Twitter 101: How to set up a professional Twitter account

by Heather Logghe, M.D.

Since starting my own personal Twitter account, I have mentored numerous peers and faculty on how to get started. I’ve noticed that most surgeons have similar questions and concerns. Below I have detailed the most common questions along with my answers.

Twitter? Isn’t that just a bunch of people talking about what they ate for breakfast? Think again. Twitter is about who you follow. Sure, you can choose to follow celebrities and people who tweet pictures of the donuts they eat for breakfast, but the beauty of Twitter is that you don’t have to. Think of Twitter as millions of people talking at once, and by choosing who you follow, you choose who you want to “listen” to. As an aspiring surgeon, I choose to follow surgical societies, surgical journals, and leading surgeons--literally from all over the world. Through Twitter, I learn about upcoming events, the latest research, and the opinions of surgeons I look up to. I also follow influential non-surgeon physicians and patients who are effecting positive change in medicine. None of the “tweeps” I follow mention what they eat for breakfast. (Well, most of the time anyway.)

But I’m not even on Facebook! Don’t be fooled by the misguided logic that if you didn’t take to Facebook, you’re not going to like Twitter. Twitter actually has a very different flavor and utility. Rather than a purely social network (like Facebook), think of Twitter as more of a “subject” network, where users share information and access it based on common interest. You can take advantage of this endless wealth of information, whether or not you are “friends” with those you are following.

Does Twitter substitute for real, live, face-to-face interaction? No, however it often leads to it. On multiple occasions I have met surgeons and medical students via Twitter whom I then chose to meet in person. Not only did Twitter provide me with these professional connections I would not have otherwise had, it also gave us a common ground to start from, enabling a solid introduction before even meeting. This really allowed us to hit the ground running.

Do I really have to join Twitter to stay “on top” of the field of surgery? Of course not, but you may be missing out on a powerful way to connect with your colleagues and learn from others both inside and outside of medicine.

That sounds nice, but I’m afraid I don’t have the time. I’m not going to tell you that Twitter doesn’t take time. As a surgeon, you know that most endeavors that are worthwhile do have a learning curve and do take time. However you do not have to become a Twitter expert overnight. Tread slowly but confidently. I will lay out some basic steps to get you started.
 
     1. Open a Twitter account at www.Twitter.com. All you need is an email address.

     2. Set up your profile. For your Twitter handle (that “@thing”), I recommend choosing something as close to your real name as possible. Try @FirstLastMD or @DrFirstLast or any variation thereof.


Do I have to log in everyday? Definitely not. Twitter is not something that you have to “keep up” with. You do not need to read every tweet. I repeat: You do not need to read every tweet. It’s like the news. It’s interesting when you feel like tuning into it, but it’s fine if you don’t as well. I like to log into Twitter with a cup of tea. Others might sneak a peek at their Twitter feed while waiting between cases or in line at the grocery store.

I’m not sure I want to use my real name, isn’t it better to be anonymous? No. The days of maintaining an anonymous internet presence are over. Besides, you will only be posting professional tweets, and it’s important you get proper credit for your effort and contributions. Think of it this way--would you attend a conference and introduce yourself as someone else? Would you tell them a fake name just in case you said something silly and didn’t want anyone to remember you? Of course not. Consider your Twitter account an extension of your professional persona. You want it to represent you in a meaningful, memorable way. 

     3. Use a real photo of yourself for your avatar (profile pic).

Can’t I use an image of a scalpel or a picture of my kids or dog? Going back to the conference analogy, picture yourself at a conference with a bag or mask over your head--kind of creepy right? You probably wouldn’t expect people to trust you or take you seriously. The same goes for Twitter. Post a real picture of yourself.

     4. Write your Twitter profile bio, in 160 characters or fewer.

My whole bio in 160 characters? Don’t stress too much about this. The important thing is to put something. You can always edit it later. For ideas, I suggest looking at the bios of other surgeons on Twitter. With the character limit, it will be slightly informal. Add your clinical interests and feel free to include something slightly personal to add character, such as you enjoy cooking or play a mean game of tennis. The goal is professional but personable.

You are now ready to confidently enter the Twitterverse. (Yes, there is a “Twitterese” version of nearly every word in the English language...)

     5. Choose some accounts to follow.

How do I choose who to follow? I recommend following liberally, as it only takes one click to unfollow someone if you do not enjoy their tweets.

For starters, I recommend following the American College of Surgeons: @AmCollSurgeons; the Association of Women Surgeons: @WomenSurgeons; and Mary L. Brandt, MD: @drmlb. Dr. Brandt is a prolific tweeter and an excellent professional example. For general medical commentary you can start by following Kevin Pho, MD: @KevinMD. Through Twitter.com you can also search for the various surgical societies of which you are a member, as well as your own academic or medical institutions.

One simple way to find surgeons on Twitter is to check out the list I have created of over 100 surgeons and surgery-related Twitter accounts. From Twitter.com, you can search “@LoggheMD” and go to my profile page. From there, click on “Lists” on the left and then “Surgery” and “List Members.” You will be presented with numerous surgeons and surgical societies. Simply click “follow” to follow those you find interesting. You will now see their tweets when you log into Twitter.

Finally, I recommend that everyone follow @TweetSmarter. They are an excellent resource for learning the unique etiquette of the Twitterverse. If you read one of their linked articles from time to time, you will become a Twitter expert in no time.

What happens when I follow someone? Do they know I’m following them? When you follow someone, they receive an email notice and have the option to click on your profile and decide whether they want to follow you back. Thus you want to maintain a professional image from the first day you sign up for Twitter.

If I receive an email that someone is following me, is it polite to follow them back? You are never obligated to follow someone back. This is the beauty of Twitter. You choose who you read and learn from. When you receive an email notice that someone is following you, I recommend clicking on their profile link. Often, you can determine whether or not you want to follow them from reading their 160-character bio. If you really want to be thorough, you can also look at their Tweets and see if their tweet content is of interest to you.

Ok. I have a profile, and I’m following a few people--now what? I recommend laying low for a bit. Spend some time skimming your Twitter feed and reading the links that look interesting. There are many unwritten rules to Twitter and it takes some time to understand how it works and how people interact.

I’m nervous about tweeting. Don’t stress about your first tweet. It’s like making an incision--hesitation suggests lack of confidence and clarity. Jump into the conversation. For your first tweet, you can try something like, "Excited to enter the Twitterverse! Eager to learn and share with fellow surgeons and beyond.” This makes it clear that you are joining Twitter to learn and be part of the conversation. This will make other Twitter users more interested in following you.

What if I don’t have anything to say? Don’t worry about having something novel or witty to say. One of the strengths of Twitter is that it fosters sharing of ideas and information. If you are reading an interesting online article and you see the option to tweet it, go for it! If you found it interesting, it’s likely that your followers will as well. Also, for many people, the majority of their tweets early on consist of “retweets.” If you like something someone else shared, retweet it!

Ok. This gives me a basic start, but I know I’m going to have lots of questions. You’re absolutely right. I recommend that everyone find a designated “twentor.” Yes, that’s a twitter mentor. This will likely be someone younger than you, though not necessarily. Find someone you feel comfortable checking in with from time-to-time with your Twitter questions. Ideally, this person will also follow your tweets and can even give you feedback via direct messages (private tweets).

What about the different kind of tweets, and what are those #hashtag things? My next post will detail some of the various types of tweets and how to get started tweeting and engaging other surgeons. In the meantime, I hope you explore the rich links in your Twitter feed. Don’t be afraid to click on the profiles of those who look interesting. You never know who you will meet!

This post was originally published in AWS Connections and on Dr. Logghe's blog, Allies for Health.

~~~

Heather Logghe, M.D. is a general surgery resident at the University of North Carolina. She graduated with her M.D. from the University of California, San Francisco. She has worked on various projects at the intersection of medicine and technology in Silicon Valley and is a tireless advocate for health equity. She blogs and tweets. 

10 Steps to a Successful Residency Interview

by Allison Hoyle, D.O.

Fall is the exciting time in our medical education during which our residency interviews begin. It is important to be prepared for what is to come, as these interviews are different from any you may have ever had before. Here are some tips to help you succeed when you meet your potential future colleagues and mentors!

1. Arrive Early. As you probably know by now, hospital parking can be complicated and with all the additions and renovations hospitals often undergo, it can only work in your favor to arrive at least 15-20 minutes before your scheduled time.

2. Dress to impress! In 2011, Dr. Karen Pine of the Department of Psychology at the University of Hertfordshire conducted research which showed that women wearing skirts are perceived as more successful. If you choose to wear a skirt, however, be sure it is no shorter than 2” above the knee. All in all, wear something flattering that makes you feel comfortable and look professional. Comfortable, professional shoes are also a must. You never know if you will be in a skills lab, a staged patient encounter, or walking the entire hospital!

3. Practice with a friend. You will be asked many questions by your interviewers. They will want to know more about who you are and what your goals in life are. Be prepared to talk about your medical school experience, specific cases you enjoyed, challenging situations, and even your personal life. Here is an excellent resource with sample questions: http://www.med.unc.edu/ome/studentaffairs/residency-and-the-match/files/MedicalResidencyInterviewQuestions.pdf

4. Make a list of questions for your interviewers. For example, “What research opportunities are available?” “Is there a formal didactic curriculum?” “How are residents evaluated?” “What kind of electives are available and how many are there?” “Where do graduates go for fellowship?”

5. Research. Know whom you will be speaking to. Read about the hospital and the program beforehand. As we learned with our clinical rotations, the more you know, the better able you will be to ask thoughtful questions and the more you will get out of your time with those you will meet.

6. Bring a copy of your curriculum vitae, journal articles which you have written, and contact information of your references. Be prepared to discuss your accomplishments as well as any setbacks you may have had, and how you have learned from them.

7. Get plenty of rest the night before, and eat a balanced breakfast before heading out. These interviews can run very long. You will want to keep up your stamina!

8. Take off your watch, turn off your cell phone. Nothing is more important than your interview, so try to minimize the chance that you might offend your interviewer with buzzing, beeping, and glancing at your watch or phone.

9. Smile, Relax, and Be Yourself! Your future colleagues are searching for someone with whom they will be spending a lot of time.

10. Handshake. A firm, confident handshake says a lot about you and makes others feel more comfortable. If you have not yet mastered this technique or if you are not sure, practice with your friends and ask for their honest feedback.

Remember, your fellow residents and mentors will be spending a lot of time with you once you are hired, so they are trying to find someone who fits in well with their group. Likewise, you will be spending a lot of time with them, so you will want to choose a program with people you wish to learn from and residents you enjoy being around. At the end of the day, you are essentially choosing your second family and the program which will shape you into the physician that you will become. This is a very exciting time and I wish you all the best of luck with your interviews and with the match!

~~~

Allison Hoyle, D.O. is a recent graduate of the New York Institute of Technology - College of Osteopathic Medicine. She was a professional pianist living in midtown Manhattan when she decided to return to school to study medicine. While volunteering at St. Luke's-Roosevelt Hospital in New York, NY as a pre-med, Allison discovered her love of surgery. Seven years after observing her first laparoscopic procedure, she was scrubbed in and learning from surgeons at Jersey City Medical Center during what she described as the most exciting time of her life. She was class representative of her school's surgery club, SOSA, during her first year of medical school, and a member of AWS's first ever Student Committee in 2011. Allison has lectured at high schools and colleges in New York and New Jersey about her experiences as a medical student and has been interviewed by NPR and ScienceHouse.com. In her spare time, she enjoys riding and restoring vintage Italian motorscooters, Astronomy, and playing the piano. Allison is in the midst of her residency application process for the 2014 Match. 

I’m going to a BIG professional meeting…now what?!?

by Amalia Cochran, MD, MA, FACS, FCCM

Your first professional meeting, even if it’s a relatively small meeting, is both exhilarating and scary. What are the norms for the group? What do I need to wear? Who do I need to meet-- and who do I need to avoid? Clearly it’s an important opportunity to make an early impression on people who can really impact the rest of your career, and you want to do it right. It’s also a chance to maximize your learning in a unique environment. Here are a few “pro tips” to help you out.

• If you have a trusted senior resident or faculty member who have been to the same meeting before, ask them what sessions might be most important for you to attend. Also-- and this is a “learn from my mistakes” tidbit-- ask about attire for ALL parts of the meeting. I went to the AAST as a senior resident and had no idea that the big dinner was VERY fancy. I ended up passing on the potential networking opportunity and had room service for dinner since I had not packed appropriately.
• Between the advice that you receive and looking for things you are interested in, go into the meeting with a plan. Identify the sessions you want to attend in advance, then use the meeting app (or plain old paper!) to keep track of where you want to be.
• If someone you know will be at the meeting with you, ask them to introduce you to people you need to know. This is an important part of networking when you are a newbie in an organization, and it’s a great way to get connected quickly.
• Should you ask that question or not? If it’s a question you are truly curious about and that is relevant to what has been presented, go for it. Please remember the ground rules: Use the microphone, introduce who you are and where you are from. Over time you’ll get to see people asking questions that seem to be simply an opportunity for them to pontificate-- don’t be “that woman.”
• Mingle, mingle, mingle. Those who know I’m an introvert are laughing as they read that because they know how hard it is for me. The good news is that, as an introvert, I can ask a couple of well-placed questions about someone’s work or interests then just sit back and listen. Please go up to people after sessions and ask them about their work if it was something that piqued your interest. And if you see someone who is a leader in the organization, PLEASE don’t be intimidated and think, “They’re too busy and too important.” Most of us in leadership roles are eager to meet new members-- you are our future!
• Be prepared with an elevator speech. You want to be able to give anyone who asks a succinct response to what you’re working on at any given time. What’s exciting you in your research? That’s always a great place to start.
• If you’re attending a meeting of an organization that will be part of your career in the long term, see if there’s a way to get more involved. Some organizations have open committee structures (the AWS is one!); others are always looking for project volunteers. If you show up and fulfill your responsibilities, it’s a wonderful way to become a leader over time and to get to know some truly terrific people. Remember, though, that over-committing and not getting the work done also earns you a reputation, and it’s not one that you want to have.
• Wear comfortable shoes. For some of you who are younger and biomechanically better suited than I am, a long day of walking around in 3-inch heels is nothing. I personally am a big fan of Cole-Haan, AGL, Thierry Rabotin, Ron White, and Anyi Lu for their fun flats and low heels. All let me be fashionable without being miserable.
• Last, but not least-- Have Fun! While meetings at this stage of my career almost invariably have some work attached to them, I always come home rejuvenated and recommitted to the work that I am doing. It’s amazing how seeing your friends from other institutions can help you remember that you’re not in this alone and that your work really does make a difference.

Readers who have been to meetings before, what piece of advice would you offer to a newbie? What do you wish someone had told YOU before your first professional meeting?

~~~

Dr. Amalia Cochran is Associate Professor of Surgery at the University of Utah. She is heavily involved in undergraduate medical education, serving as the Surgery Clerkship Director and the Director for the Applied Anatomy track for 4th year medical students at the University of Utah. Her research interests lie in surgical education and in clinical outcomes in burns. She is completing her term as the Secretary for the Association of Women Surgeons. Follow her on Twitter.

Lean In: Book Review & Discussion (Part Three)

 by Sophia Kim McKinley, Callie Thompson, MD, and Minerva Romero Arenas, MD, MPH

Chapter 8: Make your partner a real partner (Callie)

By nature, women are charged with carrying the child, birthing the child, and feeding the child (if one so chooses), resulting in an uneven distribution of work between a couple from conception. This chapter discusses some of the author’s personal struggles with being a new parent and the division of labor and responsibility in her relationship. Data show that in heterosexual couples, when both work outside the home, the women does 30-40% more of the childcare and housework, and as recently as 2009, only 9% of dual-earner marriages said they split the work evenly.

As a surgeon, I would suggest that this needs to be acknowledged and discussed prior to starting a family with a spouse/significant other. When a couple is discussing having children, there can be a lot of debate and negotiations about the vision for that child with regard to religion, discipline, schooling, extracurricular activities, and on and on. One thing should not be a negotiation; both parents must contribute equally to the care and development of the child, and if that is not okay with your partner, I strongly suggest reconsidering him for that role. This does not mean that each task needs to be done by each parent equally, just that the division of labor overall needs to be as close to 50/50 as possible. If you feed the child, your partner can bathe the child, and if you clean the dishes after dinner, your partner can vacuum the floor, etc . . . .

If that was it, things would be easy, but you also have to deal with society. You have to realize that society is going to set out to make your male partner feel emasculated because he is sharing household and child-rearing tasks with you. Believe it or not, even in 2013, men are still harassed for staying at home with their kids. Lighthearted comments and snide remarks can be hurtful to our male partners. The easiest way to counteract those actions is to let them know how appreciated they are, not because they are doing things FOR you but because they are doing them WITH you. Society will also try to make you feel badly for working outside of the home. People will tell you how wonderful it is or how lucky you are that your husband “watches” your kids for you. When this takes place, you should feel free to inform these people that the father of your children is fathering them. Nothing more, nothing less. But overall, my best advice is to ignore, ignore, ignore. If it works for you and your family, the rest does not really matter.

Do you have a family? Is your partner in medicine or surgery? Are couples in similar fields more likely to succeed or fail?

Chapter 9: The myth of doing it all (Callie)

In this chapter, “having it all” is called “the greatest trap ever set for women,” “antiquated rhetoric,” “a myth,” and a “recipe for disappointment.” I think we can all agree that this phrase should leave the vocabulary of our society and never return. Sandberg quotes some amazing women in this chapter: Gloria Steinem, Nora Ephron, Tina Fey. All of it is to say that being a working parent is hard work, and it doesn’t always (read: almost never) go according to plan, but the best way to manage is to cut yourself some slack, be willing to compromise, be honest with yourself about your own goals/desires, and be willing to change the plan. Admittedly, some of these things are much easier to do in other lines of work and at different points in our surgical careers. For instance, it would be great to be able to work the hours that worked best for my family, but those aren’t the hours that are best for my patients, my attendings, my co-residents, or my hospital system, so as a resident, I work the hours I work, and when it comes time to choose a job, I may want to take that into consideration in my choice.

Another important point is that we need to manage our guilt. This is a hard one because, no matter how many times you hear people say that your kid(s) will be okay even though you don’t stay home with them, the one time someone insinuates the opposite, it will stick with you and that one thought can fester and cause a lot of damage to your psyche. However, as lovers of science and evidence-based practice, we should rely on the data. As the author points out, data show that kids who are cared for by their mom vs. those also cared for by others develop the same, build the same relationships, and still bond with their moms. Also, having an involved dad, a mom who gives you independence, and parents with emotional intimacy are much more influential on a child’s development than having their mom care for them exclusively.

Full disclosure: despite this data, I still feel guilty quite frequently. I was irrationally crushed just last week when we missed my son’s 12 -month check-up because my husband and I both forgot. Other than reminding myself that the kid is fine, the appointment was rescheduled, and nothing bad actually happened because of this. Conclusion? I do not have a good solution to these thoughts.

How do you “do it all?” Is it really a myth?

Chapter 10: Let’s Start Talking About It (Sophia)

Sandberg encourages a conversation about the influence of gender in the workplace—the whole point of her book is to start talking about it. I’ve heard from more senior women in surgery that the attitude in the past has been one of “play along to get along.” That is, you don’t bring up the fact that you are a woman because you don’t want to bring any more attention to your obvious minority identity. While “play along to get along” may be useful for an individual to minimize any associated penalty for being a woman, Sandberg would challenge this strategy as one that would win in the long run. She encourages naming hidden biases and the micro-aggressions against women as a way to move forward toward gender equality.

Once, when I told a faculty member that I was going into general surgery, the first thing she said was “Are you planning on having children?” I highly doubt she would have asked the same question to a male medical student, which means that my gender was a strong determinant in her attitude toward my chosen career. I shared her comments with other faculty as a way to shed light on the ways in which women who pursue surgery continue to be treated differently, even by other women. Knowing precisely how and when to raise the topic of gender requires thoughtfulness and discretion, but I am hoping that forums such as the AWS Blog will continue the conversation about gender and surgery in a way that is rigorous yet respectful.

Have you encountered gender discrimination in or out of surgery? How have you addressed it? 

Chapter 11: Working together towards equality (Callie)

“Today, despite all of the gains we have made, neither men nor women have real choice. Until women have supportive employers and colleagues as well as partners who share family responsibilities, they don’t have real choice.” This is where the AWS and each of us at our institutions across the country can make a big impact. We can be those colleagues and mentors. We can encourage our fellow women surgeons to make their partners real partners. We can speak out when we see or hear a male medical student or resident praised for their outgoing spirit while a female who behaves the same is chastised for her aggressiveness. If we do not point out the inequities of such thoughts and perceptions, they will never end.

As Deborah Gruenfeld is quoted to have said, “Working together, we are fifty percent of the population and therefore have real power.”

How can we move toward equality? How can we engage the men in these initiatives?

Let’s Keep Talking

We have truly enjoyed reading and discussing our thoughts on this book and the parallels drawn in the surgical world. Please join our discussion below and share your input on how we can improve personally, as a discipline, and as leaders.

Part One of the discussion can be found here. Part Two, here.

~~~  

Sophia Kim McKinley is a dual-degree M.D./Ed.M. student at Harvard Medical School and the Harvard Graduate School of Education. She received the 2012 Association of Women Surgeons Patricia Numann Medical Student Award and spent a year as a Zuckerman fellow at the Center for Public Leadership at Harvard Kennedy School. Sophia is passionate about medical education and she hopes to be an academic surgeon who brings educationally-sound innovations to surgical training. Her clinical interests are gastrointestinal and minimally invasive surgery. Sophia will be applying for general surgery residency during the 2014 Match cycle.  

Dr. Callie Thompson is a resident in general surgery at the University of Washington. She recently completed a two year research fellowship and is now in her fourth clinical year. Callie aspires to be a burn and trauma surgeon and a translational scientist. Her research interests include genetic variations and their associations with the development and outcomes of disease and illness. Callie is married to an internist and has three children under the age of 7.

Dr. Minerva Romero Arenas is a general surgery resident at Sinai Hospital of Baltimore and is completing a research fellowship at The University of Texas MD Anderson Cancer Center in Houston, TX. She obtained her MD and MPH from The University of Arizona, and studied Cellular Biology & French at Arizona State University. She is also involved in mentoring and public policy. On her personal time she enjoys spending time with friends and family, especially when it involves good food.

 

Lean In: Book Review & Discussion (Part Two)

by Sophia Kim McKinley, Callie Thompson, MD, and Minerva Romero Arenas, MD, MPH

Chapter 4: It’s a Jungle Gym, not a Ladder (Sophia)

Sandberg reveals that she did not have a master plan at the outset or her career. Instead, she took opportunities as they arose or created her own opportunities. Again, business is a different context than surgery, in which the progression up the totem pole happens in a very particular and prescribed order. Still, there are elements of uncertainty, risk, and surprise when making decisions about a career in medicine.

Even as a 4th year medical student, I can describe junctions and branch points in my medical career where, instead of taking the safe or planned route, I pursued something else and wound up in a wonderful situation. I entered a lottery to be one of a dozen students in a novel, integrated third year and found myself having yearlong relationships with patients. It was there that I abandoned my plan of becoming a dermatologist in the operating room of a surgeon who would become one of my greatest mentors. And because of the effect of this new rotation system, I developed an interest in surgical education and ended up taking a year off to complete a Master of Education. It’s easy to look at someone successful or admirable and imagine him or her climbing a ladder straight to that position. Long-term goal setting and planning are critical to achieving ambition dreams, but Sandberg reminds her readers that there is likely more to the story, including a willingness to pursue unanticipated opportunities because of the potential for growth, whether that be taking a job in a new part of the country, starting a new research project, or taking on additional responsibilities in one’s current practice setting.

Have you taken alternative routes in your career?

Chapter 5: Are you my mentor? (Minerva)

“It should be a badge of honor for men to sponsor women.”

This chapter is full of practical advice that can easily be applied into any field, and in my opinion, can help both the mentee and the mentor. Through anecdotes of Sandberg’s own mentors and the people she has mentored herself (whether officially or not), her message becomes clear: mentoring relationships have to develop naturally and grow. As such, having ground rules for these relationships is important.

Things to consider:

1. Be mindful of the mentor’s time – mentees cannot expect to spend hours of a mentor’s time each week. As Sandberg points out “That’s not a mentor – that’s a therapist.” In my personal experience, setting up short meetings of 15-20 minutes with focused questions or goals are more effective for both the mentor and mentee. On a similar note, Sandberg suggests avoiding complaining “excessively” to a mentor and instead, ask for specific advice about how to move forward.
2. Strangers can be mentors – Just do not seek a mentor by asking a stranger cold-turkey “Can you be my mentor?” Successful mentees have approached Sandberg in a different form – a simple introduction with a well-thought out question. These individuals sparked her interest through their own success and she eventually filled that mentor role.
3. “Excel and you will get a mentor” – In surgery, strangers are frequently referred to each other by a common colleague or friend. This is how I landed with my current research mentor. The key is engaging potential mentors so they may take an interest in you and your success (via your CV or a strong referral) and following through afterwards with hard work (the mentoring relationship will naturally develop through your hard work).

In my own experience, it is important to have more than one mentor, something Sandberg alludes to through various anecdotes. For example, I have surgical mentors to whom I can turn to for various aspects of my career: my clinical concerns, career advice, and even task or situation-specific guidance. I have mentors to whom I can turn to for support and life advice. I also have some informal mentors with whom I interact on a less frequent basis (often by email or occasional text messages or calls).

The importance of mentors in surgery (as in other fields) is obvious and many employers and medical organizations, including AWS, have launched their own mentorship programs. Interestingly, Sandberg points out that “official mentorship programs are not sufficient by themselves and work best when combined with other kinds of development and training.”

What has your own mentorship experience been like? Have you been a part of an organized mentorship program?

If you have not downloaded the AWS Pocket Mentor you may do so here. You can also read our AWS blog post for good advice passed down from our mentors.

Chapter 6: Seek and speak your truth (Minerva)

In closing the chapter, Sandberg writes one of the sentences that made me think a lot about my own experience in surgery- “And maybe the compassion and sensitivity that have historically held some women back will make them more natural leaders in the future.”

What I took away from this chapter really was a lesson in effective communication and leadership. By this point in the book it is no doubt that Sandberg has research to back up the inescapable fact that gender strongly influences others’ perceptions of a person. In fact, gender strongly influences our own perceptions of ourselves. Sandberg laments that women hesitate to provide honest feedback, lest they be labeled as whiners or avoid discussing their children at work lest their priorities be questioned. Instead she advocates for honesty and a shift in leadership that strives for “authenticity over perfection.”

I have seen both types of leaders and struggled with the qualities I want to emulate. Slowly I have realized that some situations will call for a different kind of leader in order to be effective. For example, I know a leader who is generally regarded as someone who has high expectations, demands perfection, and may not be the easiest person to please. While this style may aggravate colleagues and subordinates in many situations, in surgery this type of leadership is essential when dealing with decisions that carry serious consequences such as life or death. Ultimately, more diversity in the workforce will translate to changes in leadership and eventually, I hope more equitable roles in the workforce.

Have you ever felt like you could not voice concerns out of fear that you may be labeled as a complainer or not a team-player?

Chapter 7: Don't leave before you leave (Minerva)

Sandberg points out that many women start to end their career before even getting out of the workforce. In an extreme example, Sandberg notes a young employee who worried about raising children before even being in a relationship, pregnant, or anywhere near having to worry about career-personal life balance. She raises a valid point that instead of holding themselves back from success due to being unable to meet demands later – women should aim for success and adjust or scale back as needed later when their success will lend them much more flexibility.

When I read this chapter I immediately thought of one surgery mentor. Having seen many intelligent, bright, and technically gifted female residents quit surgery for their families, he would frequently warn me not to quit surgery “because you want to have kids.” Most of the time I thought he was kidding with me, but in retrospect I feel lucky that someone saw enough promise in me and cared enough to open up a sincerely dialogue with me about career planning.

I must admit that I am guilty of nearly doing this to myself. While I had mentally prepared to make sacrifices for my career, during medical school I realistically started to consider how much of my life I would let my career consume. After my clinical rotations I was convinced in my heart that I wanted to do surgery, but all the warning alarms in my mind were going off. I am thankful that I had the sense to call one of my mentors (and a voice of reason) to help me think through this seemingly enormous decision. “Why not?” she asked during that call –I had no answer –and with that simple question she helped me realized that only I could hold myself back from a fulfilling career in surgery.

Do women really leave before they leave?

We value your opinion. Chime in on the comments below, and be sure to check back tomorrow as we continue our discussion in Part Three. Yesterday's discussion can be found here.

~~~

Sophia Kim McKinley is a dual-degree M.D./Ed.M. student at Harvard Medical School and the Harvard Graduate School of Education. She received the 2012 Association of Women Surgeons Patricia Numann Medical Student Award and spent a year as a Zuckerman fellow at the Center for Public Leadership at Harvard Kennedy School. Sophia is passionate about medical education and she hopes to be an academic surgeon who brings educationally-sound innovations to surgical training. Her clinical interests are gastrointestinal and minimally invasive surgery. Sophia will be applying for general surgery residency during the 2014 Match cycle.






Dr. Callie Thompson is a resident in general surgery at the University of Washington. She recently completed a two year research fellowship and is now in her fourth clinical year. Callie aspires to be a burn and trauma surgeon and a translational scientist. Her research interests include genetic variations and their associations with the development and outcomes of disease and illness. Callie is married to an internist and has three children under the age of 7.



 




Dr. Minerva Romero Arenas is a general surgery resident at Sinai Hospital of Baltimore and is completing a research fellowship at The University of Texas MD Anderson Cancer Center in Houston, TX. She obtained her MD and MPH from The University of Arizona, and studied Cellular Biology & French at Arizona State University. She is also involved in mentoring and public policy. On her personal time she enjoys spending time with friends and family, especially when it involves good food.

Lean In: Book Review & Discussion (Part One)

by Sophia Kim McKinley, Callie Thompson, MD, and Minerva Romero Arenas, MD, MPH

Introduction

Lean In: Women, Work, and the Will to Lead.

Sheryl Sandberg published this book less than one year ago – and caused quite a stir. Some praise her for exploring the question of why there are so few women in the top ranks of corporate America. Others criticize a perceived failure to represent the needs of the non-elite women who are not in positions to pursue C-suite offices.

We share our impression of her book – a chapter at a time– eyes of individual women in surgery. Not necessarily a book review, we try to draw out any parallels or lessons that the book offers to women who are also operating within a traditionally male-dominated discipline.

We hope you will join in our discussion – even if you have not read the book!

Chapter 1: The Leadership Ambition Gap (Sophia)

Sandberg writes from the perspective of a woman in business, but I found that many of her observations and points apply just as well to medicine, in particular surgery. She describes that, for a number of reasons, a smaller proportion of women aspire to the top leadership positions in their organizations or their fields. I wonder if a poll of general surgery applicants would also reveal that fewer of the women hope to become Department Chair or President of prominent surgical associations. Is there a leadership ambition gap in surgery?

Reading this chapter, I reflected on my own ambitions. How often had I envisioned myself ultimately becoming Full Professor or Chair or President? The answer was telling—exactly zero. Since then, I’ve committed to ignoring the thought “I could never be XYZ” and follow it with “Why not me?” And I’m going to encourage my female friends to do the same. Instead of dwelling on the difficulties of juggling multiple personal and professional identities, I’ll encourage them, as Sandberg does, “not to be afraid” of ambition. There are many valid reasons a female physician might not embrace the pursuit of being at the top of a strongly hierarchical field, but fear and cultural distaste for a woman’s ambition should not be among them.

Have you noticed a difference in ambition?

Chapter 2: Sit at the Table (Callie)

In this chapter Sandberg discusses how women often feel fraudulent when they are praised because they feel their recognition is undeserved and how she personally felt like an imposter, moments away from the inevitable embarrassment of failure. This is an easy chapter to apply to surgery because the author actually does it for me. She highlights a study that looked at students on a surgery rotation that found female students gave themselves lower scores than the male students despite the fact that the faculty evaluations showed the women were outperforming the men. I am certain that this does not stop when these ladies graduate medical school. Some of them will go onto surgical residency where they will continue to underestimate their abilities despite feedback to the contrary. I see it every day.

The most salient part of this chapter is the inherent differences between men and women when it comes to what each will credit their success to, and more importantly, what they credit their failures to. Anecdotally, I have seen my male and female colleagues deal with complications in vastly different ways--specifically with my female co-residents being quick to take responsibility for a patient’s complication but much less quick to compliment themselves when an outcome is favorable. The fact of the matter is, the data show that women are less likely to credit her success to her abilities and more likely to contribute her failures to them. In another excellent book entitled Mindset, Carol Dweck describes how this thought pattern is something that becomes ingrained in us during our upbringing and requires great focus and attention to our inner monologue to overcome it.

Do you agree that women do not sit at the table enough? Are there differences in our upbringing that make us more submissive perhaps subconsciously? 

Chapter 3: Success and Likeability (Sophia)

Sandberg begins this chapter with a reference to Harvard Business School’s Heidi/Howard study, in which students rated a case protagonist far more likeable when the only change to the case was changing the name “Heidi” to “Howard.” She asserts that a woman’s desire to be liked can be an impediment to success because success and likeability for women, unlike men, are often at odds.

I am not convinced this is as true in surgery as it is in business. Surgery is patient-focused work, and the operating room requires a great deal of teamwork and communication between many different individuals. Even research projects are far more successful when one is well-regarded by collaborators. So when I see a highly successful female surgeon, I assume that she must excel in working with others because success in this field depends so much on interpersonal skills. This is the same assumption I make for men. But perhaps relevant take-always for women in surgery are Sandberg’s points about taking ownership of one’s success and the importance of negotiation. She encourages women not to mute their accomplishments for fear of being perceived as likeable, especially within the context of negotiating for themselves.

Do men and women perceive leaders the same way? Are female leaders at an unfair disadvantage?
  
We value your opinion. Chime in on the comments below, and be sure to check back tomorrow as we continue our discussion in Part Two.

~~~ 

Sophia Kim McKinley is a dual-degree M.D./Ed.M. student at Harvard Medical School and the Harvard Graduate School of Education. She received the 2012 Association of Women Surgeons Patricia Numann Medical Student Award and spent a year as a Zuckerman fellow at the Center for Public Leadership at Harvard Kennedy School. Sophia is passionate about medical education and she hopes to be an academic surgeon who brings educationally-sound innovations to surgical training. Her clinical interests are gastrointestinal and minimally invasive surgery. Sophia is applying for general surgery residency during the 2014 Match cycle. 

Dr. Callie Thompson is a resident in general surgery at the University of Washington. She recently completed a two year research fellowship and is now in her fourth clinical year. Callie aspires to be a burn and trauma surgeon and a translational scientist. Her research interests include genetic variations and their associations with the development and outcomes of disease and illness. Callie is married to an internist and has three children under the age of 7.







Dr. Minerva Romero Arenas is a general surgery resident at Sinai Hospital of Baltimore and is completing a research fellowship at The University of Texas MD Anderson Cancer Center in Houston, TX. She obtained her MD and MPH from The University of Arizona, and studied Cellular Biology & French at Arizona State University. She is also involved in mentoring and public policy. On her personal time she enjoys spending time with friends and family, especially when it involves good food.

Unconventional: Our Couple's Match Story

by Brittany Bankhead-Kendall, M.D., M.Sc.

Match Day 2012 was supposed to be the best day of our lives. Or one of them, at least. But it was so, so not. Monday morning my husband and I left our respective rotations around 11:45am and hopped into our SUV in the hospital parking lot in anticipation of the noon email saying we had matched. We wanted to celebrate that together. My email came: "Congratulations! You have matched to a one year preliminary position." I was devastated. But it got worse. My husband's email came: "We're sorry, you have not matched to any positions."

Can that happen? Did that just happen? I didn't think that was possible. Our numbers were right. We had plenty of interviews. We were matching Emergency Medicine (him) and Surgery (me). A difficult match, but not an impossible one. Right?

He was the better candidate, but we thought Surgery was the harder match. So at match choice #18, after all of our same city match choices, we listed a match-no match option. The thought was that in this certain city we chose, surely he could find something to do for a year. A big city, close to my family, lots of options. We assumed he would at the very least be able to find a preliminary surgery spot at one of the four hospitals in the area. Prelim surgery spots aren't hard to find, right?

We drove straight from the hospital parking lot to a McDonalds and hooked up the laptop and filled out his SOAP application. He applied to all the Surgery Prelim spots in my city (the NRMP will tell a couple, in a match-no match situation, the city of your match). Tuesday, Wednesday, and Thursday came; no interviews, no offers. Match Day came and went, we "celebrated" at home with our baby boy and my parents, and occasional tears.

Then we looked for research positions for the year for him. And... Nothing. We tried, we weren't even picky. But he was over or under qualified for anything we found.

Then one day, out of the blue, he got an email inviting him to interview across the country for a position in Emergency Medicine. He got the position. And yet we struggled with it. Was this a temptation that he should pass on? Was this a blessing? Was it great for his career at the expense of our family? Would we be able to survive without each other? Could I be a surgery intern, with our BABY, without him?

Ultimately, he took the position. We're tough. Yes, he and I are tough. But what I also mean is that we women physicians are tough. We're a different breed, I think. No one can tell us no. No one can put anything in our path too great to achieve our goals. No one can tell us we can't love our job and love our child. No one can tell us we can't do it without certain features of our home life lined up. We can do it.

It's hard every day. That I won't deny. It's hard being away from my best friend and confidante; the person I want to vent to and hug and go on dates with and share in our son's new milestones and that he finally says "Mama." It's hard being a "single" parent. It's hard knowing my son is not with his mom or his dad 24-7. It's hard when your child reaches for their grandmother for comfort when they fall and you are both standing there. And oh yeah- it's hard being a surgical intern, period.

But I'm blessed. We're blessed. Training looks different for everyone (we went to a school where our basic sciences were in the Caribbean; more on that another day). Life looks different for everyone. Just because it's different doesn't make it wrong or weird or not doable. We've learned a lot along the way, and talk about it a lot (when our shifts don't overlap, that is). I'll sum it up for you, in case it would help anyone else along the way . . .

1. Don't be too proud to apply to different locations if you're couple's matching. You'd rather be a doctor in a different geographical location than not-a-doctor in the same location.

2. Surgical preliminary spots aren't as easy to get into as you might think. I think that's the going rate for almost any residency these days.

3. There's lots of spots outside the match that you don't hear about unless you look for them in the right places. Look on your specialty's program director website (a good place to start) to see if there are open positions outside the match.

4. Don't panic if things don't go how you saw them. Where there's a will, there's a way. Don't let anyone tell you something isn't possible.

5. Family comes first, but deciding to be apart doesn't mean they don't still come first. Don't feel bad for choosing it. It doesn't mean you ranked them of less importance. It just means your story looks different.

6. Speaking of stories: Life looks different for everyone. You can use yucky situations for learning and growing, or for being miserable. It's a choice.

7. When you rank programs, go where you love. The rest will fall into place.

Of note- at the time of publication of this blog, my husband has an interview for an open PGY1 EM position that came available in late July right down the street at a phenomenal academic center.

Either way, we know what we've learned through all this.

Either way, we're good.

What obstacles have you overcome to achieve success? Do you have any words of advice for surgeons or aspiring surgeons who are going through a difficult time? Please share your thoughts in the comments below.

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Brittany Bankhead-Kendall, M.D, M.Sc. is a PGY1 general surgery resident at Methodist Dallas Medical Center. She obtained her M.D. from Ross University School of Medicine, M.Sc. from Barry University in Biomedical Science, and studied Biomedical Science and Spanish at Texas A&M University. She enjoys being a surgical intern and mentoring medical students. In her personal time she enjoys spending time with her husband and son, interior design, international travel, and Texas Aggie football.