to thank for that guidance and support. Without the support of past and present members of the council, the Foundation Board and the management personnel, I would never have known how to write a real CV, a letter of recommendation, a division chief and chairman prospectus, a budget and many other things. Thank you Drs. Ephgrave, Hooks, Numann, Walsh, Scott, Bergen, Cochrane, Sanfey, Dunn, Nuemeyer, Gantt and so many others. I have had the opportunity to be supported and work with so many wonderful mentors. How do I honor them? By being a mentor myself. I have tried as I have risen through the academic ranks, to support, encourage, and train women with a focus on teaching clinical care, and precise operative skill. I have a list of trainees with whom I feel particularly close on my CV and who I have advised and promoted during my career. I now find myself the only woman Division Chief at my institution and have been a woman chair. In order to honor our mentors, we must work tirelessly to make sure no matter where we are, that there are the basics for equitable treatment (ex: a maternity leave policy and paternity policy), and performance based assessment for every trainee. We as more senior members, need to take advantage of our seniority and position to often place ourselves “in the line of fire” to demand justice and fairness for all of trainees and junior faculty- if the need arises. We need to be the mentors that some of us didn’t have and give out career advice and support, and make phone calls to ensure that the all of our trainees, but especially the women, have access and opportunities to train at the best places they can train. Times are changing and it is a great time to be a surgeon. We are all beneficiaries of the people who have supported us and trained us over our lifetimes, and we can honor them by being mentors to our cadre of students. I would encourage all of our members to honor their mentors with a donation to the foundation, so that the AWS can continue what we do to support all of us. This is their year !

My favorite “old dad” story:

Dr. Jesse H. Meredith is currently Professor of Surgery, Emeritus at Wake Forest University. He was a pioneer in many aspects of surgery including portal hypertension surgery, renal transplantation, reattaching severed limbs and the formation of Critical Care Units. He won the AMA’s distinguished service award in 2011 for his meritorious service in the science and art of Medicine and the Order of the Long leaf Pine in 2010, from then Governor of North Carolina Beverly Purdue. However, he is originally from Fancy Gap Virginia, plays a great fiddle and speaks with the native tongue of the South. He is a man of few words but when he speaks, everyone listens. When I was a third year medical student, I was rotating on trauma surgery of which Dr. Meredith attended. Being my first rotation, and being extremely uncomfortable and not knowing how to actually “do” anything, I would stand as close to the wall in the trauma bay when our team had a trauma patient, hoping no one would notice me and I could watch but not be in the way. One night, a young man came to the ED with a stab wound to the chest and was rolled in the trauma room in full arrest. There was a flurry of activity and everyone seemed to be moving at once, drawing blood, giving blood, examining the patient, achieving IV access. It was a hive of activity. Finally, the chief resident called out that there was a stab wound over the left nipple and he was going to open the chest. The chest tray was opened, calm came across the room and the incision was made, the retractor placed and the pericardium opened. A large hemopericardium was released with some improvement in the patient’s hemodynamics;  however a small laceration was noted in the right ventricle that started spurting blood over the patient and the tray. It seemed like time stood still, with everyone watching the blood spurt when a gloved hand came through the back of the crowd, and a long gloved finger plugged the hole in the heart. Suddenly you heard the “old dad” say “well.., y’all know what to do now don’t cha…..” and off they went to the OR in a rush. He had appeared as if he were out of nowhere to solve the issue and save the patient. I do not remember to this day if anyone called him, he just knew when he was needed and he showed up. 


Do you have a story to share about your mentor? Email us at or tweet us @womensurgeons and #HonorYourMentor. 

Or make a donation to the AWS Foundation to #HonorYourMentor today. 

2014 AWS Conference

The annual Association of Women Surgeons Fall Conference was held at the stately Westin St. Francis in San Francisco, California on Sunday, October 26. The 2014 theme was “Transitions: Thriving Amidst Change.” The conference was attended by 124 people, 33 of which were medical students and residents. Presentations were interspersed by opportunities for networking with other attendees and corporate partners.

Celeste Hollands, MD and Lois Killewich, MD moderated the Sunrise Scientific Session. Five abstracts of excellence were presented from among those manuscripts accepted for publication in the American Journal of Surgery:
  • Hillary Braun, MD “Perceptions of Surgeons: Women Surgeons Prefer Female and Communal Surgeons”
  • Courtney Collins, MD “Effect of Pre-Injury Warfarin Use on Outcomes after Head Trauma in Medicare Beneficiaries”
  • Amy Liepert, MD “Protecting trauma patients from duplicated CT scans: the relevance of integrated care systems”
  • Lisa McElroy, MD “A Meta-Analysis of Complications following Deceased Donor Liver Transplant”
  • Betsy Tuttle-Newhall, MD “Prognostic impact of mechanical ventilation after liver transplantation: A national database study” 
Ethicon has supported our Grant program since 1996 – enabling us to award over half a million dollars in research grants to AWS members. Heather Yeo, MD, the 2014 AWS Foundation/Ethicon Endo-Surgery Fellowship winner presented her study: “Clinical trial on the efficacy of sacral neuromodulation (SNM) with Interstim for fecal incontinence following surgery for low rectal cancer with sphincter preservation”.

Simultaneously, the 20 residents and medical students whose posters had been accepted for the 2014 STARR poster competition were being judged. The volunteer judges had a difficult assignment however eventually chose exemplary winners. The overall winner in the resident category was Dr. Fariha Sheikh for her poster entitled “Anesthesia Induced Neurotoxicity” and the overall winner in the medical student category was Martha Henderson from Emory for “Gender Differences in the Correlation of Objective and Subjective Assessments of Surgical Frailty.”

The keynote presentation of the conference was graciously provided by Nancy Ascher MD, FACS, the Professor and Chair, Department of Surgery Division of Transplant Surgery Isis Distinguished Professor in Transplantation, Leon Goldman, MD, Distinguished Professor in Surgery, University of California, San Francisco. Dr. Ascher has devoted her career to organ transplants and transplant research and has had a distinguished career of public service that includes appointments to the Presidential Task Force on Organ Transplantation and the Surgeon General's Task Force on Increasing Donor Organs. She also served as Chair of the Advisory Committee on Organ Transplantation for the Secretary of Health and Human Services from 2001 - 2005. She was also the 2007 AWS Nina Starr Braunwald Award recipient. Dr. Ascher’s presentation focused on women in leadership roles in surgery. She described the influential role artistic works in Detroit had on her while growing up, statistics of women in all leadership roles and the work yet to be done to achieve position and pay parity for women in surgery. She discussed the roadblocks to success-patients, employers and ourselves. Evaluation of our performance can be stilted due to the “abrasiveness trap”: high-achieving men and women are described differently in reviews. How we are perceived matters, and issues of family concerns, pregnancy and work-life balance need attention at every level of training. View Dr. Ascher's presentation here

Attendees next heard “The Changing Face of US Healthcare: How to Optimize Your Career” presented by Patrick Bailey, MD, Medical Director for Advocacy, American College of Surgeons. An Arkansas native, Dr. Bailey is Chief of Pediatric Surgery at Maricopa Medical Center in Phoenix, AZ. He is completing work towards a Master of Legal Studies degree at Arizona State University’s Sandra Day O’Connor College of Law and is a Captain in the U.S. Navy Reserve. Dr. Bailey’s presentation focused on several topics of interest to the practicing surgeon. He discussed the implementation of regulations under the ACA, funding proposals for GME and the important role of advocacy in ensuring patient access to quality care. Dr. Bailey inspired many attendees to pay attention when opportunities for their expertise arise.

As a surgeon, balancing personal and professional demands while maintaining some semblance of personal wellness can seem impossible. The next speaker, Dr. Carol Scott–Conner MD, PhD, MBA, Professor of Surgery, University of Iowa Carver College of Medicine is armed with a wealth of both personal experience and unique insight into success as a female surgeon.  Dr. Scott-Connor, whose clinical focus is Surgical Oncology and Endocrine surgery, is the consummate surgical educator, the author of innumerable papers and texts and the recipient of many awards. She was named a “local Legend” by the National Library of Medicine and will be awarded the Honored Member Award from the American Association of Clinical Anatomists (AACA) in June 2015. In her spare time she serves as a Governor of the ACS. 

Dr. Scott-Connor’s inspiring and grounding presentation “The Challenge: Transition to a Healthier You” focused on the oft-neglected areas that require attention in order for women to be personally successful and enjoy it! She discussed organizational skills, ergonomics, mindfulness, exercise, companionship, reflective writing, burn-out and many other topics. Her addition of personal anecdotes gently drove home her bottom line- that many areas of our lives need tending if we are to be healthy. View Dr. Scott-Conner's presentation here

The final formal presentation of the morning was by Janet Bickel, MA a nationally recognized expert in faculty, career and leadership development with 40 years of experience in academic medicine and science.  In addition to a wide-range of individual coaching clients, organizational clients have included United American Nurses, US Department of Commerce, and US Department of Health and Human Services. She is an Adjunct Assistant Professor of Medical Education at George Washington University School of Medicine and has also taught Leadership and Innovation at the CIA and the National Reconnaissance Office. During the Executive Leadership in Academic Medicine [ELAM] Fellowship Program's first 15 years, she served on its Advisory and Selection Committees; among her many other roles she continues to serve as faculty and is a Principal Member of its Executive Development Council. AWS recognized her contributions and support of the goals of AWS by awarding her the AWS Honorary Member Award in 1992. 

Janet’s presentation "Transitions and Resilience: Growing and Thriving throughout your life and career" focused on how women professionals are inequitably evaluated, the challenge of balancing short-term benefit with long-term satisfaction, success traps and important decision criteria for taking on something new.  Multiple small group breakout sessions inspired discussion about the challenges facing women professionals as they advance through their careers. Issues discussed included: How aligned are your professional goals with your current roles and your vision of “success”? How do you effectively communicate your goals and accomplishments in a 30-second “elevator speech”? How can you increase your influence in ways important to you? What is standing in your way? What interferes with adaptability? How can you become more agile?

Janet emphasized preparing for success, transitioning, sustaining success, and then transitioning again all the while interweaving self-efficacy, political savvy, personal/professional growth and “communities of practice”. She emphasized that attendees needed to identify what resilience-promoting practice they were willing to commit to-and what supports were needed for this to work. View Ms. Bickel's presentation here. 

After the AWS Business Luncheon, including election of 2014-2015 AWS officers, attendees reconvened in the Ballroom for directed networking sessions. Table topics included:
  • Financial management: Meredith Duke, MD
  • Work-Life Balance: Joyce Majure, MD and Lauren Paton, MD
  • Private Practice: Yvette LaClaustra, MD and Shirin Towfigh, MD
  • Alternate Career Pathways: Liz Robertson, MD
  • Family Planning: Sharon Stein, MD and Stephanie Bonne, MD
  • Social Media: Erin Gilbert, MD
  • Contract Negotiation: Jennifer Rosen, MD
  • Mentorship: Emina Huang, MD and Nancy Gantt, MD
Discussion and networking at each table was lively-the session moderators found that once settled none of the attendees wanted to move!

Overall the 2014 AWS conference was fun, informative and provided attendees with valuable skills to achieve personal and professional success. Please join us in Chicago for our 2015 Fall Conference on Saturday October 3, 2015.

Respectfully submitted by Nancy L. Gantt, MD FACS