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Women in Neurology Should Be Aware of Gender Issues and Work More on Self Promotion, Career Development Coach Says

ARTICLE IN BRIEF

The number of women in neurology is growing, but they still face challenges with career advancement. A leading career development coach and other women neurologists focus on strategies to change that trend.

BALTIMORE—The list of accomplished women neurologists is growing, but they still contend with a challenging environment that makes it more difficult to succeed and move up in the ranks, Janet Bickel, a career development and executive coach said here at a meeting of the Women of the American Neurological Association (ANA) at the ANA annual meeting in October.

The tendency of women to underestimate themselves poses an additional hurdle but this can be overcome with effort and practice, she said.

“You are in such intense competition, not only for resources but also for people's attention,” Bickel said. “So not only do you have to be excellent and relevant, you also have to be visible. Your social capital, your relationships, are golden. And it's not only important for you to know people, it's important for them to know you.”

The number of women in neurology is growing. In 1998, 19 percent of respondents to an AAN census were women. In 2004, 23.3 percent were women. Today, 29.9 percent of members who have supplied gender information are women, according to Laurie Weyandt, the Academy's membership manager.

The medical field is particularly fierce terrain, and the last thing that should be holding women back is their own inability or unwillingness to promote themselves, Bickel said, calling it a “personal glass ceiling.”

“You work in the most complex organizations of the world,” she said. “You've learned that hard work and talent are not enough to ensure your success and that keeping your nose to the grindstone and just tending to your little patch and waiting for the Good Citizenship Award are not sufficient. To achieve your potential, you must also develop organizational savvy and build relationships.”

She urged the audience members to practice summarizing their accomplishments so that they are ready to draw attention to their work and goals whenever the opportunity presents itself.

She offered an easy-to-remember format with three components: a “problem/opportunity” including what needed to be fixed; “action,” or what you did to fix it; and “result/benefit” — the difference you made.

Bickel recognized that drawing attention to yourself “feels really yucky to a lot of you.” And even for those who find it comes naturally, it's still tricky because the range of assertive behavior allowed for women is narrower than it is for men and because if women don't remain “likeable,” their competence will be seen in a more negative light. But practice works, she said.

“There's a visceral learning,” she said. “And you're also laying down — as you know, you're neurologists — neural pathways. So for those of you for whom this doesn't come naturally, practice is really important.”

Bickel noted that studies have found that men tend to have a “positive illusion” of their abilities — that is, they tend to overestimate their skills — while women have a “negative illusion” about their abilities, underestimating them.

Because of social expectations, women can have a more difficult time communicating effectively, she said. What might be seen as confidence in a man might be seen as conceit in a woman. Being analytical might be seen as cold.

It's important for women to develop a style of self-promotion that works for them, Bickel said.

“Get better at shifting gears, at adapting to your listeners,” she said. “You're all excellent diagnosticians and you're really good at asking questions. And you can translate your clinical skills into the world of organizational politics and relationship-building by just discovering what would be most persuasive. What style would work best with this individual?”

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JANET BICKEL: “You are in such intense competition, not only for resources but also for peoples attention. So not only do you have to be excellent and relevant, you also have to be visible. Your social capitals, your relationships, are golden. And its not only important for you to know people, its important for them to know you.”

OTHER WOMEN WEIGH IN

Commenting on the session, Anna DePold Hohler, MD, assistant professor of neurology at the Boston University Medical Center and chair of the AAN Women's Issues in Neurology (WIN) Section said some women are hesitant to pursue opportunities.

“I think that in some cases women may undervalue their experience and not apply for promotions and leadership positions for which they are qualified,” she said. “The WIN section tries to address this with the mentoring program.”

She said she advises her colleagues to establish a health-work-life balance that fits their situations, develop a professional network and support network and not to be afraid to take on more responsibility and take advantage of opportunities when they arise.

Eva L. Feldman, MD PhD, the Russell N. DeJong professor of neurology and director of the Neuropathy Center at the University of Michigan Health System in Ann Arbor, and president-elect of the ANA, said the “personal glass ceiling” that Bickel talked about is seen all too frequently.

“I think that's a very common problem with young women faculty,” she said. “I can tell a young male junior faculty, ‘You know, you didn't really perform up to standards today,’ and he'll say, ‘Okay, I didn't,’ and he'll just move onward and not take it personally. If I were to tell that to a young woman possibly she'd break down into tears.”

But, she said, “There clearly are more opportunities for women than there were 20 years ago when I started.”

Anne Louise Oaklander, MD PhD, associate professor of neurology at Harvard Medical School, said she has seen no overt gender bias, but a leaning toward values “that men have more often than women” an over-eagerness to embrace technology.

“Boys like toys and there's this tremendous valuation of high-tech expensive science that may or may not have actual clinical benefit but it's sexy,” she said.

Beth Malow, MD, MS, professor of neurology at Vanderbilt University and medical director of the Vanderbilt Sleep Disorders Center, said she has taken to writing down each day three things she did that were positive. These could be personal achievements or examples of how you have helped others (family members, patients, colleagues) achieve their goals or feel good about themselves. That's a good way to keep the self-esteem fueled, she said.

“Even though we're supposed to feel good about ourselves because it comes from inside regardless of what we've done,” she said, “I think the reality is that this track record of positive accomplishments helps you maintain this self-esteem, especially during times of stress.”