In this episode of Small Talk Big Topics, host Dr. CS Tse and co-host Dr. Bahar Adeli are joined by Drs. Laurel Fisher and Asma Khapra for a conversation about the role of women in gastroenterology. Dr. Fisher is a professor of clinical medicine for gastroenterology and the director of the small bowel imaging program at the University of Pennsylvania. She is also chair and serves on the committee for women in GI at Penn. Dr. Khapra is a physician at Gastro Health in Virginia and specializes in gastroenterology with concentrations in inflammatory bowel disease and women’s health. In this episode, they discuss women in GI, equity in the field and advice for women in GI.
To begin, they explain their GI career journey. Dr. Fisher started in the humanities field and once she changed to medicine, she wanted to take an elective in Michigan. The only one available was GI. She spent a month there and fell in love with the field. Dr. Khapra loved GI in medical school, and was promoted to fellow that threw her in the deep end very quickly. She specializes in private practice and in women digestive disorders. Dr. Adeli shares how she had always been interested in GI and was fascinated how GI connected with autoimmune disease. She loved to learn about how GI connected people to how they felt, and she also loved doing things with her hands, which made this the perfect track for her. They all serve as course directors for the women in GI northeast regional workshop.
Dr. Fisher reflects on how women have taken a greater role in GI, but they are not where they need to be. There are many women in leadership positions and the AGA workshop will encourage women to network and build communities together. There is a huge burnout in medicine, but they want to keep women in GI, Dr. Khapra says. Part of the goal of the workshops is to encourage self-care, reduce burnout, help women feel like they’re in a community and create that work-life balance to do what they love. Dr. Adeli notes how AGA continues to encourage the advancement of women in the field which includes sponsorship, education and leadership opportunities. The numbers for women in GI are growing, but still need to increase.
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Next, they discuss challenges in the GI field as women. Dr. Fisher shares how she had four young children in the early years of her career. She notes how she couldn’t have done it without help, but that it also led her to be extremely careful with her time and very efficient. This changed her perspective on family, patients and illness and says that support is very important. There were not a lot of rules or help for women in residency, and no parental or lactation policies. She found a balance with being a physician and a mother but notes how women do not peak as quickly as men because of juggling personal and professional commitments like this. It’s not okay to lose 10 years of your life in your career, she says. Systems should be built in a way that offer women support to build their careers and families. She also says asking for help is a sign of strength because then you can use that energy in other places.
For Dr. Khapra, she shares how she was the first woman in her practice to have a child and she had to negotiate maternity leave. She says private practice is different– she felt like she had to prove herself and also take care of her family. She suggests finding a job, practice or position where you feel like the people are good people, especially since people spend the most time with the people at their job. To figure out if an employer has good people, she suggests looking to see if other women are employed and talk to them to see their stories. Also, find out if values and priorities align. Are they saying the same things you want to hear, and if not, is there a reason for that?
In addition, they talk about how women in GI can negotiate and advocate for themselves. Good negotiation skills are important for everything and there is no need to be afraid of asking. The worst someone can say is no, but not asking ensures it’ll never be received. They also suggest finding a male colleague who can be an advocate. They recommend having a private discussion before going to the employer to make a request. It’s important to independently negotiate, but it is helpful to get the support of an ally. The ally can also provide tips on how to ask or frame it, or get influence on the back end. It’s important to pick an ally wisely, and to choose someone who can be sympathetic towards you. In the GI field, 18% of GI practitioners are women and ⅓ of GI fellows are women. They’ve always been told that equality is down the pipeline, but it has to be changed now. Women need to see other women in leadership positions, and there is a need to have more workshops and networking opportunities to encourage and instill confidence in women.
Lastly, they discuss mentorship for women in GI. While they did not have formal mentors, they saw women they wanted to emulate and state that there needs to be more mentoring programs for women in the field today. Initiatives are extremely helpful in building a community since it can be very difficult to prioritize community, along with family and a career. It doesn’t have to be a full commitment, but to participate when time allows. It’s also important to get out of the house, which is one aspect of self care. Doing the small things with each other is equally as powerful as the big events. It’s also okay to say no because not every decision is a monumental decision. It’s okay to say no to things that aren’t high in personal value structure and won’t provide higher rewards. Saying no means unintentionally saying yes to something else in the future.
To wrap up the episode, the women share the best advice they’ve received. They emphasize the importance of taking care of yourself, which impacts personal happiness and helps to better take care of others. This means sleeping and eating well, going to the doctor, prioritizing mental health and spending time with friends. They also remind women that there will be a lot of success, but also a lot of failure. It’s important to not let failure be an obstacle – it’s just another step on the way to success.
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