Women Radiologists Seek New Solutions to Professional Challenges
 Etta D. Pisano, M.D. University of North Carolina |  Kimberly E. Applegate, M.D., M.S. Indiana University School of Medicine |  Lynn Fordham, M.D. University of North Carolina |
An increasing number of women practicing radiology around the globe are fueling a drive for solutions to the professional challenges they face. Many find themselves struggling with some of the same issues faced by the specialty's pioneers.
Traditional work patterns and life-work balance were among the topics addressed during a special 2008 European Congress of Radiology (ECR) session focusing on female radiologists, while the address during the American Association for Women Radiologists (AAWR) President's Luncheon at RSNA 2008 will focus on improving job negotiation skills.
Numbers Slowly Increasing
Surveys by the American College of Radiology found women made up 18 percent of professionally active radiologists in the U.S. in 2003, up from 16 percent in 2000, 14 percent in 1995, 13 percent in 1990 and 12 percent in 1982.
In Canada, meanwhile, there are many more women in radiology. Studies by the Canadian Association of Radiologists show women made up 33 percent of practicing radiologists in 2005, up from 30 percent in 2003 and 25 percent in 1998. Reports from European countries show the percentage of women practicing radiology varies widely throughout the continent.
The ECR session, "Women in Radiology: How to Maximize Their Input," featured a panel of speakers addressing such topics as the sociology of gender employment, the working environment, family obligations throughout one's career and conflicts in combining parenthood and academic work.
RSNA Board Chairman Hedvig Hricak, M.D., Ph.D., Dr. h.c., participated in the session, offering advice garnered during her successful 30-year career.
"Ask questions and don't assume that people know what you think or want," said Dr. Hricak, who currently serves as the Carroll and Milton Petrie Chair of the Department of Radiology at the Memorial Sloan-Kettering Cancer Center in New York.
Other advice offered by Dr. Hricak: Don't take comments personally; sit at the front of the room or around the executive table—that is, not in the background; and avoid being defensive or confrontational when asking for promotions.
"Offer constructive criticism," Dr. Hricak added. "Propose the changes that you believe will improve the working environment. And remember, you don't need to ask for permission to do the right thing."
Grant Funding Advocated
Kimberly E. Applegate, M.D., M.S., is among those proposing change. Dr. Applegate, a professor of radiology and pediatrics and the director of pediatric radiology research at Riley Hospital for Children and the Indiana University School of Medicine in Indianapolis, advocates grants designed especially for young female radiologists. Data about women in science show women need flexibility early in their careers, whereas men seek it later, she said.
"The system is set up by well-intentioned men, but it disadvantages women," said Dr. Applegate, adding that she considers herself "very lucky" in her home life. "I have a fabulous husband who also works full time and three very independent children, ages 15 and 13-year-old twins," she said.
Dr. Applegate received a Research Seed Grant from the RSNA Research & Education Foundation in 1997 for a study titled "The Impact of Imaging on Diagnosis, Management and Cost in Pediatric Patients with Abdominal Pain Presenting to the Emergency Department: "A Comparison of Capitated versus Fee-for-Service Plans."
Dr. Applegate cited data from a Massachusetts General Hospital (MGH) program designed to improve the retention and advancement of women faculty. Launched in 1997, the Claflin Distinguished Scholar Awards program provides bridge funding to junior women faculty during their child-bearing years. A study of program outcomes to date, published in the February 26, 2007, issue of the Archives of Internal Medicine, reported 90 percent retention of award recipients, with 36 of the 40 recipients remaining at MGH. Additionally, 22 of the 40 have been promoted.
A grant program focusing on radiologists, radiation oncologists and medical physicists would be similarly successful, Dr. Applegate said, and may help not only women but also men. Applauding how radiology's increasing international focus has increased the stature of the specialty, she noted, "Now, I want to see radiology think more about helping young researchers who need to balance family and career goals."
Negotiation Skills Can Be Improved
Women radiologists—both the young and more experienced—can also benefit from improving their salary negotiation skills, said AAWR President Etta D. Pisano, M.D. In her positions as vice-dean for academic affairs and the Kenan Professor of Radiology and Biomedical Engineering and director of the University of North Carolina Biomedical Research Imaging Center, Dr. Pisano negotiates contracts with all senior hires.
"The literature shows women and men behave differently in negotiations," said Dr. Pisano, who will address the AAWR President's Luncheon at RSNA 2008. "I am always struck by the differences when I negotiate with women and men. The range is enormous, from accepting whatever is offered to making incredible demands."
The message during her talk at RSNA 2008, said Dr. Pisano, will not be one of "We need to get our due."
"We haven't learned how to negotiate," she said. "My goal is to offer some idea of what to expect in negotiations. Some people have never negotiated before. You need to ask yourself what you need to have, versus what you want to have."
Dr. Pisano said she has always prided herself on being a good negotiator, even at the beginning of her career. Part of the lesson she wants to impart, she said, is that women need to get an appropriate salary from the start. She also offered this advice: "The faster you move up, the more flexible your hours become. Keep asking yourself, 'What are you doing to reach your goals?'"
Setting Priorities, Finding Mentors Critical
Women radiologists interviewed for this story said their success has hinged on setting priorities, finding mentors and seeking new solutions to challenges.
"Have a plan. Have a back up plan and have another back up plan," said Lynn Fordham, M.D., section chief of pediatric radiology and an associate professor of radiology at the University of North Carolina and AAWR president-elect.
Balancing it all is an ongoing challenge but well worth the effort, said Dr. Fordham. Good childcare, both when her children were babies and now at ages 12 and 14, has allowed her to work full-time, she said. She added that her husband has always been supportive; however, the couple has found they have little time for their own pursuits. "I have an ever-growing list of things I want to do when our children go to college," she said.
Dr. Fordham added that she has sought advice from mentors but separated her work life from her family life. "I tried not to involve my colleagues," she said. "This is my issue, not theirs." She said she listened well to the advice of her role models, who told her how to maintain personal and work balance. "Hearing creative solutions from other women helped inspire me," she said.
"I am happy to be in radiology," Dr. Fordham continued. "I have a rewarding career and rewarding children. This can be a family-friendly career, given appropriate leadership. We need more administrative support to allow career flexibility and more support for part-time people. We need to find better solutions."
Silvia D. Chang, M.D., F.R.C.P.C., chose to work 90 percent time after her child was born almost two years ago. Dr. Chang, an assistant professor at the Department of Radiology at the University of British Columbia and head of abdominal MR imaging at Vancouver Hospital and Health Sciences Center, said she knew it was going to be a challenge. She has made her life more organized and efficient as she allocates time for work and family. It is important to have balance and to make time for yourself once in a while, said Dr. Chang, and a supportive husband and family are essential. Separating job and family is important, as no one should bring family issues to the workplace, she added.
Dr. Chang, also a member of the RSNA News Editorial Board and the RSNA Education Exhibits Committee, said the best guidance she can offer to others in her situation is to prioritize: "Ask yourself what you want out of life, so that you don't have regrets later."
2003 RSNA President Peggy J. Fritzsche, M.D., encourages her female colleagues who have succeeded to share their experiences as role models for the younger generation.
"I believe that radiology has the reputation of being not only fast paced and exciting, but also very competitive," said Dr. Fritzsche, during an interview with RSNA earlier this year. Dr. Fritzsche, who will receive the RSNA Gold Medal at RSNA 2008, was the Society's second female president and one of just a few women in her medical school class in the 1960s.
"It's possible that women see radiology as too difficult, too competitive," said Dr. Fritzsche. "Medical students see the typical day for trainees in surgery and medicine, but they have only a vague idea of variations in a day for a radiology trainee; therefore, they avoid radiology based on hearsay. We need to change that, and one way would be to arrange informal discussions with medical student interest groups and radiologists who love their work."
