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This article appears in the March 2021 issue of the

PE GI JOURNAL

April 8, 2021

PE’s women physicians on bridging the gender gap in gastroenterology

Year over year, more women are entering the gastroenterology specialty, slowly bridging a gender gap that has always existed within the field.

According to the Association of American Medical Colleges, there is still significant room for further female representation among practicing gastroenterologists (see chart below).

At PE GI Solutions, we take pride in the partnership opportunities available for renowned female gastroenterologists. To celebrate National Women’s Month this March, we sat down with three of our physician partners to discuss their varied experiences throughout their careers, how the GI field has shifted in support of more women, and their outlook for the future.

Julia Pinter (JP): How did you initially regard choosing the GI specialty, having less female representation than most others—did this affect your considerations?

Elizabeth Rock, MD (ER): In my time of training, women usually headed toward pediatrics, family medicine, or psychiatry, if they became physicians at all. I remember my conversations with my dad, a family doctor, encouraging me to think twice about going to med school as the years of study were long and arduous. Headstrong, I insisted I could do it. I was lucky enough to be accepted to the Medical College of Pennsylvania (formerly the Women’s Medical College of PA) where no specialty was considered “unfit” for a woman to pursue. I was drawn to gastroenterology during a rotation I took at Temple University Hospital. I was fascinated by liver disease and the many facets of inflammatory bowel disease. I was also mesmerized by what could be seen in the gastrointestinal tract with the use of endoscopy. In a word, that rotation had me “hooked.”

Sonia Godambe, MD (SG): When I was applying to training programs, I had heard rumors of programs taking only a certain number of females, but it didn’t really factor into my decision at all. If anything, I saw the underrepresentation of women as an opportunity. I was interested in women’s issues, and in GI there are many women’s issues, such as inflammatory bowel disease during pregnancy and incontinence.

Kristin Braun, MD (KB): When I was choosing a specialty, I knew I wanted to use advanced technology. I considered ophthalmology, but after hearing gastroenterologists speak in a series of lectures, I was impressed—they were always very precise and well-spoken. I was also fascinated by the technology of scopes, and after hearing the gastroenterologists speak, I could tell they were very passionate about treating a variety of conditions. Fewer women in the specialty didn’t sway me from my interest in GI.

JP: How did your experience being a woman in med school differ from your experience once you entered the field?

ER: When I began my residency, I went from most of my classmates being female to being the only woman in my residency year. Four years after that, I became the first female chief resident in internal medicine at Temple University Hospital. It was definitely a big change, but this did not keep me from pursuing the field I was most interested in. I began my GI fellowship the next year.

SG: Medical school has been split approximately 50/50 men and women for some time. However, when I came to interview for jobs after GI fellowship, being a woman became an advantage, as many practices were looking to add a female partner in their all-male groups. Working in the field has been nothing short of amazing. I am grateful to have worked with a great group of physicians. We support each other and are constantly striving to provide outstanding care to our patients. I am grateful to have made strong relationships with patients of all walks of life and provide care to them. Patients now come to me for all sorts of reasons and not just because I’m a woman. At this point, my experiences as a woman and a physician shape the care I provide for my patients today.

KB: When I attended med school, Jefferson was 51% female, but not many women chose gastroenterology. But during the years I was there, my two co-fellows were also female, which was awesome. That gave me women to connect with and look up to. At the end of my fellowship, I realized there was a huge demand for women in GI. Many all-male or majority-male practices were looking to fill their positions with women to attract and retain female patients—many prefer to see female physicians.

JP: How have your experiences as a woman GI physician changed or improved over the course of your career?

ER: This year marks the beginning of my 40th year as a gastroenterologist. I have seen great advancements in work and family life balance, like the restriction of on-call hours. But there are definitely still improvements that can be made, especially in childcare policies.

SG: My experiences have certainly changed over the last 10 years, especially with motherhood. As the first female partner in my group, we had to create a maternity policy. With the support of my managing partner, I was able to create a parental leave policy for both men and women for all doctors in our group in the future. I wanted to create a policy that allowed me to keep the practice I had built but also gave me time for my family. This was the first time I sat at a table and lobbied for myself and for others to follow. This continued as we added nurse practitioners to our practice. I now find myself trying to provide mentorship to them. Most recently, another valuable resource for balancing work and family demands has been telemedicine. From using patient portals to meeting with patients virtually, technology has given physicians the opportunity to educate our patients with flexibility.

KB: As I have been in practice, I have seen female patients become much more comfortable with seeing a female GI physician for different reasons, whether it’s disclosing symptoms, understanding hormonal changes, or being more comfortable with being asleep for a procedure with a female doctor. So it’s become very rewarding to treat female patients with issues in the GI tract that statistically occur more commonly in female patients for unknown reasons.

JP: Are there any specific steps that you find necessary to continue empowering more women to join the GI field?

ER: I was lucky to have a supportive group of fellows and attendings to work with during my fellowship and an extremely supportive family who helped with raising my children. My husband and I prioritized hiring childcare for my two children, which brings me to what female physicians need—advances in work and family life balance. Some advances in work and family life balance have already been made by implementation of laws that restrict on-call hours. This certainly helps young women who are in training and trying to raise young families. Further steps can still be taken, perhaps passing on a tax credit to employers who either give young parents discounted childcare or vouchers to help defray childcare costs. Larger institutions may even be able to provide on-site childcare.

SG: My hope would be that any woman physician who is interested in GI because it’s the right fit for their medical interest can jump in with both feet and find support and mentorship from those of us here to achieve their goals. I think using a support network is a necessary step. The network can come from many places. I have a local women’s physicians’ group that “Zooms” every month to talk about our experiences. I also sat on a national GI society to help women in GI last year, and the group put out programs and resources to support women in GI. Individually, we must keep pushing to create opportunities for ourselves to achieve our goals. Each person will have to find the right balance of work, research, teaching and administration for them. These perfect opportunities might not exist, but we should try to create them. The networks should also include friends and family as the love and encouragement you get from them is motivating.

KB: I think continuing the progress that has been made in offering work-life balance is important. Gastroenterology is a hot, competitive field for the balance it offers. Ultimately, individual work-life balance depends on a lot of factors, like your family, your hospital affiliation, if you have a supporting corporate partner. You have options within the field to make choices that you feel will be best for your own life balance. When you consider different options within the field, evaluate what the workload and hours will really be like. Fortunately, with PE, I have found a great balance with my other physician partners. Endoscopy centers are great workplaces because they can be more flexible in scheduling than hospitals, and patients also tend to be happier coming to endoscopy centers rather than hospitals. On the other hand, you’ll still get to see some of the more interesting, acute things you can treat when you are on-call at the hospital, but it does not take up too much of your life balance.

JP: If a young woman in medical school today was considering going into gastroenterology, what would you tell her?

ER: Gastroenterology is a wonderful career for women, particularly within the growing field of nutrition and therapy requiring dietary modification. As the years have passed,

I find that I am easily accepted by patients. Patients often comment on the empathy and understanding offered by female physicians. As the senior physician in this group, I am always happy to consider other women for partnership and growth opportunities.

SG: I would tell her to absolutely pursue a career in GI. Like many things in medicine, it’s fascinating, ever-changing, and so rewarding. You can create your own blend of clinical medicine, research, and procedural medicine.

KB: If I could go back, I would choose GI again. This is a competitive field with amazing technology, something that always interested me. You can almost always make real improvements in the lives of patients. It is truly rare that after meeting with a patient, there is nothing we can do to improve their quality of life. In GI, the treatments, procedures, or lifestyle interventions can help patients majorly feel better on a day-to-day basis. Even with colon cancer, it’s highly treatable especially when detected early. Getting involved with colon cancer awareness and increasing screening rates is another fulfilling part of joining the GI field.