The following manuscript was submitted to the September 2017 Women in Medicine theme issue.
by Jennifer Schwartz, DO, Shelini Sooklal, MD, and Asyia Ahmad, MD
We offer unique perspectives from three women at different levels of their gastroenterology careers.
“You know that GI is the most competitive fellowship to get, right?” This is the response I usually receive after revealing my plans to pursue a career in gastroenterology. Data published after the 2016 Fellowship Match show that, once again, GI remains the most competitive subspecialty within medicine. Despite these intimidating statistics, I started residency with aspirations to do gastroenterology, prepared to meet these challenges head-on. However, the difficulties of fellowship become amplified as a woman in medicine. I am married and have hopes of one day starting a family. A three-year fellowship puts constraints on this, as many female physicians put off starting a family until they have finished their training. A 2011 article published in Gastroenterology Clinics of North America emphasizes the difficulty of balancing a career and child rearing, citing a survey of GI fellows in which female fellows were more likely to choose programs according to parental leave policies and other family policies than the male fellows. Furthermore, female fellows were more likely than men to alter their family planning because of training program restrictions (20% vs 7%). Additionally, they were also more likely to remain childless or have fewer children at the end of training despite marital status. At times, it’s overwhelming for me to plan my personal goals amidst my professional ambitions, and it appears I am not alone. There is a need for strong female leadership that promotes a healthy work-life balance and proves that it is not an impossible feat in a medicine subspecialty.
—Jennifer Schwartz, DO,
second-year internal medicine resident at Drexel University College of Medicine
My interest in advanced therapeutic endoscopy was undeniable at the start of my gastroenterology fellowship, but became solidified after two dedicated, hands-on rotations in this field. This interest was met with some skepticism from colleagues and faculty, who commented that the majority of women in gastroenterology do not follow this path. A recent article by the American Society for Gastrointestinal Endoscopy in August 2017 cited that only 16% of practicing gastroenterologists are women. It is undeniable that a paucity of that number proceed with an additional year of training and an eventual career in advanced endoscopy. As was alluded to in an 2016 ACG Case Report, advanced endoscopy training and early practice usually coincides with childbearing years, and female gastroenterologists have voiced concerns about both delaying starting a family to facilitate an additional year of training, as well as the potential effects of frequent radiation exposure to a fetus. Given the small percentage of women in this field, finding female mentors can also be challenging. Strong female leaders and mentors in gastroenterology are essential for female trainees to be able to discuss the potential rewarding aspects of such a career, as well as the intricacies of navigating this field. It seems that more so for women, the quest to achieve academic and personal goals, as well as to pursue one’s personal and family aspirations outside of medicine becomes an essential balancing act.
—Shelini Sooklal, MD,
gastroenterology & hepatology chief fellow at Drexel University College of Medicine
The challenges faced by women in academic medicine doesn’t end with training. Recent data published in Gastrointestinal Endoscopy in January 2017 revealed that women in gastroenterology are less likely to hold leadership positions and more likely to hold a lower academic rank. In fact, only 18% of fellowship program directors and only 7% of GI division chiefs are currently women. As one of only five women in the United States who hold both positions, I can offer some basic advice. For one, seek mentors who not only guide you in your daily work functions but who also can guide you in work-life balance, negotiation and promotion. Second, network with physicians in your prospective fields. Although senior faculty seem far removed from the training process, most will remember the outgoing and eager trainee who took the time to introduce themselves. Third, be persistent. It is not always easy for women in medicine to succeed in a procedural specialty of medicine, as most fields are still dominated by men. With that being said, the presidents of all four major gastroenterology societies (ASGE, AGA, AASLD, ACG) are all currently women. My final piece of advice to young women aspiring to become future gastroenterologist is to simply not give up. The sky should be the limit!
—Asyia Ahmad, MD,
Program Director, Gastroenterology and Hepatology Fellowship Program; Chief, Division of Gastroenterology; Drexel University College of Medicine
Jennifer Schwartz, DO is a second-year internal medicine resident at Drexel University College of Medicine. She obtained her BS from the University of Michigan in Ann Arbor, returning to Philadelphia to attend the Philadelphia College of Osteopathic Medicine, where she obtained her degree in osteopathic medicine. Schwartz currently serves a resident representative on the Graduate Medical Education Committee and plans to pursue a career in gastroenterology.
Shelini Sooklal, MD is a third-year gastroenterology and hepatology rellow at Drexel University College of Medicine. She also currently serves as chief gastroenterology fellow and the Delaware Valley Society for Gastrointestinal Endoscopy Fellow Liaison. Her interests include hepatobiliary and pancreatic disorders, as well as gender-based and cultural issues in gastroenterology.
Asyia Ahmad, MD is an Associate Professor of Medicine, the Chief of Gastroenterology, and the Program Director for the Gastroenterology Fellowship at Drexel University College of Medicine. She also serves as the Program Director for the National Forum on Women’s Issues in Gastroenterology and Hepatology, which held its fifth national conference in 2015. Her special interests include gastrointestinal motility disorders, gender based issues within gastroenterology and novel training techniques.