Dr Rosie Baruah

Rosie is the Chair of the WICM group. She is a consultant in critical care and anaesthesia at the Western General Hospital in Edinburgh. With WICM she aims to promote ICM as a female-friendly specialty to women in all stages of their medical training, from undergraduate level upwards.

@rosieICM

August 2018: Organising a local WICM group

 

WICM has been set up to identify and remove barriers to a career in intensive care medicine for women. The potential barriers to recruitment and retention can be a lack of role models, and the lack of a supportive network – it is easier to imagine doing something if you are surrounded by people like you who are already doing it.

To this end, the WICM group are piloting Regional WICM meetups. I decided to hold a meetup in Edinburgh and named it the South East Scotland Regional WICM Group – trainees and consultants, drawn from hospitals in Edinburgh, Fife and Livingston.

We know each other well, having trained and worked together in what is quite a small region, but this was the first time so many female intensivists in our region had gathered together to talk about our lives as intensivists. In the spirit of equity and inclusion, the invitation to attend was extended to every intensivist in the region, and one male – Dr Naz Lone, soon to speak on ‘how to be an affective ally’ at Critical Care Without Ceilings took up the invitation.

We mainly wanted an evening of socialising and good chat over good food, but I took the opportunity to quiz those attending on their thoughts about the following, using a free-text questionnaire:

  • What, if any, careers advice were you given as an under or postgraduate?

  • Do you have sufficient positive role models in ICM?

  • Is role modelling important?

  • Do you have a mentor, are networking events like this helpful?

  • Do you think ICM holds particular challenges for women?

 

To give you a flavour of the responses:

 

Careers advice

This varied from excellent, to none whatsoever. A lot of careers advice was not given in a gender-specific way – some of the gender-specific advice was unhelpful, such as being told that doing ICM as a woman would never lead to any kind of work life balance, and to concentrate on anaesthesia as it’s a lot easier to be a part-time consultant in anaesthesia. Interestingly, some of the negative careers advice came from female colleagues who were now consultant anaesthetists, and some of the most positive advice came from male colleagues. Some of us who received no careers advice felt it made applying for ICM training tougher, as it’s harder to know if you are the right sort of doctor to pursue ICM training without having a senior colleague confirm this.

 

Role modelling and mentorship

Much of our discussion recognised the importance of role models and those attending felt they had as many positive male role models as female ones; negative role modelling wasn’t restricted to one sex.  Discussion suggested that in the last 10 years there were far more visible female consultants and trainees in ICM in our region, and that they were positive and enthusiastic to women working their way up the training ladder. Visibility of diverse role models is also important; there is more than one way to be successful. Above all, it is really encouraging to see someone ahead of you with similar circumstances outside of clinical practice succeeding!

Only one member of the group had been able to access formal mentoring, through the AAGBI’s GAT Mentor scheme. There was unanimous feeling that a formal mentoring relationship would be beneficial to all levels of trainee. A mentor scheme should focus on all aspects of life, not just career related issues. Life and work aren’t separate entities, they affect each other closely. In a formal mentoring relationship, the mentee should feel actively encouraged to approach their mentor and the mentor should not have a managerial or supervisory responsibility to the mentee. This creates a safe space to develop professional confidence. Being told you’re not confident enough happens quite commonly – but no help is given to address this.

 

Is networking helpful?

There was an overwhelming ‘Yes’ to this question, phew! Networking events provide a relaxing environment to meet up with colleagues. Meeting face to face with other people in the region helps foster good relationships. Networking is very helpful for stimulating thought and discussion to take back to your local department. It’s also lovely to be reminded that there are many women in ICM who are inspiring, excellent clinicians. Overall, the opportunity to share experiences in a friendly environment was felt to be really positive

 

Challenges of the job

Men and women don’t always face the same professional challenges. Establishing your career whilst being a primary caregiver for young children or having to go away for specialty blocks of training can be especially challenging for women. There was a general feeling that men with young children also wanted to be closely involved in family life and so this wasn’t exclusively a female issue. However, many male trainees and consultants had partners who took on a greater share of domestic duties, allowing a degree of career facilitation that not all female intensivists with young families can benefit from.  Several of our group noted it can be challenging standing your ground in front of colleagues from other specialties who may disagree with you – there was a perception perhaps that as a woman, you would be more of a pushover. Gender-based stereotypes of the ‘scary female ICM consultant’ were also unhelpful – doing your job well sometimes means disagreeing with people but this doesn’t always go down well. The fear of burnout, and the mental load of trying to spread yourself too thinly with your family, your work and your health all suffering as a consequence, was also a concern.

 

Take home messages

Firstly, we will definitely meet up again!

  • WICM is a group that is working to make the specialty an inclusive one, our events should be inclusive too, as many of the issues that affect women also affect men.

  • Attending a get-together like this can require a bit of confidence, especially if you’re new to the region and don’t know anyone, so it’s possible that people who may benefit most from the support of a network may need more encouragement.

  • We need a better careers advice structure for medical students and trainees – the mere name of our specialty might be off-putting to some, and it’s important to get the message out there that it is possible to have a great work-life balance in a career in ICM.

  • Role models come in all shapes and sizes, and there is an increasing number of female intensivists to draw upon.

  • WICM will train its first batch of mentors at this year’s annual meeting (Critical Care Without Ceilings) and set up a national network of mentors to fulfil the need for this additional career support.

  • WICM as a group should embrace everyone who is committed to making ICM an inclusive specialty.

Finally, there are challenges for women in ICM, some of which are a result of gender stereotypes that are very deeply held by society and will be hard to shift – but we as a specialty need to develop a pattern of working that protects the wellbeing of those working within it – at all stages of our professional lives, regardless of gender.