Hello and welcome. I'm so excited that you all have logged on to join us for this virtual community session for AAPMNR, the women's physiatry group. And I am very excited to be able to introduce our speakers for tonight. Our keynote speaker is Dr. Jasmine Marcelin, who is an assistant professor of medicine and infectious disease, co-director of digital innovation and social media strategy for the Division of Infectious Diseases and associate medical director of antimicrobial stewardship at the University of Nebraska Medical Center. As an associate program director of the internal medicine residency at UNMC, Dr. Marcelin founded Diverse, which is developing an inclusive and varied environment for residents, students and educators. And that was a task force she developed. Dr. Marcelin effectively uses social media for her mission to advocate for diversity in medicine. And this has led to her major involvement as a founding member of the Infectious Disease Society of America, America's inclusion, diversity, access and equity task force, where she has played a pivotal role in developing and maintaining principles of inclusion, diversity, access and equity in IDSA, and is an incoming director on the IDSA Board of Directors. She's also founding vice chair of IDSA Digital Strategy Advisory Group and founding member of the AMWA IGNITE Board of Directors. You can follow her work on Twitter at Dr. J.R. Marcelin. And we're going to have a presentation from Dr. Marcelin, followed by a panel discussion with Dr. Marcelin and Drs. Ivanhoe, Cucurillo, Verduzco Gutierrez, and Dr. Hammond. So please help me in welcoming Dr. Marcelin to our community session. Thank you. Thank you so much for that wonderful introduction. So I learned from my sister friend, Dr. Kimberly Manning, that starting talks from a place of gratitude sets the stage. So I would like to thank all of the people who have supported me along this journey that I'm going to share with you, from my parents to my husband, Dr. Alberto Marcelin, my biological family and my friends and chosen family, as well as colleagues, sponsors, mentors and allies. And we're going to talk a lot about those terms here today. And I just want to say thank you. And also in gratitude, I'd like to acknowledge that regardless of the location from which we are accessing this virtual AAPMR, we are all guests living on lands represented by Native nations, whose sovereignty, governance and treaty lands existed long before the creation of the United States of America. And finally, I would also like to acknowledge some gratitude to my ancestors, whose dreams I am fulfilling by my very presence as a presenter here today. So I have no disclosures, and I would like to thank the community session chairs for inviting me to be with you here today. I was born on the island of Dominica in the Caribbean. There, despite being surrounded by countless strong women who are community leaders and the absence of significant racial discrimination, these women I learned from growing up did have to contend with their womanhood as an expression of otherness. So I wanted to tell you a little bit about two women who were pretty inspirational for me growing up. The Dame Mary Eugenia Charles was Dominica's first female lawyer. She was the first woman prime minister of Dominica and in the English speaking Caribbean. While she was prime minister, there were two attempts to overthrow her, including one that was backed by the KKK in 1981. I watched her as she navigated politics and became the most powerful woman in the Caribbean. And in fact, the nickname for her was the Iron Lady of the Caribbean. And she was somebody that even though I chose not to pursue a career in law, I was really pleased to be able to watch how she continued. Next is Dr. Carissa Etienne, who was my childhood doctor and the first person to suggest that I become a physician. I was eight years old when we had that conversation. She was one of the largest influences in my journey to where I am today, and is now the director of the Pan American Health Organization, or PAHO. So when I lived in Dominica, I spent my first few years of my childhood there, and then subsequently moved to Antigua, another island in the Caribbean. I came to the US as an adult, my identity was formed, and I had never been told that I could not achieve my dreams. While I was in the United States, though, and I soon came to realize that my peers were not only facing discouragement from seeking their goals, but there were barriers that were actively being placed that systematically excluded them from achieving those goals. And as soon as I arrived, I realized I would be subjected to those barriers too, regardless of my childhood. During my undergraduate and medical school years, I would experience these things and not have words to name them, nor would I know that there was data that would actually show that I was not the only one experiencing these things. So what's the data? There are disparities that start way before undergraduate medical education, including fewer numbers of underrepresented individuals choosing STEM. And these choices are influenced by their experiences in grade school. We don't have a lot of time to delve into everything. So let's consider medical school. Less than 15% of applicants to US medical schools in 2018 to 2019 were from racial or ethnic groups that are underrepresented in medicine. Of the 2018 to 2019 graduates, 6% and 5% were Black or Hispanic, respectively. And less than 1% of graduates were from Native American or Hawaiian groups. Now we must also consider that when we use terms like diversity and underrepresented, that these terms do not only apply to race or ethnicity and gender. Because of stigma and bias in application development, we do not have a lot of reliable data on outcomes and metrics for many of our colleagues who belong to LGBTQ plus communities or are disabled. In fact, fewer medical students with disabilities actually share or report their disabilities than practicing physicians with disabilities. So even as we talk about things here through my lens of being a woman of color, it is important to recognize that mine is not the only perspective that one must consider when it comes to diversifying leadership. So if we go back to the breakdown of women faculty by race and ethnicity in US medical schools, there is a huge drop off between the number of graduates and number of underrepresented minority women who are faculty members. Between 2009 and 2018, the number of all URM faculty went from 12% to 13%, URM women faculty. And in 2018, only about 2% of the academic faculty were Black women. I often wondered why I didn't see more women that looked like me at my institution when I was in training, and this is the reason. This problem of racial and ethnic underrepresentation is not only medicine. So Hagen et al. looked at pharmacy, medicine, and dentistry and published in 2016 that all of these healthcare professions had a faculty representation problem. But medicine was the worst. And there is both a pipeline entry and a leak-related issue for underrepresented women. So how are we meant to aspire to leadership when we don't see people like us in those roles? There is a key importance of mentorship and sponsorship, and these are the issues in keeping underrepresented women in the pathway to leadership. There's also a lack of opportunities that significantly disadvantage underrepresented individuals. The Wells Fargo CEO was recently cited in September of 2020 as saying that there just aren't that many Black leaders to choose from. But what the evidence shows is that underrepresented individuals are simply not invited and offered these opportunities. So here's an example from Dr. Julie Silver's publication from 2018 showing that fewer women were invited to speak at the Association of Academic Physiatrists annual meeting over a seven-year period. If people are not invited to speak, how is the community expected to know that they are experts in their field and therefore invite them for further opportunities to collaborate on papers, to speak again at larger venues, and to also nominate them for awards or other things? And we'll talk a little bit more about that. So at my annual conference, ID Week, there has been an intentional effort to achieve gender equity among invited speakers. And indeed, we can see, we have seen over the last several years that gender equity has been achieved. In the last couple of years, the number of women speakers has exceeded 50 percent of the invited speakers. They're about 36 to 40 percent of the infectious disease membership are women. But this is a figure on your screen that I presented as a poster at this year's ID Week that examined the trends in speaker representation at the ID Week conferences over a seven-year period across race and ethnicity. And this shows that there is still inequitable representation of minoritized individuals that are invited to speak at the meeting. And similarly, Dr. Silver has shown that women have been disproportionately underrepresented in national society awards. When we think about my specialty organization, Infectious Disease Society of America, there's been a great progress and further achievement in gender equity in the board of directors and committee chairs. And actually, our board of directors and the collaboration of our committees have more women chairs or members of the board than men, which has been a slow trend that has been increasing over time. But despite this, similarly to the gains that have been made with invitations for speakers, there has been a notable lack in racial and ethnic diversity on board of directors or as chairs of many of the committees. And we are not previously collecting information on LGBTQ plus identity or disability. And there have only been seven women presidents since 1963 when IDSA was formed. And the presidency has been typically a one-year presidency, although the total cycle is about a four-year cycle. So individuals are elected as vice president, then move to president, elect, then president, then immediate past president. And despite this, only seven women across that entire timeframe have been presidents of IDSA. To my knowledge, there have been no women of color as president. So what has my personal leadership journey been like? So as you know from my introduction, I'm currently joining the board of directors of Infectious Disease Society of America. So I've had some kinds of leadership roles at varying stages of my career. But in recent memory, I remember founding a medical school newspaper after I lost an election for student government. And then that led me on a path of exploring biomedical writing. And in my training, I co-chaired our trainee diversity and inclusion task force while I was a chief ID fellow. My first faculty appointment, which is here at University of Nebraska Medical Center, started off with a leadership position as associate medical director of antimicrobial stewardship. And I had serious on-the-job learning to do, which I'm still doing. I then recognized that I wanted to have a much more deeper engagement with my medical subspecialty society. So I joined this inclusion, diversity, access, and equity task force when it was inaugurally formed in 2018. With that at UNMC, I continued to then use social media for advocacy and was appointed co-director of digital innovation and social media strategy in 2019. So following those in the same year, I was appointed associate program director of the internal medicine residency and vice chair of the IDSA digital strategy advisory group. And that vice chair position I've since had to relinquish since I'm joining the board of directors. Ultimately, this summer is when I threw my hat in the ring for the board of directors and started my term in October. Along the way, however, there have been multiple professional development opportunities that I have taken along the way. Although at the times that I participated in them, the goal was not necessarily for specific advancement purposes. But finally, I had a lot of sponsors and allies, some who were my peer mentors, people that I could have discussions with about things that I wanted to do. They supported me and encouraged me. And most importantly, they advised me when to wait on several opportunities. And here's the list of some of these individuals. So although the way that I presented this part of my journey to you seems very linear and positive, I intentionally provided a very rosy straightforward picture, because that is what is often assumed when people look from the outside. The reality is for underrepresented women, the path is often unclear. It is filled with unknown landmines, and the end may not be obviously in sight. And there are lots of things that we encounter and have to consider along the way. So let's walk through some of these things. The first thing that we have to grapple with is the impact of intersectionality. So this term was coined by Professor Kimberly Crenshaw to mean the interconnected nature of social categorizations, such as race, class, and gender, as they apply to a given individual group. And these are regarded as creating overlapping and interdependent systems of discrimination or disadvantage. So what does this mean in plain language? What it means is, if I get passed over for a job, or told that a job is not available, when I know that to be false, that that particular thing happened because of my race, or my gender, or both. This is something that is borne out in financial terms as well, where we see that when we're looking at the pay gap, there is a pay gap between men and women, and there is a pay gap between black and white people. The pay gap between a white man and a black woman is the most significant. So another concern that I have had to contend with is, who do I present myself as for job interviews, for patient evaluations, for conference presentations? For a woman of color, we are judged a lot by the way that we look, the colors that we wear, the size of our earrings. And for black women, we are judged very frequently on our hair. And so the question that you see on your screen is, which versions of me would be favored for a job? And I ask this question only half facetiously, because I have worn my hair in many styles, as you can see on the screen. And the fact that I have a completely different style right now from any of the ones that you see on the screen. But only one of these hairstyles on your screen was expressly recommended to me for my residency interviews, so that people would view me more favorably. If we were in a face-to-face, in-person, I would get some guesses from everybody to see what people think, which one of those hairstyles is the one that people told me that I should wear for all of my interviews, so people could take me seriously. Maybe we can talk about it on the panel later. Black hair is really a constant source of discussion. With this degree of negative attitudes towards their hair in the workplace, it is no surprise that most black women will describe a struggle with loving and owning their curls. I know that because it has only been recently in the last five years that I have truly grown to love my hair, because of many of these attitudes. And for me, I still have some of these internalized issues to work out with my own hair. So, add to that the constant barrage of conscious and unconscious discrimination faced by people with intersectional identities. When these are the constant messages one receives from colleagues, from leaders, patients, so-called friends, what are the chances of someone internalizing these messages? What are the chances of them feeling like they don't belong? Another issue that people with intersectional identities have to grapple with is that of imposter syndrome. Oftentimes, one is plagued with questions of whether they belong in an environment where they are a minority, which may translate to enormous pressure to excel, because people expect them to fail. The problem is that such an environment is not nurturing, and it is not supportive. And if they fail, there is the added burden that their failure represents a failure for their entire identity group. This is really interesting, that from my personal experience, my success may continue to be attributed to me individually as an expression of exceptionalism. However, my failure can be attributed to all Black women, or immigrants, or international medical students that may come after me. That is a lot of pressure that comes at significant cost. So, in all of the history of diversity efforts, and particularly in today's 2020, where we're not only seeing the impacts of COVID-19 ravaging Black, Indigenous, and people of color across the country, but also witnessing disabled folks being marginalized, anti-LGBTQ discrimination, and abhorrent racism and police brutality, there have been a flurry of institutional organizational statements about diversity and inclusion that are released by these institutions organizations. Unfortunately, many of these statements are not backed with financial resources to tackle systemic change and dismantle the structural racism that infects our institutions of health care. Nor is there obvious valuation of our work in the currency of academic leadership, which is promotion and tenure. So, this means that this work disproportionately falls upon the very same marginalized groups who are obviously passionate and committed and receive little or no compensation or recognition for this work. And that is what this work is all about. So, amidst all of that, how does someone with an underrepresented identity even aspire to leadership? And how do we get there? So, here's a few books that I've read over the past few years, which I, from which I learned, you know, several lessons that I think have helped along the way. And I have also had the privilege to speak to several phenomenal people who have been And I have also had the privilege to speak to several phenomenal underrepresented women physicians with different identities that I will share some of their wisdom with you. One of the most impactful books I've read in the last five years is Stacey Abrams' book, Lead from the Outside. She talks a lot about what ambition means for an underrepresented woman. The context of internalized bias and imposter syndrome were not lost on me, as I found myself turning down opportunities because I was too afraid to fail at them. Or I passed on applying for opportunities because I didn't want people to think that I was too uppity and trying to get into a space where I did not belong. The truth is, we should all dare to want more. And the discomfort that we feel when we consider something beyond our comfort zone is the growth needed for us to truly excel at being leaders. So, if we want to go on this journey to get that leadership position, whatever it may be, we do need to invest in ourselves. So, that investment can be either of time or of leadership development opportunities. One thing I learned from Tonya Dalton's Joy of Missing Out was to create a personal mission statement. It took a lot of time and multiple revisions, but it was a really useful exercise for me because it allowed me to remain grounded whenever I considered career decisions that I needed to make. So, here's my personal mission statement that I wanted to share with you. It is to create and support a healthcare workforce and graduate medical education environment that strives for excellence and values inclusion, diversity, access, and equity as not only important, but necessary for excellence and success. It really takes time to develop yourself as a leader. So, Dr. Lillian Albaugh, who's an infectious disease physician in Miami, suggests that we need to set goals and review them frequently and spend the time that we need to update our CVs and bios because you may have an unexpected opportunity that requires you to send that quick CV and bio, and you want to be ready. Dr. Neda Fadol, who is one of my colleagues here at University of Nebraska Medical Center, suggests that we need to explore our strengths and learn how to use those strengths for leadership. So, speaking of strengths, I also read Strengths-Based Leadership, and I really, I recommend this book. I learned from reading this book how to recognize not only what my strengths were, but also how others perceive them. So, for example, my strength of achiever means that I am satisfied when I am busy and productive. I pride myself in working hard, and I hold myself to a high standard. However, it might also mean that I could hold others to possibly unacceptably high standards, and I need to recognize when perfect is the enemy of done. So, Dr. Gigi Osler suggested that being intentional involves investing in leadership development courses and reading that enlightens you, and I agree with her. And Dr. Carissa Etienne, who is my childhood physician that I mentioned earlier, she thought that awareness of these strengths really allows you to be able to recognize when a platform is presented to you so that you can fully occupy it. It's easy to think that you may not be ready or you may not be qualified for a particular opportunity if you don't have a full grasp on what your strengths are and what you can bring to the table. So, the second thing that I learned from reading is that we must invest in others, those that look up to us and those from whom we draw our own support. The sense that we're representing others can be a burden, but it can also be a blessing if we recognize that we can be the light that others need to recognize their potential. It is okay to celebrate being the first, but with that must come resolve to not be the last, according to Drs. Etienne and Dr. Abbo, as well as according to our new vice president-elect, Kamala Harris. I'm reading currently Alice Wong's Disability Visibility, first-person stories from the 21st century. In her introduction, she talks about the importance of community. So, according to Wong, community is political, community is magic, it is resistance, and most importantly, community is power. I have learned over the last few years how important community is and the importance of having people you feel safe to tell your dreams, like Dr. Camille Clair says. And, you know, this is a shout out to my MOCA docs, which is a group of Black women physicians and scientists in Omaha who are there to give feedback, to give support, to support my dreams, to share rage, to offer hugs now virtually, and send food even when we're sick. Everyone needs a squad, and for underrepresented folks, it is even more important. Another thing that I learned is about negotiation. This is something that we hear a lot when we talk about leadership for women in medicine. How do women negotiate? Can we have better ways for our negotiation? One thing that I've learned is that negotiation is not just about money, and it is really important to consider your time and your personal well-being. And I will be the first to admit this is something that I still struggle with, but I aspire to achieve, is full negotiation for my time and well-being. So, two important lessons I learned from these two books that sort of helped me to put that into context. The joy of missing out, or JOMO. So, basically, everything that we consider agreeing to do has to be in the context of our personal mission statement. If it does not align, we must seriously consider declining. And the issue here is, well, how do I decline, especially if you're a junior person? I remember when I first took my faculty position, one of the pieces of advice that I got was say yes to everything, because you want to make sure that you can put yourself in front of people's faces and that they can know who you are and give you more opportunities. What I can say about that piece of advice, it is exhausting as a junior faculty, because you are already doing things that are more than maybe others from a clinical standpoint. You're trying to get yourself noticed from an academic standpoint, or maybe you're not even academic, but you're just doing a private practice, and you are, you know, starting to get this clinical work done, and then there's potential leadership opportunities within your practice or in the community. And people telling you to say yes to everything will ultimately lead to some form of burnout. So, really centering that mission statement and being able to say a wholehearted no and feel that joy of missing out is really important. So, one of the ways that I say no is, this sounds like a fantastic project, but given my commitments, I'm unable to devote this project the time that it needs. And that's something that I learned from Tanya Dalton in The Joy of Missing Out. So, then the second one, the second negotiation lesson is the BATNA. And so, I first learned about the BATNA from Dr. Julie Silver, and then I heard about it again from Dr. Harriet Hopps, who showed me about the power of a positive know this book from William Ury. And so the BATNA is your best alternative to negotiated agreement. When negotiating, it is so important to consider all possible outcomes and then reflect on that personal mission statement. I love that personal mission statement. Identify what is the alternative outcome that would be acceptable to you and then draw your line in the sand. Taking that time to reflect before the negotiation will help you to feel more at peace with the outcome of the negotiation, even if it means walking away from a potentially great offer or opportunity. And then another lesson that I learned is how important it is for us to control our own narratives because oftentimes others influence, others' impressions of us might be influenced by their individual bias. So Dr. Lisa Iazioni recognized that those of us with intersectional identities are often held to higher standards. So it is important to know the metrics by which you will be evaluated. And then Dr. Abbo says, you gotta be on all the time. Have a 20 second elevator speech ready to tell anyone who you are and what you are about. So when I had this nice conversation with Dr. Gigi Osler in September, she asked me this question. She said, give me your elevator speech. I was not prepared. I did not have one. But you know what saved me? My personal mission statement. Tonya Dalton calls it your North Star and I have learned that it really does guide you. So excuse me for saying it so many times during this talk, but I really believe in it. And regarding what others read or hear about you, one way to do this is to curate your digital and social media presence. So Google Alerts can help keep you abreast of what is being published about you. And I recognize that that may seem a little narcissistic to get alerts about yourself, but it is important because when someone is looking for a speaker or a collaborator or an assistant dean, for example, and your name is suggested, what is the first thing that you think they're gonna do? They're gonna Google you. So you wanna know if things are being published that have your name, that may not necessarily represent who you are or what your brand is. The bonus is that by creating and nurturing your social media presence, you may actually increase your opportunities that might come your way. And so that is something else that can help to build your brand and your presence and help people to know who you are. On the screen here, you will see a non-comprehensive list of the things that have happened in my career just because of connections that I have made through social media. There's so much more that I wanted to share, but unfortunately we don't have a lot of time and we've got a great panel that is set up for us that is gonna be talking a lot about these things and what they mean for us individually. So what I wanna leave you with, with these next few slides are some challenges. So right now, first, I wanna challenge you to do the following three things. If you are an underrepresented individual aiming for leadership, or if you are not, go home first, go home and write your personal mission statement. Take the time that you need to do it and revise it as needed. And it's okay if that mission statement changes over time as you reflect on what you want in your career. The second is to nurture your relationships with members of your squad. Call them, text them, support them, thank them. Make sure that you are there for them and that you are also giving as much as you are receiving from your squad. And then invest in yourself and in those behind you. This is time and money well spent, trust me. And for those who are not underrepresented and wants to be supportive, here is a list of things that you can do to help. So first and foremost, we need you to see us. When you see us, you will pledge to invite us, to speak and collaborate. Include us in conversations, mentor us, sponsor us, recommend us for leadership, pay us equitably for our jobs and compensate us for extra work that is done for diversity, equity, inclusion. And finally, promote us. You can learn more by searching the Her Time Is Now campaign that's led by Dr. Julie Silver, which is one of your colleagues. And Dr. Quinn Capers, just to wrap this up, who's one of my colleagues, an interventional cardiologist who contributed to the Her Time Is Now report, he said this really eloquently. When institutional bias and racism are layered on top of gender disparities, it becomes a feat of heroic proportions for women of color to advance to the highest levels of medicine. Eventually, the hope is that it will not be a heroic effort, but it will just be every day. But until then, I leave you with this poem written by Canadian poet, Rupi Kaur, and referred to me by Dr. Gigi Osler. It's called Legacy. It says, I stand on the sacrifices of a million women before me thinking, what can I do to make this mountain taller so that the woman after me can see farther? Thank you, guys. Thank you, Dr. Marcelin. That was a great and inspiring presentation. So I hope that everyone enjoyed it. And now I would like to have the panelists kind of join on. And so for those of you that don't know me, my name is Mary Beth Russell, and I am chair of the Women Physiatry Group. I work at UT Houston, down in Houston. And so I'm a woman of color, and so a lot of the panelists here are my mentors and people that I look up to and do just amazing things. So with that, I would like to ask, we got one question from the panelists. And so if you have any questions, please feel free to put them in the Q&A after the session, and then we'll kind of go around to the panelists and get those asked. But first, one question that I wanted to ask y'all was if you can go along and talk about your path to leadership and how things that you've experienced and how you overcame any barriers. So Dr. Ivanhoe, would you like to start? So as you write, it's a long path. I don't know how long we have. I did my brain injury fellowship at Tier as a Baylor fellow at the same time that Stuart Yablon actually was doing his fellowship. He was a research fellow and I was the, Flora's smiling, and I was the clinical fellow. And through a host of different twists and turns, we became co-directors and then he left, I became the director of the program. Interestingly enough, even though I was already running the program for a couple of years, there was a big meeting over whether or not I could go from co-director to director. And I remember that meeting. I remember who was in the meeting. And I remember that I was pregnant and hadn't told anybody. And that was when my son decided to kick. So my shirt was like bouncing during the meeting, but they were all men and didn't seem to notice. But I wonder to this day, my son's in his early 20s now, how many of us would be able to sit in a meeting like that, determining your promotion and say, oh, and by the way, I'm going to have a baby in a few more months when, you know, I mean, granted they can't ask and it shouldn't matter, but I think it still does personally. So I did that for quite some time. And then at a certain point out of the blue, three very well-respected brain injury programs tried to recruit me. And I realized that I was being somewhat taken advantage of under the circumstances that I was under. I probably could see it after this, but, and it made me kind of reinvent myself here in Houston. And as a result, I stayed part-time Baylor and part-time at my current institution, yet again, TIER. And I started a post-acute residential program and I started a part-time private practice. And I don't know how I did it all at the same time, but I did. And eventually the residential program grew to four or five brain injury programs with different components and was flipped by private equity. I left them. And I'll skip the next steps because I don't think they're that significant, but I have come full circle in a way to being at TIER. First I was at TIER as Baylor faculty, and now I'm at TIER as University of Texas faculty and doing different, somewhat of a different role. Yes and no, different role. I do a lot of teaching. I do a lot of patient care. And I've tried really hard to maintain what I say, not going crazy again. Because in all those things that I did do, program development at TIER, at Baylor, for what used to be called MENTUS and my practice, I don't know how I did it. And I think it comes with a lot of drive, a lot of trying to prove that you're not an imposter. And I will throw out there that I'm also an international medical graduate because I studied music and medical school was a sort of, yeah, I really do want to do that kind of thing. So maybe it's some of that. And, but it's, I don't think I would change any of it, but I do kind of wonder and I look back and I talk, I do a lot of mentoring, at least I think I do. And I sometimes, you know, I once had a resident tell me when she was applying for a fellowship that she wanted to grow up to be me. And I said, be careful what you wish for. I'll just end it there for now. Dr. Hammond, you're next on my screen. Would you like to go next? Well, I have to say, in interviewing people year after year for fellowships, they all came from Houston and they would say that they wanted to grow up to be Cindy. So it was more than one person. It was quite, quite impressive. Gosh, so I would say probably a theme for me is basically just I've been driving, I've been following my passion. So I've actually never really dreamed to be, to do any leadership for leadership sake, but because I can't actually sit and not constructively contribute to something. I'll try to go into a meeting and not speak up and sit on my hands. And the next thing I know is, you know, I'm knee deep wanting to get involved in it. So I think following your passion and letting opportunities come from that, of course, yeah, you know, you have to be careful with that has been outlined and exactly knowing what your goals are and not getting too far off. So definitely, as at least for me as going along, trying to figure out what aspects of all of that, that I enjoy, that I wanna do more of and that tap into that passion because the passion for me is, and I think for all of us is what keeps us going. Like Dr. Ivanhoe, I had the opportunity to do a fellowship and at the time we all kind of talked about fellowships and decided a fellowship really was a gift. And that's exactly true, it was a gift that opened up doors for me. So that definitely probably changed my trajectory if I had not done the fellowship and if I had not taken a job at a place, an academic institution where things could blossom. My goals truly were to go back home to do private practice. So by choosing an academic facility, it actually allowed me to grow. So it kept those doors open that I was opening without really knowing it, but by following my passion, by doing research as I went along, just in case I ever needed to do research. So you can tell it was not a real purposeful, knowing where I was gonna end, but constantly I think that following that passion. I will say one thing that I'm not comfortable, I have to constantly feel uncomfortable, like knowing that I'm not growing if I'm comfortable. And I think probably my mom and dad demonstrated that to me. So I always put myself out there to try to do stuff that I don't know how to do. And I think that goes a long way to growing you and growing opportunities. And I mentioned the research. A lot of what I first started off doing was more advocacy, community service and policy, but then that grew to be research. It grew to be research because that's what my institution needed. And they looked to me to do that since I had done some research along the way. So it was really kind of blooming where you're planted. And I thought I could do what my institution needed. And so decided to do that and see where it went. And yeah, I think that summarizes my story. Thanks. Okay, thank you so much. Dr. Cucurillo, you're next on my lineup. So would you mind telling us a little bit about your story? Sure, sure. And thank you again for the invitation to be on this panel and to be with all these great women and for all your organization efforts, Mary and Monica. So I basically started as a consult attending right out of residency and was asked to really help the residents prepare for boards. And I started a board review course first year out of my residency. And I was an education minor. So I was very invested in education and as a result can continue to teach and then was offered the program directorship at my facility because I revamped the curriculum and organized it in a way that along with the board review book, the residents started to do very well on the boards. And really that inspired me tremendously. And to speak to Flora's piece, I was very, very passionate about education and helping residents move forward and really trying to work with them and help them succeed and move forward. I was asked at that point by residents, both in my program and outside the program to start to mentor them. And I was part of the PAL program through the AAP and that was tremendously gratifying. While I was at the national meetings, I was approached by Demos Publishing and asked about publishing my notes from my board review course. And a lot of residents were contacting me. At the time I was actually having my program coordinator photocopy my notes and send them out to residents who were saying that they just couldn't afford to take these expensive board review courses and could I share my notes with them. So my program coordinator who is still with me 25 years later, so she didn't throw in the towel but she used to help photocopy all those notes and send them out. But Demos had asked me about publishing the notes and as a result, the PM&R board review book came out of that and I got a lot of very positive feedback from residents who said, the goal with working with Demos is that they kept the book at a very affordable rate to the residents and that all the monies from the board review book were and still are converted back into a resident education fund. So that was very important to me. I remained program director for years. It was very interesting because at a national meeting I was sitting around the table with seven other people. We were having workshops and it was at that national meeting that all of a sudden I just had asked about, salaries had come up and I realized sitting around the table they were all men, that we were going around and I was the last person to report and I was completely embarrassed because I was making so much less than them. And I was saying, I just can't believe this that I'm so significantly, my salary is so different. So it actually gave me and inspired me to go and have a really frank conversation with my chair at the time. And he was very responsive and he said, okay, we'll move forward. But it really planted a seed in my head. Like, why was it that I had to go and advocate for myself when I was clearly we were getting better prep at board pass rate. My outcomes were such that I thought I should have been moved forward just organically from the work product that I was producing. So I really started to work with residents that were graduating to negotiate their salaries properly. I've done lectures on negotiation strategies and things like that and became part of the AAP board. I became part of the chair council and I've actually worked very closely with Julie Silver as a co-chair of the women in academic physiatry task force her and I are co-chairs. And we've really looked at the analytics of how women were treated, how women are treated via societies because a big part of moving women forward is them being nominated for the awards that Dr. Marcelin was talking about. And that getting those chair positions of the committees and getting invited as plenary speakers. So we were very committed to seeing how we could move women forward and also get involved in workshops to help sponsor and mentor and sponsor women and get involved with workshops such as this that have been established. In 2014, the position for chair became available in my department. And again, it's almost like to say that to wanna become the chair, it really impacted me that I was initially saying, I'm not really sure I check all the boxes here. I'm not sure I can do every one of these specific duties that are responsible. And actually it was very interesting because I was asked to interview a few of the chair candidates. And I realized that they were, I was very afraid after interviewing that the culture at JFK Johnson would change dramatically surrounding education and research if I had not applied myself. And there's the whole book about leaning in that as far as not, you don't have to check every single box. And I think that's important to know and really engage role models at your regional and national level to kind of talk and say, is this a good time for me to move forward with this? And it's interesting because I asked both men and women. I made multiple calls before I threw my hat in the rink and then decided to, there were 29 candidates when I was applying for chair. And I had 28 plus interviews, but then was selected as chair, which was very gratifying. And have worked when I started at this position, I had 10, I started with a department of 10 individuals. I've been chair for five years. I've hired over 22 positions. So we're up to 32 within our department, but we've grown expansively on the outpatient side in addition to the inpatient side. And then we are the department of PMNR for Rutgers Robert Wood. And our hospital system merged with Hackensack Meridian, which is actually a competing healthcare system. But because we're a strong department, Rutgers Robert Wood agreed to keep us in place. And Hackensack Meridian said, even though you're their department, will you also be the chair for Hackensack Meridian School of Medicine? So I'm actually chair at both Rutgers Robert Wood Johnson School of Medicine and Hackensack Meridian School of Medicine. And that's, and then came the next level where they asked about, it's an 18 hospital system, if I would be in physician-in-chief and manage rehab throughout the 18 hospital system. And so now that is also part of my responsibility and we're growing rehab through the entire system. And it's challenging, it's exciting. And, you know, look forward to what's ahead. So thank you. Well, thank you, Dr. Cucurillo, the double chair. Dr. Berduzco-Gutierrez, would you like to talk about your journey? Sure. I think it's a journey that starts with us being inspired by women in the field. So my, I didn't know about PM&R when I went into medical school, but then when I finally did learn about it and then got to do rotations, my first rotation was with Susan Garrison. I got to work with her for a couple of weeks and see what she did. And then my next big rotation, I got to work with Dr. Ivanhoe. And so then it was like one of those people who wanted to be her when they grew up. And I also, the resident that I had was Danielle Melton. And so she was pregnant at that time as a resident when I was a medical student. And she was just like the most efficient, amazing resident I'd ever worked with. And then she was like, it was a super team, was like me, Dr. Melton, as a medical student, Danielle Melton as a resident, and then Dr. Ivanhoe as the attending. And it was just like, see all the inpatients and like tons, tons, they had tons then. And then like have clinic and slang talks everywhere. And it was just like, you know, good old time and super inspired by the women that I got to work with. And they were both moms, they're moms to be. And so it was like, okay. And then I love the field and the patients and seeing the patients get better. So I ended up in the field, you know, did my residency, had my kids in residency. So in residency, I wasn't like, I was a good resident. I worked hard, I did my work. And then, you know, I wasn't a chief. I wasn't a, I didn't do 20 research projects or anything like that. I kind of focused on having my family at that time. And that was fine. And when I was done, I almost was like, I was just, I wanted a job. It wasn't like I had these great plans in my head that I was, you know, wanted to be a chair in so many years and whatever. It was just like, oh my gosh, I need to have a job. I have to like help feed my kids and start paying off student loans. I think a lot of people kind of think that when they're done but then it was like, I want to be in this academic setting because there's all these amazing people that I was exposed to when I was in residency. And I love the teaching and how they touch lives and such. So, you know, I was really happy when I got to be a faculty at UT Houston. And I think I did all the wrong things at the beginning. Like I said a lot of yes, yes, yes. And I just like worked myself to the bone. I was very efficient. I was a workhorse. I just, you know, just did a lot of clinical work, made a lot of money for the department. Not that that's bad. As a chair, I'm like, continue to make lots of money for the department. But, you know, I didn't have enough time to focus on developing interests or like a lot of research interests or getting involved in the academy earlier on than I did. And so, but I did kind of try to get involved at the hospital level just because I was so involved in clinical work, then it became really important to make things better in the hospital system. So that means I got asked to be on all the committees like, oh, will you be on the informatics committee? We're getting a new EMR. Yes, because I want things to be efficient and I want that to work. Oh, will you be in our medical records committee? Yes, you know, I just said yes to a lot of things and continued to work, work, continued to teach. I love teaching. I got teaching awards and, you know, loved working with residents that way. And then just along, and then I feel like just timing is kind of important too, like place, time, people that are around you. It just happens that things work the way they work. And, you know, there was someone in our department that was higher up and he was the director that was brought in to be the director of the brain injury program. And then he left and it was like, okay, well, we need someone to be the fellowship director for brain injury. And I was the next person on the UT side that had the most experience. It was like, do you want to do this? And I was like, that's the imposter syndrome. Like, can I do this? Like, can I be the fellowship director? But it was almost like there wasn't anyone else. So it was like, okay, I guess I'm doing it. And, you know, I did just fine with it as program director. We made our program, we made it an accredited brain injury fellowship. And, you know, we had had multiple fellows who've all done, you know, excelled ever since. And, you know, we had an excellent program with UT and Baylor and at TIER. So that was very nice as well. And then came the time when, okay, the brain injury director left and they needed another brain injury director. And it was like, well, again, I'm the person that's the next, that has the most experience there. And this is at this major rehab hospital, it's at TIER. And so there's another, like, how can I be the director of a brain injury program for this major, like top three rehab hospital in the country? But it was kind of like timing and there I was. And I was this person with the most experience and worked really hard and worked with all the people. So it was like, okay, I'm going to do this. So these are just more things that I was, you know, putting under my belt, getting more experience, got to, you know, be involved in more things. And then the other thing is I really felt that I was then getting more involved in my academy and societies and AAP, and then got very supported by those organizations as well into different positions and getting into some of their leadership programs as well. So I'm very, very thankful for both the academy and AAP for helping in my career. I became a vice chair in my department as well. I was the chair of our faculty Senate for our whole medical school. So it's something also that I did. So just kind of, you know, try to cover, or I mean, it wasn't purposely, it was just kind of my mission, my advocacy, things that I love to do, seeing people get better, both at the faculty level. This is when my big thing that I did there was burnout and getting an ombudsman person and getting a white paper for our faculty, where we talked about burnout and everything that we could do for it. So just kind of followed things that I was really passionate about, and then, you know, moved up the academic chain. And then when the time to come, I heard about this opportunity to be chair, that a chair position had opened in UT Health in San Antonio. At first, you know, I read about it, you know, they send you emails and you read about it, and they asked for like, oh, you must be a tenured professor, and we want someone with experience, and have you already led a department, and I was like, oh my gosh, I don't meet any of those things. I was an associate professor, and I wasn't a tenured associate professor, and I wasn't a chair already, and, but then, you know, word gets around, and you kind of hear things like, who else is applying, and what, you know, and then I got support from other people, you know, everyone's talked about Dr. Silver, and, you know, she is one of my mentors, and she's like, well, why, this is something that interests you, why not try? What's the worst thing that's going to happen if you go for chair? You don't get it. Okay, what's your BATNA? You know, I'm still here, I'm still vice chair, I'm still a medical director, I mean, you know, maybe I'll want to be the program director. There was other options for me, so it was like, okay, what's going to hurt in going for this position that aligned with my values? I got to go, you know, go back to South Texas, where I was from, serve population that I love, and care for, that's super diverse, and lead this like young, enthusiastic department, and so, and then the other thing is, while going through this process, I got support from every person on this panel, so it's like, you know, Flora would take calls, Sarah would take calls, Kathy Bell, who I know is watching, would take calls, Cindy, always, you know, I can always go for, to her for advice, you know, they helped, they looked at my statements, they talked to me, you know, the night before interviews, and just so, really supported by women in PM&R, who are like, so welcome, and open, and you know, willing to help, and so here I am, seven months into being a chair, and even in the middle of the pandemic, it's going well. Yeah, starting your position in the middle of the, the start of the pandemic, right? You have zero dollars to start with. So, our next question is one from the audience, to, we can start with Dr. Marcelin, so, how do you work on empathy with others who are unable to have similar goals, like of constantly striving to be the next project, just, etc., as a leader? Yeah, that's a really good one, especially, so with, with my, one of my strengths as an achiever, and wanting to always do the next thing, and that can be, that can be challenging, I think it starts with sitting with that person who's a part of your team, or that you are leading, and, and really getting a sense of what is their mission statement, what, what are the things that they want for their careers, and recognizing that as much as you might want to influence, and inspire others, that can be done in a number of different ways, and asking first what people want is, is better than trying to impose your own way. And developing empathy, I think I always think about it in terms of my relationships with my children, and how, how do I communicate to my four-year-old and my eight-year-olds what I really want, what I want them to do, but in a way that still retains their independence, and how can we come up with an alternative that makes both of us sort of happy with the direction that we're going, oftentimes with me secretly sort of knowing that they'll get to where I want them to go to eventually. So I'll stop there, but I think it really comes from approaching it on what does that individual want as their personal mission statement. Okay, yeah, thank you for that. Dr. Hammond. Yeah, so you know, each faculty member brings different things to the department, and so they have, I start with wanting, really wanting to know people's goals, because ultimately I want them to be successful in their life, and so what is it they want to achieve, and then also what can the department, what opportunities does the department have to match that, and wanting what, if it's going to be successful, you want to grow together, and I have no intentions of having, I don't want all of our faculty to be just, you know, the exact same. I don't want everybody to be trying to chase the next project. Actually, more and more, we're realizing how important wellness is, and so wanting to know what their goals are, and their passions, while also wanting to make sure they're watching out for themselves and their family, and if they follow their passions, I think the wellness will be there as well. Okay, thank you. Dr. Ivanhoe, your thoughts? You're muted. Yeah, enjoy that while it lasts, too. I think that, you know, I kind of read the question a little differently, and I wasn't 100% sure if it was developing empathy in other people, having empathy for other people, but I think that either way, it's sort of a question of emulating who you want to be, and seeing who it is that they want to be, and what is important. A lot of what Flora said, I think, rings true as well for me, that we're all driven by different things, some similar things, but a lot of different things, and I think sometimes we've gotten so paranoid as a culture about what's personal, and what you can or cannot talk about with people, and so maybe it's, I'm working this out as I talk, maybe it's just being real, you know, being authentic about our own experiences opens up a door for the person that we're talking to to be the same, and understanding what drives them, and, you know, we've all had times, like Monica said, she wasn't, you know, particularly, I don't know how you put it, Monica, but, you know, as a resident, it wasn't like she was driven, she was having her kids, and as driven as she is now, but, you know, you just understand there are times in people's lives where we're all affected by things that are going on at work, things that may be going on at home, and where life takes you, and how life takes you there. Yeah, thank you. Dr. Cucurillo? Yeah, I think to, as, I think being program director was one of the best preparations I had to be chair, I really tend to look towards people's strengths and their passions in order to grow them, and to grow whatever program that they're very passionate, and very hungry to move forward with, much like what Flora had said, you know, really working around someone's passion, you know, there's an energy there when they're doing what they love, there's an energy that they want to, they want to be there kind of running with you to help develop those programs, to develop those, you know, to go out and recruit, you know, patients for their services, and I, you know, and, you know, and I made a point when I became chair to have, I was going to have one hour meetings with each of the attendings that were existing here, and it turned into two and a half hour meetings with each one of them because they had so many ideas pent up that they wanted, they really wanted someone to listen to them, so that listening tour was, was so important to me in, in, in helping grow service lines and identifying strengths that were existing within the department that were untapped, and they, and, and then identifying with each person, I tried to find some low-hanging fruit to be a win, to really show them I wanted them to move forward and to work with them to develop the services, and keeping in mind what Cindy said as well, because there were those, you know, there were those attendings that came in and, you know, at one point, you know, saying the third, they were pregnant within four years with a third baby, and being in tears in my office saying, I'm so sorry, and I'm like, listen, I'm the last one to talk, I, I have four kids, I was pregnant four times in five years, and still moved forward, but I had a very supportive chair at the time who supported me and kind of helped me move along, even while I was having my family, so it's, it's, you know, identifying, like Cindy said, those waxes and wanes in, in people's lives, and realizing that there's children, there's children to be born, and that there's elderly parents that might need help, and really kind of, you know, working with the faculty, and, and I just find my faculty and the residents are so supportive of those life events, and they're so grateful when they get the support to develop programs that they're passionate about. I never want to put somebody in a position of a job that they hate to do, because I, I just feel it will never be a successful end result. I really want to put, match people to do what they want to do, like one of, one of my attendings who, for years, for years prior to me becoming a chair, was trying so hard to develop this spasticity program, and didn't get the support, and, you know, over the last five years, it's expanded exponentially, because we got him, he sat down, told me what his vision was, and then you, you know, he, we ended up giving him not everything, but parts of what he wanted, and it's just, it's grown substantially, and that's his kind, and everybody takes it as their, kind of their baby. This is their service, they're going to grow it, they're, they're passionate about it, and I'm thrilled to see them, to see them grow in that direction, and also, like I said, being residency program director, some of these attendings that were hired were my graduated residents, so I'm thrilled to see them excelling, and exceeding, and in all, in different areas that they're passionate about. That's great, thank you, and Dr. Verdusco-Gutierrez. I think everyone said everything wonderfully, just the only other thing that I would add is, you know, knowing the people that you work with, knowing the people around you, knowing their, you know, their story, their life, what they want at this time, and then, kind of, you know, it's a partnership, also, when you work with people, and it's negotiation, so it's like, I may have something in mind, you may have something in mind, listening to what they want. I had a faculty last week that was like, just saying, oh, she had a hard week, and she felt like she wasn't doing enough, and, you know, and her, she has young girls, and it was like, that's okay, you know, you are doing great clinically, you're excelling, I want you, you're building the pediatric rehab program, that's all I want, I'm not asking you to do, like, 10 papers, and build a pediatric rehab program, and so, you're working on that, you're doing great, and, you know, take that extra time with your kids, and she just felt a lot better, knowing, okay, you know, our goals are aligned with each other, so, kind of, make sure that goals are aligned for both people. Okay, thank you so much, and so, we have a couple more questions, hopefully, we have about 16 more minutes, so, hopefully, we can get through them, and the next question is also an audience question, so, many women work less than full-time due to family and life balance. Do you feel that part-time physicians can be effective administrators? Why or why not? Dr. Marcelin, would you like to start? Yeah, I think people can do whatever they want to do, whenever they want to do it, whether they're full-time or part-time, and I think it boils down to, what is the support that you have, that is both your leadership and also supporting actors around you, and really knowing what those goals are. I mean, the caveat is, I have not, I've not done a lot of, you know, private, like, outside of academic administrative work, and I've also not been part-time myself, but if I wanted to be part-time, and I also wanted to lead something, as long as I feel like I would be able to produce a request to my chair or my chief and say, this is what I'd like to be able to do, and yes, I'm part-time, but I can do this with this amount of time, and this is how I can show you. So, I hope that people are not being discriminated from leadership positions because of part-time status. That would be a shame. Hey, should we go backwards and start with Dr. Verduzco-Gutierrez? Right, I just agree. I think I've seen, you know, many women physicians be part-time and be extremely successful in what they do and be able to hold leadership positions, and I just always make sure, you know, when I'm in the room and when I'm at the table, that I am standing up for people I am standing up for people who are part-time. Usually, it does happen to sometimes be women, but even if it isn't, you know, I'm going to make sure that their voices are heard, that they get representation that they need, so that's just something that I make sure that I do. Okay, Dr. Cucurillo? Yeah, I'm really about the person and where they are in life, and if they need to talk with me as a chair and need that part-time status for personal reasons, whether it's children or elderly parents or just that, that is what they need at that point in their life, and they're a talented individual that I want as part of my department long-term. I am more, you know, I'm a big, big advocate of trying to keep them in the department and attend to their needs. I was, early on when my children were very small, I was part-time for those until, for a period of time until I worked out my child care, and if I was shut down very early in those first couple of years, I couldn't have continued to progress, so I think about that very frequently and really try to work with, you know, each individual as they are building their family or they're dealing with other life events that require them to be part-time. Okay, Dr. Ivanhoe, I feel like you've had like six part-time positions at once, right? Yeah, I'm going to say that I think women in particular need to be very careful to not be full-time for a part-time salary. I also will say I don't necessarily a hundred percent agree that you can be in a leadership position as a part-time physician. I think that a lot depends on when you're building your reputation, where you are in your life, who, if it's an academic position, who your chair is, and I, you know, how many women on this call right now, on this course right now, are part-time? Raise your hands. So I think that, salute Mary Beth, I think that it kind of depends what it is you're trying to build. When I was first trying to develop the brain injury program here at TIER, I worked so many hours doing acute care consults. I remember coming home pregnant one night at like four in the morning because I wanted to develop, or it was stupid, but I wanted to develop a relationship with neurosurgery, and I came home pregnant and, you know, I'm divorced. I'll admit that too. It's another topic, maybe next year's course. But, and my then husband said to me, if this child is normal, it'll be a miracle. But I did build a very strong, very large program when I stepped down. I think that you need to be present, and when you go part-time, you're not at all the meetings. If it's on an academic floor, you're not on the floor all the time, and it's a little bit harder to develop something that somebody said to me when I first ended up president of the active medical staff here at one point, and she said, I said, well, why would I want to do that? And the woman who had nominated me said, well, that's how you get your power, and at that point in my life, I wasn't thinking power. What a weird concept. I just want to be a good physician and do the right thing and teach, but I now, at a different point in my career, understand what that meant. You have to develop your clout. I think it's a lot harder to develop clout and have all that inside information that goes with it if you're a part-timer. If you want to be part-time and you have a chair like Dr. Cucurello or Dr. Verduzco-Gutierrez or Dr. Hammond, I think that's fine. People need to do what they need to do, but I think that it will come at a price either way, whether you do consults at two or four in the morning or whether you choose to go part-time and look for a different sort of path. That's your choice, but as we use a good Texas expression, I learned when I moved here from the East Coast, I'm not going to blow smoke up whatever orifice you choose to pick. Okay, thank you, and Dr. Hammond? Yeah, so I think when you're talking about part-time and administrative or leadership positions, there ought to be two things you think about. So part-time can look all sorts of different ways, so different amount of hours, different days of the week. You could work while your kids are in school, but five days a week. You could work three days a week, so it really depends, and the leadership position depends on how much do you need to be present, or maybe it's a leadership position that doesn't require you to be present all the time, and perhaps things are going to be different now with more Zoom meetings that allow you more flexibility to be present but not present. So I think you have to match the part-time and you have to match the administrative position to make it doable, but as Cindy said, there are some things you have to be present for, and you can't lead when you're not there, and you need to put the people around you. Anyway, everybody needs to have the role that fits them, and certainly being part-time doesn't mean you can't do leadership, but just make sure it's a good match. Mm-hmm. Okay, so we have about eight minutes left and two more questions that have come in, so the next question that we have is, have any of the panelists encountered workplace bullying because you aspired to leadership position? Dr. Marcelin? Okay, well, I've encountered many things. One example, I guess, this is, maybe you can see, this is an example of microaggressions. This was not, I mentioned that I was interested in being a chief resident, so this is like going way back when I was an intern, to one of my program directors, and I said, you know, I really would like to be a chief resident. Leadership is something that I aspire to, and she looked me in my eyes and said, no, chief resident is not for you, and that kind of put a roadblock for me and actually led to me just, you know, going into the shell and not trying for anything from then on, up until I reached a later stage in my fellowship, and so I'll stop there, but it's definitely, there's definitely people that have been negative towards me with my desire to be more active with leadership. Thank you. Dr. Hammond? Not that I can think of. Dr. Ivanhoe? I wouldn't say blatant bullying. I'd say, I think there are some conscious, unconscious biases and microaggressions in general. Dr. Cucurillo? Well, again, I'm not sure it would be bullying or more taking advantage of. It was interesting when I, when I did apply for this chair position, I was brought up to the administrative offices, and they said, they had a bottle of champagne, and they said, we want to congratulate you. You know, we've chosen you as the chair of the department, and they had the champagne glasses there, and everybody was, you know, they, and then the two administrators that were leading the search for the chair position, you know, said, oh, come, you know, come and sit down with us, and they handed me the contract, and I had already done market analysis and had wonderful mentors and sponsors through the PM&R that I had done. I really knew what the ground, the salary should be, and they literally gave me a bump of, you know, they gave me a very small bump of my existing salary, which was way far away from what the market analysis showed that I should be at, and I looked, I went to the last page right at the start, looked at it, I closed it, and I pushed it back to them, and I said, no. I said, we need to come to an agreement of a fair salary. I'm not going to start at a point of feeling as though I'm being grossly underpaid. And they said, well, no, you know, there's, you know, we thought you'd be thrilled. We're letting you take over this position, like it was, like they were doing, you know, giving me this great honor, and they wanted me to be grossly underpaid. I said, I know what the position should be paid, what I should be paid for the position, and I want you to go back, and you do, you know, you do a market analysis, and I said, I can give you my personal one, but I want you to come back with a much more competitive salary. So they said, well, you know, the other person we're thinking of is Dr. So-and-so, who's a male, and if you're not going to take this salary, then we're going to give it to him, and I said, then that's what you should do. You should give it to him, and they were shocked, and I later, of course, they went back, and they, and we renegotiated. It took, it was a month-long, very difficult negotiation, but they finally came back with what I was satisfied with, and I then, you know, I get, I get a listing of the attendings, and their intention was to pay, pay me less than two men in my department that would be reporting to me at the salary they were going to give to me initially, and I said, I, I said to them, I sat them, and I said, you know, this is not a great starting point that you were going to pay me substantially less than two men that would be reporting to me, and, and they said, well, we knew you were going to come back and forth, so we wanted to start at a low point, and I said no, and they said, we, and, and they said something that was, that really, I said, I said, they said to me, you know, we thought you cared more about the patients than about money, and I said no. I said, don't even go there. I said, I am, I said, I'm a physician, and my body of work has proved that I should get this position, and I should be paid for what I'm worth. I said, you know, going down the road of thinking I'm, I, I'm not caring for patients, or I said, honestly, this, this is very disturbing, and I said, I'm going to tell you when I look at these salaries, I'm already seeing that the women in this department are not being well represented from a financial standpoint, and my first order of business is equality for, for, for whoever's doing their, the work that they're doing, that they're paid fairly, and my first two years, I worked to make sure that everyone fell within the appropriate market analysis of where they should be, and that was, that was disturbing to me, and it, and it really kind of inspired me to even get more involved in helping young people that were struggling with negotiations to try to get the salaries they should get, so. Yeah, amazing story. Thank you, and Dr. Verdescu-Gutierrez. Again, if we're ever in a real conference and have a drink, we'll go into details, but like I said, I don't think major bullying, just like Cindy said, microaggressions, I think it's like oversights, people don't realize, they don't think, they think they can pay you less, they're okay with, even though you're doing all the work, not inviting you to be part of the research project, and it's just, you know, sometimes you have to speak up for yourself, and so. So, unconscious, I'm hoping. Yeah, yep, and so I'd love, just want to remind you all to join the women physiatry community to learn a little bit more. I think we have about a minute left, so I want to throw out a question to anyone that would like to answer about, it came from Dr. Atul Patel, and the question was, has there been any insights from the Scandinavian countries that have a little bit more equity built in to their practices? I'm not familiar with the data on the gender equity for pay in Scandinavian countries compared with the U.S. Okay, yeah, Dr. Ivanhoe, did you, you're on mute, you're on mute. You'd think I'd have it down by now, there's been so many courses and conferences, like, no, I was going to say that there are so many factors that influence gender equity and inequity, they're much more homogeneous than we are as a culture, as for one thing, their whole tax structure and healthcare structure, all those things are very different, you know, from the way we are as a country currently, so I don't know what we've learned specifically from them. I guess time will tell. Yeah, and so I want to thank everyone for coming tonight, and a special thank you to the panelists and keynote, Dr. Marcelin, for taking time out on a Monday night to be here and talking with us about these important topics. Thank you. Thank you. Thanks for the invitation. Goodbye. Thanks, everyone. Thanks, Maribeth. Thank you so much. Bye-bye.

video

panelists

leadership positions

PM&R

mentoring

advocating

career advancement

work-life balance

equal pay

opportunities

discrimination

empathy

gender equity