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VOICEOVER:

Welcome to ASA’s Central Line, the official podcast of the American Society of Anesthesiologists, edited by Dr. Adam Striker.

DR. ADAM STRIKER (HOST):

Welcome back to Central Line. I'm your host and editor, Dr. Adam Striker. Today, I'm joined by Dr. Allison Fernandez to discuss her new project, Women of Impact in Anesthesiology. Dr. Fernandez is a Pediatric Anesthesiologist, Pain Medicine Physician and Clinical Researcher at Johns Hopkins All Children's Hospital. She's also the host and creator of Women of Impact in Anesthesiology, A series of video interviews featuring prominent women in our field. Dr. Fernandez, welcome to the show.

DR. ALLISON FERNANDEZ:

Thank you. Thank you for the introduction, and thank you for having me.

DR. STRIKER:

Yeah, my pleasure. Well, before we get into the details of the initiative, I'd like to hear about why this all got started. What drove you to create and share these public conversations with so many dynamic female anesthesiologists? What did you hope to get out of it when you set out down this path?

DR. FERNANDEZ:

So, this idea came out of, one day I was talking to my colleagues at work because I was feeling very frustrated and starting to feel burnout, juggling my academic responsibilities and my personal responsibilities. So, I started talking to them about all of these feelings. And then serendipitously, the following day I saw an email on, in my inbox about applying for the Professional Diversity Mentoring Award. And so that got me to thinking like, oh, maybe I can do something that will fit into this application grant and address some of the things I've been feeling about.

So that's how I started. I started thinking about it, and then I wrote a little proposal for the grant to talk about women in anesthesiology, gender disparities, diversity, equity and inclusion, work-life balance. And I hoped that by covering these topics with women leaders in anesthesiology, I would create kind of like a, an advice column for other women to look to, especially if they don't have, or don't feel that they can find someone in their own local area.

DR. STRIKER:

Well, certainly impressive to even have the idea anyway, but especially to make something like this a reality. Do you mind telling our listeners a little bit about that journey, going from the initiative to actually, making it real?

DR. FERNANDEZ:

Yeah, I don't think I realized how hard it was going to be. So, I think negativity was in my, was a help to me. But once I a, applied for the grants and actually for the grant, I had to find a mentor, which I was lucky to be connected with Dr. Linda Mason. And once the grant was awarded to me, that really gave me the confidence to really pursue this. So, I quickly had to learn how to video record through Zoom and, and learn how to edit. And then I started scheduling practice interviews with some people, learning how to edit on those practice videos.

And at the same time, I was talking to my coworkers on, on coming up with the questions that I would ask the women who agreed to participate. And so slowly but surely, I was able to schedule the interviews, start recording, and now I've been in the process of editing. I also had to learn how to set up the YouTube channel and some marketing things to get the word out about this video series.

DR. STRIKER:

Well, did these conversations give you what you expected? And additionally, what do you hope your audience will get from watching this series?

DR. FERNANDEZ:

I personally learned a lot from talking to the women. It was very interesting to hear all the common themes and all the ways that they overcame obstacles or found new paths to reach their goals. And I felt that there was a no one size fits all, and they all found ways to make the situations work for them. And by hearing all of these common themes and experiences, it kind of gave me comfort knowing that I'm not the only one who has had these experiences or had these feelings. But also I learned a lot from hearing how they, they accomplish things. And I hope that the people who listen, who take the time to listen to the video series also gain a lot of advice like I did, especially when it comes to leadership development and work-life balance and diversity and gender bias.

DR. STRIKER:

Well, you’ve connected with some amazing anesthesiologists - Linda Mason, Jane Fitch. Mary Dale Peterson, Beverly Philip, Roberta Hines. We could go on and on, and it must have been rewarding to share these authentic, in-depth conversations with so many terrific anesthesiologists. Do you mind sharing a few of your favorite moments and additionally, any surprises?

DR. FERNANDEZ:

Yes, it was very rewarding and exciting to hear all of their experiences throughout their journey, and I found it very interesting, especially from Linda Mason and Dr. Mary Dale Peterson and Dr. Genie Heitmiller, and even Dr. Finch also alluded to this, was how when they entered medical school and went through the medical school application, how, how much gender bias they faced. And they all said that it's, it’s improved over time, but we still have gender bias and we need to continue to, to work on that and encourage more women to enter the field of anesthesiology and support and sponsor women to enter roles of leadership. More women have entered the field, but not enough women have been successful at attaining leadership positions.

Other women I've spoken to, such as Dr. Paloma Toledo and Dr. Crystal Wright, write about work-life Balance, and it was very interesting how they framed work-life balance and the fact that most of us probably never really feel that we've achieved that and learning how to prioritize and learn how to say no to things. It's really important to attain more feeling of balance.

And I also spoke to Dr. Cynthia Wong and Dr. Roberta Hines about leadership and what it is to be a leader and being a good listener, and also recognizing leadership qualities in your colleagues and helping them by mentoring and sponsoring so that they can achieve to the next level.

DR. STRIKER:

Let's go ahead and talk about some of the topics that you addressed in these series of interviews. Let's start with work-life balance. First, do you think women still get the short end of the stick on this issue, even yourself? And do other interviewees express similar sentiments?

DR. FERNANDEZ:

Yes, I think that work-life balance is a misnomer. I think women have to pay a lot of attention on how they're going to prioritize their time. And I think that even today, even though there is a more shared experience for family responsibilities, women still hold many of the hidden and unrecognized tasks. And in the conversations I had with the other women leaders in anesthesiology, they all have the same sentiment and use different tactics to address those issues. Everyone commented on how some of the home responsibilities, although they are very fruitful in a personal level, at your career level, it could hinder you in the sense that it limited your ability for attending conferences, which limits your ability to network and really meet other anesthesiologists and, and participate maybe at a level that you would have wanted, but you unable to because of your home responsibilities.

DR. STRIKER:

Well, let me follow up with you on that. Have you ever been personally told that it was your decision to be a mother in addition to being a physician, so you will have to just figure out how to manage that? And if so, what would you say to that?

DR. FERNANDEZ:

I personally have not heard that. Actually, I've been very fortunate. My co-workers actually were really helpful and supportive to me when I had to go through fertility treatments to have children, and they actually worked around me and my schedule at that time. But I can see that it can be an issue for other women, depending on their work environment. I do understand that having a family is every person's choice, but it's a choice that everyone has. It’s not just a choice that women have because they have their spouse or their partner, and they choose to have their own children. And I think that as a specialty, and as people, we should be caring and supportive of our colleagues so that they can achieve their own personal goals and lifes. And I think that it also makes us a stronger specialty because we are encouraging women to enter the field, and we know that diversity brings positive attributes to the medical profession.

DR. STRIKER:

Well, let's go on to the second topic, gender bias. It's still a problem. It's certainly a problem that many people experience firsthand, and others don't quite believe that it's real or, or much of a problem. What would you say to the listeners who think we've moved on or that this isn't a big deal?

DR. FERNANDEZ:

Gender bias, I think, is still a problem, and I think that gender bias has changed throughout time, which is what other women leaders have alluded to, like Drs. Judy Heitmiller and Dr. Linda Mason, where, you know, when they started medical school or during their whole interview process, it was pretty blatant. They were like, oh, well, you're a woman, so you're not going to be able to do this. And that's not acceptable any longer to say things like that.

But we know that gender bias is still present because in our specialty alone, we're not a 50/50 group of anesthesiologists. And when you look at the leadership level, women haven't been able to really break into that as much as we should have, especially in, if you look in the last 20 years where 50% of medical schools are women and we don't see that level of women entering our specialty and we don't see that level of women achieving that level in terms of academia, getting to Associate and full Professorships or even in the leadership in the ASA, where we've only had four women anesthesiologists be President for an organization that's been over 100 years.

DR. STRIKER:

Why do you think the leadership disparity exists? Is it simply gender bias? Or is there something more to it?

DR. FERNANDEZ:

I think it's a combination of things. I do think some of it is gender bias. I also think that there's been, maybe a lack of mentorship and sponsorship. I don't know if that's necessarily all related to gender bias, but not having been afforded the opportunity to participate in things also leads to, you know, not being able to be invited to the, to those talks or those positions prevents you from moving up in leadership.

DR. STRIKER:

Some of my female colleagues over the years have, you know, expressed concern about someone they've worked with, whoever it is. And I've heard male colleagues discussing that same person saying to them, well, I've never had a problem with them, and they'll say, well, you know, you're a man, and it's not the same thing. And I'm paraphrasing a lot of this, and this is over the years here and there. But have you had that issue or do you, do you know of other or any of your interviewees have had that issue? And is that a real thing that it's, there is an issue that a lot of times male colleagues don't see that are happening with their female colleagues when it comes to gender bias?

DR. FERNANDEZ:

Yes, I think that there is a lot of unconscious bias, whether it's to women or people of color or people of disability. I know I personally experienced it. And I think that some people maybe don't recognize that it's present because they don't know and haven't been trained in, in that venue. And so I think that it's important for people to not just say, oh, it doesn't exist because I don't see it. You can only recognize things if you know about them, so maybe you're not knowledgeable enough to recognize what is unconscious bias and what are those, what are the signs of that or that, you know, that it's going on in your area?

So, I think that that's why it's so important for us to take classes and learn about unconscious bias and learn about equity, inclusion and diversion, diversity, equity inclusion and to have those difficult conversations within your group or with your friends and, and colleagues so that it becomes more to the forefront. And we can recognize and help support those people who are encountering these kind of problems and help them change, maybe, the culture that's in that area.

DR. STRIKER:

Well, how do we diversify the profession?

DR. FERNANDEZ:

Yeah, I've had a lot of conversations about that, and a lot of the women that I spoke to commented that, that it's important for us to really start looking into how we can do this, diversifying the anesthesiology workforce. And a lot of the women mentioned that it's important that we should partner with the medical school education and work with them to, to have more rotations early on in the medical school education with anesthesia and maybe even having it to be like a required course that you take so that we can gain more exposure to the medical students.

We can also, as anesthesiologists, work within our community in being advocates in outreach programs with high schools or colleges, and teach about what anesthesia is and also talk about other aspects that are important for anesthesiology like COVID education and vaccination, or smoking or vaping cessation education. And so, there are ways that we can reach out to our community, not just necessarily in the hospital. And also again partnering with the medical schools and improving that connection and exposure to anesthesiology early on.

DR. STRIKER:

Well, I know you addressed leadership, development and mentorship. Can you share any key takeaways from your interviewees along those two lines?

DR. FERNANDEZ:

Yes, that was very interesting for me. A lot of the women who talked about leadership development really spoke to taking leadership courses early on in their career, whether it was at their home institution or through the ASA or through the AAMC. They have a lot of these leadership courses that, that they felt were very valuable to them and that it really helped propel their career forward.

Also, a lot of women spoke about mentoring, and they all felt that it was very important to have a mentor, to have more than one, not to feel like you can only have one, because it's important to hear advice and perspectives from different people. And that they felt that was really helpful to them, having mentors.

They also spoke about sponsorship that, that they felt that was actually very helpful for their career as well, was having a mentor to talk about different ideas, but having a sponsor, someone who would really help them gain access to leadership positions within their hospital or through the ASA. And they felt that was also very, very important for their academic career.

DR. STRIKER:

Well, what's the general consensus about the future?

DR. FERNANDEZ:

All the women that I spoke to felt very, very optimistic for the future in terms of women in leadership and diversity in the workforce, as well. They felt that we are as a society, we're addressing these issues. The ASA and the ASA conferences and at the ASA leadership level that these conversations are happening and we're trying to address these issues and we're starting to take action. And they felt that by starting to take action and starting to measure our successes, we're going to see a brighter future.

DR. STRIKER:

Well, what's next for you?

DR. FERNANDEZ:

Well, for now, I'm going to continue to interview more women of impact in anesthesiology, and you can find it on YouTube and soon on the ASA website. We'll have some of the interviews on there as well. And I've been very grateful to have had the opportunity to really talk to these women and gain so much of their knowledge and perspective, and I appreciate their enthusiasm and candor in participating.

DR. STRIKER:

Well, excited to see those available, especially on the ASA website, where there's certainly a plethora of great resources and information, and that'll make it accessible for everyone. Anyway, I just, I think this is a wonderful project. I'm excited to see how it continues, and I'm just thrilled that you took the time to share it with us today.

DR. FERNANDEZ:

Thank you so much and I appreciate your time.

DR. STRIKER:

Well, Dr. Fernandez, thank you again for your time. It was great talking with you. Thank you, everybody, for tuning in to this episode of Central Line. Please tune in again next time. Take care.

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To check out Dr. Fernandez’s interviews with luminaries from our specialty, visit ASA’s website and search for Women of Impact in Anesthesia or visit www.asahq.org.education-and-careet/women-of-impact.com

VOICEOVER:

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