What would you do if you knew you could not fail?” Every morning, Valerie Montgomery Rice, MD, president and dean of the Atlanta-based Morehouse School of Medicine, starts her day with this inspiring quote, attributed to various sources. Then, she looks for facts and figures to help her achieve her goals.
“I want you to understand that data matters. I always make decisions based on data, particularly when you talk about mission alignment,” said Dr. Montgomery Rice, the keynote speaker at the Women in Otolaryngology (WIO) General Assembly, held October 8, 2018, in Atlanta at the AAO-HNS Annual Meeting. She discussed topics ranging from mentorship to compensation equality to work-life balance for women physicians. The room was packed with mostly women otolaryngologists, along with a handful of male colleagues.
A reproductive endocrinologist and fertility specialist, Dr. Montgomery Rice’s goals include finding ways to achieve Morehouse’s mission to advance health equity for people living in underserved communities. The medical school has an intentionally diverse enrollment, as minority medical students are more likely to go back to practice in underserved communities, she said. “We must diversify the healthcare workforce.”
Education As Equalizer
Education is a great equalizing force, said Dr. Montgomery Rice. Although women’s medical education has been around in the United States since the 19th Century, “we haven’t quite removed all the barriers.” She cited the Medscape Physician Compensation Report from 2017, which showed that otolaryngologists are among the top five specialties for compensation, and that 92% of otolaryngologists surveyed said that, if starting over, they would choose their specialty again (Available at: medscape.com/sites/public/physician-comp/2017). Diversity in medicine is one of the challenges not yet overcome, but slightly more than 50% of new matriculants in U.S. medical schools in 2017 were women, she said. Data from 1963 show that only 0.3% of U.S. otolaryngologists were women, a percentage that rose to 14.5% by 2014.
“There is still room for growth and potential here. Only 2.3% of otolaryngology residents, for example, are African Americans,” she noted. African American females outnumber males by three to one in applications to U.S. medical schools since 1978, she said. Still, when controlling for all factors, women otolaryngologists still make less money than their male colleagues.
Equality vs. Equity
Like any other professional, women physicians seek to reach their optimal potential and to be treated fairly, said Dr. Montgomery Rice. “How do you have conversations with others as you build your toolkit to promote change? I always say that I am a scientist first,” she said. “As we work to close the gaps, how do we ensure that each of us reaches the optimal level of experience so we can reach our potential?”
Health is influenced by social determinants, such as income, healthy behaviors, healthier neighborhoods, and social and psychological benefits. Poor health puts education, the great equalizer, at risk, she said. Interventions like mentoring programs may move people toward access to education, which leads to healthier behaviors and sustainability, she noted.
Dr. Montgomery Rice talked about her childhood in rural Georgia: an African American child diagnosed with osteomyelitis at age seven, raised in a single-parent household in the 1960s. Despite barriers, she had strong support from extended family, her church, and her teachers as she achieved high educational and professional goals, including a medical degree from Harvard Medical School. Education and mentorship, another great equalizer, propelled her toward her goals. Her “village of mentors” included women and men, teachers, physicians, and family members.
Barriers and Burnout
Women physicians and scientists often face a crossroads in their careers when they want to start a family. Some may delay pregnancy, struggle with infertility, or consider adoption. “There is no right or wrong answer, only what you want,” she said. Many women physicians may face burnout as they juggle family and career responsibilities. “You must evaluate yourself and ask, ‘Is this still what I want to do? Am I still passionate about my career?’”
Dr. Montgomery Rice advised the women in the audience to: find mentors and be a mentor, become a content expert, serve on at least two key institution-wide committees, engage in at least one national professional organization, eat a healthy diet, exercise regularly, and consider getting an executive coach.
“Meeting regularly with my coach is a part of my contract” with herself, she said. “I have aligned my passion with my purpose. I have a white coat, a red cape, and I love high heels,” she said, and later quoted novelist Alice Walker: “The most common way people give up their power is by thinking that they don’t have any.” Women have power in medicine, science, and society, she said in closing: “Let’s continue to use it!”
Awards and Election: The WIO General Assembly closed with Stacey L. Ishman, MD, MPH, receiving the Helen F. Krause, MD, Memorial Trailblazer Award, and Sarah N. Bowe, MD, receiving the Exemplary Senior Resident Trainee Award. WIO also elected Angela M. Powell, MD, as the new Chair; Megan L. Durr, MD, as Member at Large; and Priya D. Krishna, MD, as Information Officer/Secretary for the coming year.
Susan Bernstein is a freelance medical writer based in Georgia.