Cultivating Culture Change: How to Foster An Inclusive and Supportive Environment in Academic Medicine

Over 50 early-stage anesthesiology scholars and established anesthesiologists gathered together to strategize how to promote and cultivate culture change to foster an environment of inclusion, collaboration and support in academic medicine during the Q&A period of the session, “Expanding the Footprint of Academic Anesthesiology,” held on Saturday, April 2 at the IARS, AUA, SOCCA and eSAS 2022 Scholars’ Day. Attendees posed thoughtful questions and explored meaningful topics with the presenters, all with the central goal of searching for solutions for retaining and nurturing academic anesthesiologists in the specialty.

Kimberly Rengel, MD, Assistant Professor, Anesthesiology and Critical Care Medicine at Vanderbilt University Medical Center and Co-Chair of the IARS Meetings Committee and Co-Vice President of the Early-Stage Anesthesiology Scholars (eSAS), led a thought-provoking discussion on important topics, which included gender disparities, establishing collaborative atmospheres for success and how to generate significant progress for a more supportive specialty.

The three speakers, Vesna Jevtovic-Todorovic, MD, PhD, MBA, FASA, Jeanine-Wiener Kronish, MD, and Michael Mathis, MD, shared their struggles and lessons uncovered throughout their careers with the audience and encouraged an open dialogue on these topics.

One attendee asked what “he for she” advocates could do to break the cycle of gender disparities in academic anesthesiology. Dr. Jevtovic-Todorovic, Professor and Chair of the Department of Anesthesiology at the University of Colorado School of Medicine, relayed her own experience with such mentors throughout her career. Creating opportunities and helping to build a name in the specialty is the biggest role that a “he for she” mentor can provide, she explained. From providing connections to recommending you for speaking roles and awards, mentors can help women to be considered for substantial opportunities and leadership roles.

However, through studying the research, she discovered that nothing substantial has changed in this area over the past 25 years. All changes have been incremental. She emphasized that this is one reason why it is so important to rely on your family, friends, partners and mentors to find success.

The discussion shifted to contemplate how systemic change might be reached and what some of the factors might be for why the field of anesthesiology isn’t more successful in recruiting and retaining more women. Another attendee inquired if there was a stage in the academic medicine pipeline where the disparities in gender were more severe. Referencing the research on this topic over the past 10 years, Dr. Jevtovic-Todorovic revealed that these disparities transcend all career stages.

Dr. Wiener-Kronish, Isaiah Dorr Distinguished Professor of Research and Teaching in Anesthetics and Anesthesia, Harvard Medical School and Massachusetts General Hospital, pointed to the COVID-19 pandemic for uncovering some of the systemic problems that impact the specialty, one being support for childcare. In the US, there is currently no systemic support for childcare while other countries offer such resources. Juggling childcare and a career is challenging and often falls to the woman, she explained. Although, this can also be true for men but not usually at the same frequency as for women. Having a supportive department chair or mentor can help alleviate some of these pressures but some are inevitable, Dr. Jevtovic-Todorovic shared. For example, she explained that during a difficult pregnancy women may be waylaid from their usual clinical rotations and research routines.

One audience member questioned why surgery has had more success in recruiting women to its specialty and anesthesiology has lagged behind. The speakers acknowledged that this was a very intriguing question and one to explore to find a definitive answer. Currently, a paper has been submitted for publication on this topic that includes research on disparities in leadership roles, the composition of study sections and why requirements are higher for women to receive research grants, Dr. Wiener-Kronish revealed.

The conversation turned back to opportunities and the motivations behind the opportunities that might become available to women. Dr. Jevtovic-Todorovic shared that sometimes it hurts when you realize you are in the room mainly to check a box. However, she emphasized that no matter the reason for being given an opportunity for leadership and influence in the specialty, you should take advantage of that opportunity. Another attendee agreed that often you may not have that opportunity otherwise, even if it is for the wrong reason. Dr. Wiener-Kronish added that academic organizations should be more intentional in their efforts to create more inclusive environments in the leadership pipeline.

Often this intentionality starts with leaders and mentors imbuing a culture of collaboration and inclusivity at their institutions. Dr. Mathis, an Assistant Professor of Anesthesiology in the Division of Adult Cardiac Anesthesia at University of Michigan and Research Director for Multicenter Perioperative Outcomes Group (MPOG), revealed how his experience having a supportive mentor and leader at his institution has created an infrastructure that promotes collaboration, quality improvement opportunities and mentorship within the academic medicine pipeline. Having access to a good role model can help this cycle of support continue for future generations. Dr. Mathis has been inspired personally by just such a role model to pass on this message to his own mentees.

Re-emphasizing this important point, the speakers encouraged the attendees to reach out to them for support, guidance and mentorship to help them along their path in academic anesthesiology, offering another step forward in the journey towards a culture of support and inclusivity for the specialty.

Continue this conversation in the eSAS Member Community. A discussion is currently in progress around this topic here.