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October-December, 2013


A bimonthly update to inform you of the current activities of our Academy in an effort to make this organization a strong advocate for women in academic emergency medicine.

Table of Contents
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Presidents Challenge: The 2nd A in AWAEM Committee Update: A Culture Conducive to Success XX in Health: The State of Women in Healthcare Leadership AWAEM Events at ACEP: A Recap of the 2013 Scientific Assembly Annual Awards! Featured Women in Academic EM Annual Luncheon Summary - Pearl of Leadership

!rom a" of us at AWAEM...

AWAEM AWARENESS October-December, 2013

Presidents Challenge
By Esther Choo, MD, MPH

The 2nd A in AWAEM: 7 Reasons to Choose Academics

Since application season is in full swing, Ive been spending a good bit of time lately sitting in my office with medical students and residents discussing career trajectories. This has made me think a lot, naturally, about why one might choose an academic career. So with the help of colleagues across the country,* I decided to cobble together my own list of reasons to go into academia. Of course, a list like this needs a host of caveats. It is not meant to disparage the community choice, just to emphasize why academia may be fulfilling. To some. As with any bit of advice, these may or may not fit the needs of a given individual. However, as this is the Academy for Women in Academic Emergency Medicine, allow me the luxury of presenting some of the reasons women might choose an academic career. You will notice that none of these are unique to women physicians, although some, I would argue, play very well to the strengths of women. 1. Its never boring. Emergency physicians are, perhaps, on the far end of the spectrum of needing to be constantly stimulated, and academia offers a constant supply of more appealing opportunities than time to take advantage of them, whether avenues of research, education or administration, developing a particularly scholarly interest, choosing the right mix of clinical practice and teaching, or getting involved in service at the medical school or with local, regional or national organizations. 2. Its never lonely. In any ED, you are working on a team of some sort, but in academia, that team is on steroids, involving many people at different levels of training in a constant dialogue about clinical practice. This goes for scholarly work, as well. Ive yet to write a paper without a coauthor (and sometimes seven) because it takes a team to build and carry out research. Academia is inherently collaborative. 3. Its an outlet for the curious mind. If you ever think to yourself, in the middle of a shift, Why do we do it that way? or Why dont we do this another way? and realize that theres no answer, then academia provides a wonderful outlet for your curiosity through scientific investigation. Put another way: research can be a very healthy way of sublimating perennial frustrations encountered during clinical practice. 4. Teaching and mentorship provide rich rewards. Many of my colleagues describe the joy of seeing students and residents have that Aha! moment the breakthrough, the sudden grasp of a new concept that will be used for years to come. It is amazing to watch people fulfill their potential and develop into physicians and scholars. Sometimes you are allowed to play a nurturing role in that process. It never gets old. 5. You are constantly pushed to advance your knowledge. The learning is mutual. Residents get smarter every year, come straight out of conference (and off webinars, blogs and chats) with new evidence-based knowledge, eager to challenge dogma. There is no resting on ones laurels not for a minute and your mind is forced to grow as a result. 6. It provides a counterbalance to clinical work. While I dont know anyone (community or academic) who has attained that holy grail of work-life balance, academia does offer a certain type of balance in emergency medicine: scholarly work balances out the lack of reflection during our fast-paced clinical shifts and can provide solutions for the problems encountered in clinical work; clinical work provides the short-term gratification and connection to the real world lacking in scholarly work, and is a constant reminder of the impetus for the work you chip away at incrementally in the office. And if you thrive in this mix of scholarly and clinical work, you bring home a self that is fulfilled, energized, and joyful. 7. You can be inspired every day. Academias reputation for pettiness has been famously captured in Sayres Law: The politics of the university are so intense because the stakes are so low. But in my experience, the vast majority of academic faculty are there because they have the itch: the desire to solve a particular problem, to share their knowledge, to satisfy their curiosity, to advance the practice of medicine. The talent and generosity of others who choose academic medicine are inspiring, and can propel you through the natural highs and lows of your career. I know there are countless other reasons for choosing academia. My aim here is not to exhaust the topic but to provide a springboard for further discussion. I invite you to join the conversation at the AWAEM community site at http:// community.saem.org/Home/. Take a moment to share your own motivations for pursuing academics and help inspire the next generation of women in academic EM. *Many thanks to Teresa Chan, Carl Seashore, Rich Duszak, Tricia Lanter, Michelle Lin, Raina Merchant, Megan Ranney, Seth Trueger, Amy Walsh, Lainie Yarris for contributing their insight and humor to this column.

In a completely rational society, the best of us would be teachers and the rest of us would have to settle for something else. - Lee Iacocca

AWAEM AWARENESS October-December, 2013

Wellness & Best Practice Committee Update

A Culture Conducive to Success in Academic EM
By Wendy Woolley, DO

The ladder of success is best climbed by stepping on the rungs of opportunity. - Ayn Rand

Women and men are different. Decades of literature have shown inequality in the levels of achievement obtained by women and men in academic medicine (1-7). A tool was developed recently to evaluate the culture conducive to womens academic success (CCWAS) (8). Through literature reviews, focus groups and expert input, Westring et al determined that a CCWAS consists of four distinct domains: equal access to opportunities and resources, work-life balance, freedom from gender biases, and supportive leadership. While their work was limited to women assistant professors at a single institution, they found valuable evidence that cultural change must target the departmental level as opposed to the individual or broader organizational levels(8). The goal of AWAEMs Wellness & Best Practices Committee is to identify those priority areas and to work with a spectrum of stakeholders to develop best practice recommendations to encourage and support women in Emergency Medicine. We recently conducted an informal poll of AWAEM members to explore the most common issues women face in academic EM today. The responses indicated a number of common themes consistent with those identified in the CCWAS: work-life balance, equal access to networking and sponsorship, and supportive leadership were consistently raised as the most salient issues in our group. The responses were from women practicing at all levels of academic medicine and represented a broad diversity in terms of geography and department structure but the issues were the same. Many respondents voiced a desire for part-time options, flexible scheduling and tips or tricks to maintain balance in EM academics. The Mommy Track had its own representation in terms of struggles with maternity leave, breastfeeding and childcare. The effect of maternity leave on the timetable of tenure, pay differentials, and the glass ceiling were raised as important issues still being faced today. There was also a concern that there is a paucity of professional development programs directed towards women in academic EM highlighting key skills such as negotiation and self-promotion.

As a specialty, EM has experienced a significant increase in the proportion of residents and program directors who are women; however, these increases are not reflective of the total number of female EM faculty (9). Becoming cognizant of the barriers to true equality and having a willingness to address them is the first step towards balancing the scales. The goal of the Wellness & Best Practices Committee is to bring these issues to light as well as foster discussion to determine how to best overcome them. AWAEM has many opportunities for everyone to join in these discussions whether through the online community or through didactic sessions at regional and national meetings. Our hope is to establish best practices that departments can adopt and follow as they strive to become a CCWAS.
References: 1.Reed DA, Enders F, Lindor R, McClees M, Lindor KD. Gender differences in academic productivity and leadership appointments of physicians throughout academic careers. Acad Med. 2011;86:43-47. 2.Wallis LA, Gilder H, Thaler H. Advancement of men and women in medical academia. A pilot study. JAMA. 1981;246:2350-2353. 3.Bickel J. Women in medical education. A status report. N Engl J Med. 1988;319:1579-1584. 4.Tesch BJ, Wood HM, Helwig AL, Nattinger AB. Promotion of women physicians in academic medicine. Glass ceiling or sticky floor? JAMA. 1995;273:1022-1025. 5.Nonnemaker L. Women physicians in academic medicine: New insights from cohort studies. N Engl J Med. 2000;342:399-405. 6.Ash AS, Carr PL, Goldstein R, Friedman RH. Compensation and advancement of women in academic medicine: Is there equity? Ann Intern Med. 2004;141:205-212. 7.Carnes M, Morrissey C, Geller SE. Womens health and womens leadership in academic medicine: Hitting the same glass ceiling? J Womens Health. 2008;17:1453-1462. 8.Westring AF, Speck RM, Sammel MD, Scott P, Tuton LW, Grisso JA, Abbuhl S. A culture conducive to womens academic success: Development of a measure. Acad Med. 2012;87(11):1622-1628. 9.Long TR, Elliott BA, Warner ME, Brown MJ, Rose SH. Resident and program director gender distribution by specialty. J Womens Health. 2011;20(12):1867-1870.

AWAEM AWARENESS October-December, 2013

A leader takes people where they want to go. A great leader takes people where they dont necessarily want to go, but ought to be. Rosalynn Carter

XX in Health State of Women in Healthcare Leadership

By Megan Ranney, MD

The non-profit XX in Health recently released a sobering report on the state of women in positions of healthcare leadership (http://www.slideshare.net/RockHealth/xx-inhealth-report-20130818-2100). Despite the fact that women make up 78% of the healthcare labor force and 70% of medical/health service managers, according to XX in Health: - Only 19% of hospital CEOs are women - Only 14% of hospital boardmembers are women - ZERO of the CEOs of Fortune 500 Healthcare companies are women. Not surprisingly, the women surveyed by XX in Health cited a number of sources of dissatisfaction and barriers to advancement, including: a lack of opportunities to advance their career; poor financial rewards and benefits; lack of active support from leadership on the advancement of women; difficulty navigating workplace structure and bureaucracy; and challenges in work-life balance. These statistics may also reflect a gender bias in promotion, similar to the well-documented pay differentials between female and male physicians. After all, other industries have similarly low rates of female leadership. But I think theres more to it. Honestly did you ever think of being a so-called C-suite manager? One very real explanation for these numbers is that they simply reflect a lack of aspiration or awareness on the part of female physicians. Indeed, until I read this article, the thought of a

physician entering a managerial position was one that had never crossed my mind. I feel like we talk about program director and chair positions, dean positions, non-profit leadership but not a physician career path in hospital or business management. Since reading this report, I have asked many people about their goals. And more than a few male colleagues -- but no women have admitted to aspiring to a CMO, CIO, or CEO role. So this report reinforces the importance of us actively DOING SOMETHING to increase our female colleagues chances of advancement into leadership positions. The one bright spot in the report was the list of what women think will help with advancement to leadership roles. The most commonly cited needs are networking events, mentoring, and enhanced industry knowledge. These are purposes that AWAEM serves for all of us. So I wonder if, to change these statistics, we need to start by making junior women physicians aware that these positions are an opportunity. And, second, whether we may need to change our conceptualization of how women can make a difference in healthcare. And third, whether we need to legitimate desiring a position of primarily business leadership. Perhaps one of our current AWAEM members will someday be part of changing the gender balance in hospital management!

AWAEM AWARENESS October-December, 2013

AWAEM Events at ACEP 2013 A Recap of the 2013 Scientific Assembly

By Wendy Woolley, DO

Monday October 14th AWAEM Meeting & Resident CV Workshop

Dr. Esther Choo led a brief business meeting with updates from the various committees. Resident membership drive was very successful and there were a few residents present to check it out. Following the business meeting, we opened The CV Doctor is In for interested residents and fellows to have the opportunity for review of their CV by a member of AWAEM. Many young physicians took advantage of this opportunity which was very beneficial for all involved and offered some great networking. Ideas for the next event would be a slightly more structured set-up and a way to keep track of how many people are involved.

Tuesday October 15th James D. Mills, Jr Memorial Lecture - Closing the Gender Gap: Women in Emergency Medicine
Dr. Diane Birnbaumer led a panel composed of Drs. Gillian Schmitz, Sheryl heron, Brian J. Zink (token Ychromosome), Mary Jo Wagner and Ghazala Q. Sharieff through a discussion of the history of women in medicine, the challenges faced by women in medicine today and the solutions that they employed to overcome challenges in their own careers. Women make up a majority of medical school classes but are still underrepresented in higher level academic positions (Dept Chairs and/or academic deans) and are paid less than male colleagues in the private sector. The panel counseled the audience through stories of their own challenges and successes to be more assertive, speak up and take credit and to just ask.

Tuesday October 15th AAWEP Meeting and Panel Discussion - Flex for the Best: Best Practices for Recruiting and Retaining Women Emergency Physicians
We joined with AAWEP to discuss the issues that are most pressing to the recruitment and retention of women physicians. There was a very lively discussion of experiences ranging from small private groups to large private groups to chairs of large academic departments and the different views on issues such as family friendly recruitment policies, family friendly scheduling options, medical leave (including parental leave) policies, and how to survive with family members as co-workers. Next steps will be for smaller groups to get these ideas onto paper with the plan for a resolution to be proposed next year at ACEP.

Don't nd fault, nd a remedy. Henry Ford

AWAEM Annual Awards New Award This Year!

By Jenny Saltzberg, MD

Outstanding Department Award

To honor an Emergency Medicine Department that has shown support of women in academic EM through organizational initiatives that address the recruitment, development, and advancement of all women as well as promoting gender equality, diversity, opportunity and inclusion. Eligibility criteria: Academic division or department. Selection criteria: 1. Adopted policies that allow and encourage women to be academically productive and advance in the promotions process. Focus on overall wellness of faculty members through efforts providing a wide variety of workplace

policies, programs and practices that support employees in work-life navigation, including flexible scheduling, familyfriendly environment. 2. High percentage of female faculty 3. High percentage of women in leadership. This will examine the percentage of women in administrative leadership positions as well as the percentage of women achieving promotion. Required Documentation: 1. One nomination letter explaining why the department merits the award. Nomination letter should include examples of the programs and practices mentioned above. 2. One support letter from departmental faculty. Award Descriptions Continued on the Next Page...

AWAEM AWARENESS October-December, 2013

AWAEM Annual Awards Nominate Soon!

By Jenny Saltzberg, MD

... Continued from page 5

Resident Award
The Resident Award honors a female resident who has shown promise for significant career achievements in emergency medicine through research, education, advocacy, or administration, and/or who has worked to promote the role of women in academic emergency medicine. Eligibility criteria: Female EM resident in accredited ACGME program in good standing Selection criteria: Evidence of achievements, innovation, and dedication in academic emergency medicine through education, research, advocacy, or administration. Required Documentation:* 1. Nominees CV \One nomination letter. 2. Nomination letter may be submitted by former or current colleagues, mentors, mentees, or employers. Selfnominations are welcome and encouraged. 3. One letter of support from residency director. If nominator is the residency director, one letter may suffice for both this item and the previous. 4. Two letters of support from other residents.

Early Career Award

The Early Career Award honors early career female faculty who have shown promise for significant career achievements in emergency medicine through research, education, advocacy, or administration, and/or who have worked to promote the role of women in academic emergency medicine. Eligibility criteria: 1. Female EM physician 2. Faculty member in a U.S. academic EM department 3. Graduation from residency within 10 years (as of June 2003)

Research Award
The Research Award recognizes a faculty member whose outstanding efforts and achievements have promoted the research in womens health in Emergency Medicine. Efforts to be recognized are: advancement of womens health and womens issues through research. The accomplishments of the winner of this award should have had signicant impact on advancing knowledge about womens health issues as they relate to emergency medicine.

*Other supporting documentation, such as additional letters of support from mentees, is optional and will be reviewed by the awards committee on a timeavailable basis.

Eligibility criteria: 1. Female Emergency Medicine physician Selection criteria: 2. Faculty in a U.S. academic Emergency 1. Evidence of achievements, innovation, Medicine department and dedication in academic emergency 3. Current SAEM Membership medicine through education, research, advocacy, or administration. Selection criteria: 2. Involvement on a national level (e.g., Nominees should have: through SAEM committees, research 1. Demonstrated dedication to the EM consortiums, or advocacy groups). research and womens health. 3. Activities demonstrating commitment 2. Multiple publications and lectures on to advancing the role of women in womens health issues. academic emergency medicine. Required Documentation:* Required Documentation:* 1. Nominees CV 1. Nominees CV 2. Nomination letter explaining why the 2. Nomination letter. Nomination letter candidate merits the award. may be submitted by former or current Nomination letter may be submitted colleagues, mentors, mentees, or by former or current colleagues, employers. Self-nominations are mentees, or employers. Selfwelcome and encouraged. nominations are welcome and 3. Letter of support from chair or encouraged. mentor.If nominator is the chair, one 3. Letter of recommendation from letter addressing items 2 & 3 may department chair or research director. suffice. If nominator is the chair or research, director one letter addressing #2 & 3 may sufce.

Submit all materials electronically to Jenny Saltzberg at jreifelsaltzberg@umem.org. Deadline: January 31, 2014, 5 pm Eastern Standard Time.

AWAEM AWARENESS January-February, 2013

Featured Women in Academic EM:

Commitment to Research & Education
By Priya Kuppusamy, MD

Gillian Beauchamp, MD PGY4, University of Cincinnati

Gillian Beauchamp is featured in our newsletter this month for her commitment to research. She received her undergraduate degrees in Biological Sciences and Dance at Rutgers University in New Jersey and then moved to Pennsylvania to obtain her medical education at University of Pittsburgh. Gillian is currently in her last year of Emergency Medicine training at the University of Cincinnati in Ohio. With strong interests in research and toxicology, Gillian wasted no time. Even prior to starting residency, she had already won the SAEM EMF Research Grant as a medical student where she explored the emergency response system. Thus far as a resident, she has been the recipient of two research grants where she investigated the performance and cost-effectiveness of an observation protocol for acetaminophen toxicity and studied the utility of a field test for diagnosing femur fracture. This year, she was recognized with the prestigious American College of Medical Toxicologys Michael P. Spadafora Resident Travel Award, which will fund her travel and attendance at the International Congress of Toxicology. As a second-year resident, Gillian developed a clinical treatment pathway for atrial fibrillation as part of her evidence-based medicine project and she was the first resident to fulfill all requirements of a newly created Resident Research Track at University of Cincinnati. Most notably, Gillian is well-loved by faculty and peers. She demonstrates humility and generosity at the bedside and beyond and serves as a true team player..

Teresa Wu, MD Assistant Professor, Maricopa Medical Ctr

Teresa Wu is featured this month for her commitment to education. She attended Johns Hopkins University for her medical training and then traveled westward to complete Emergency Medicine residency at Stanford University in Palo Alto, California. She stayed at Stanford to complete a Chief Resident/Administrative fellowship as well as an ultrasound fellowship. Currently she is an attending physician at Maricopa Medical Center in Phoenix, AZ. In such a short period of time at Maricopa, Teresa has taken on numerous tasks which focus on medical student and resident didactics. She developed an ultrasound elective and fellowship and serves as Director for both programs. Having a passion for simulation, she led a team of Maricopa residents to the EMRA SimWars Championship in 2012 and is currently Co-Director of the Simulation Based Training and Research Program. While juggling these many hats, she also serves as Associate Residency Director for the Emergency Medicine Residency Program. Teresa has authored several publications and was invited to be a guest editor for Critical Care Clinics of North America. She is a frequent lecturer at ACEP and won the Rising Star Speaker Award in 2007. Additionally, in 2011, her efforts were recognized with the Kenneth Jackimczyk Award for Dedication to Emergency Medicine and Teaching. This prestigious award is reserved for the most respected and honored physicians at Maricopa.

She leads quietly and without much fanfare and people respect her for that. When she speaks, people listen. They listen because she leads through her actions and accomplishments and thus serves as a role model for other residents, both male and female. -- Erin McDonough, MD Assistant Residency Director at UC

Her commitment to advancing the role of women in academic emergency medicine is displayed by her mentorship of our residents, her encouragement and facilitation of their involvement in academic emergency medicine, and her achievements as a role model. J. Stephan Stapczynski, MD Executive Chair and Professor at Maricopa

AWAEM AWARENESS October-December, 2013

Annual Luncheon Discussion Pearls on Leadership

By Basmah Safdar , MD & Mary Jo Wagner, MD

Reasons why people chose the table: curious about female leadership role, challenges at different levels, how to face them, how to balance perception of being a bitch versus being pushed over, subconscious bias. Thoughts on gender-specific communication: Feminine way of communication: consensus building Male way of communication: presumptive decisionmaking women have to figure out how to start the conversation. Be straight forward about what you think Be more aggressive than you want to be because you will not be heard otherwise. Say something forceful but say it with a smile Dont show emotion and dont argue Men are afraid to yell at you and make a scene At points of confrontation, dont lose your calm. Stay polite but firm (e.g. like when talking to drunk patients). No reason to compromise if you really want something. Women are told you are aggressive and men assertive.

Tips for improving communication MAKE YOURSELF VISIBLE Go to the front of the room and make yourself visible. Women who persist often are told you are strong woman dont internalize it as a bad thing. Translate it into you are assertive. When people ask how are things dont say Im fine say Things are great because. Prepare end of year summary of your activities (or every 4-6 months) and present it to your boss or relevant people so they know what you are doing. Its not bragging, its a summary of what you have done. Align it with goals of the department (our goals and my goals and my contributions). And then request what you need to grow. e.g. Yale template: Clinical goals and where you are Administrative goals and where you are Teaching goals and where you are One-page summary of achievements (elevator speech) and ask for what you want to get your goals Prepare an Elevator speech: 30 seconds to summarize who you are and what your last best accomplishment was (just finished submitting a grant, got a grant, got a paper published, just finished a project etc) Be a leader ask people what they are doing and remember what they are up to and connect them to the right opportunities.

The secret of a leader lies in the tests she has faced over the whole course of her life and the habit of action she develops in meeting those tests. - Gail Sheehy

Time to Nominate YOUR LEADERS! Deadline: March 15, 2014

Thinking of running for an Executive Committee position or know someone who would make a great officer and leader? The Nominating Committee will notify the membership no later than mid-January of upcoming elections and will solicit nominations. Nominations will be accepted until March 15, and electronic voting will be conducted in early April. Each nominee for an elected officer position will submit in writing a position statement and brief professional biography which will be reviewed by the Executive Committee and circulated among members prior to election. For the final ballot, there will be no more than two candidates for each of the following offices: Secretary and Treasurer. There may be up to 3 candidates for each at-large position. The nominees receiving the most votes shall be elected to the contested position. The winners will be announced at the annual business meeting in May.

AWAEM AWARENESS October-December, 2013

Available Committees for 2013-2014 Time to get involved!

If you are interested in helping with any of these committees, as a member or possibly leadership role, please e-mail the Chair so you can be included. If you do not hear from the Chair within a week please contact Esther Choo (esther_choo@brown.edu) as sometimes messages do get lost in the cyberspace of e-mail land. We need people like you to keep AWAEM a success!!
Awards Chair: Jennifer Saltzberg, MD!jenny_moyna@yahoo.com E-Communications Chair: Stacey Poznanski stacey.poznanski@gmail.com Medical Student & Resident Initiatives Chair: Michelle Lall, MD michelledlall@gmail.com Membership Co-Chair: Judy Linden, MD jlinden@bu.edu Co-Chair: Neha Raukar, MD nraukar@gmail.com Regional Mentoring Chair: Angela Fisher Research Chair: Basmah Safdar, MD basmah.safdar@yale.edu SAEM Meeting Initiatives Chair: Tracy Madsen, MD Tracy_Madsen@brown.edu Wellness & Best Practices Co-Chair: Dara Kass, MD, darakass@gmail.com, Twitter @darakass Co-Chair: Wendy Woolley, DO woollew@mail.amc.edu Co-Chair: Lisa Moreno-Walton, MD lwalto@lsuhsc.edu International Emergency Medicine Taskforce Chair: Bhakti Hansoti Bhakti.Hansoti@gmail.com; Twitter @bhaktihansoti Senior Faculty Taskforce Chair: Sandra Schneider, MD AAEM-RSA Resident Member-at-Large: Meaghan Mercer, MD mercer.meaghan@gmail.com EMRA Resident Member-at-Large: Ije Akunyili, MD iakunyili@gmail.com

Im a woman of very few words, but lots of action. - Mae West