Women in Oncology, with Perspectives from an Academic Trainee
— Written by Neha Abeywickrama (University of Leicester BONUS Representative)
As a female medical student, it can be difficult to envision that only 150 years have passed since the first women were admitted to medical school in the UK. The famous ‘Edinburgh seven’ who were still ultimately denied their medical degrees from the university of Edinburgh despite their perseverance and dedication to the field. Only in 2019, were they posthumously awarded their degrees. Just six years later, the GMC reported that for the first time in UK history there were more female than male doctors registered.
Women in medicine have made great strides to maintain their seat at the table and over the last century have made incredible progress toward greater gender equality.
Within oncology, despite the fact that there are more female clinical oncologists than men, women are underrepresented in leadership roles. The Women for Oncology (W4O) initiative was started in 2013 by the former European Society for Medical Oncology (ESMO) president Professor Martine Piccart when she noticed this imbalance between men and women in leadership positions. This organisation monitors the gender imbalance within leadership position in oncology, trains women to support the creation of women leadership positions and provides access to career development opportunities for female oncologists.
An analysis of the 2016 ESMO W4O Committee Survey provided insight into the barriers that women face in career development. These included, but not limited to, work and family life balance and organising family commitments. Suggestions to increase gender equality within the field, were promotion of work-life balance, leadership training for women and more support for flexible working schedules.
Within academia, between 2017-2019, it was found that women were more likely to be first authors than last authors in major oncology journals supporting the general patterns that women are underrepresented as senior authors. Increased mentorship of younger female oncologists by women in leadership roles has been proposed to be one way to inspire and guide the upcoming generation of academic female oncologists.
In general, within academic medicine, female academic doctors spend an extra 8.5 hours on domestic and childcare activities compared to men in their field. This highlights the pressing importance of supporting female academic oncologists in progressing in their careers and fulfilling their potential in the same capacity as their male colleagues.
Taking into account all the issues with gender equality present within the field, I was keen to hear the perspective of a women in oncology earlier on in their career regarding women in leadership roles but also their passion for oncology and future aspirations.
I interviewed Dr Emilia Postaleniec who is currently in her Academic Clinical Fellow Specialty Training Year 1 in Medical Oncology who kindly agreed to share her story.
What motivated you to pursue oncology?
My interest in oncology can be traced back to one book read on a Lanzarote beach when I was fifteen: The Emperor of All Maladies by Siddhartha Mukherjee. I always loved biology in school but felt that cancer which affects now 1 in 2 people, isn’t taught in detail. This interest in oncology grew throughout medical school, but I only really appreciated the beautiful human aspect of this speciality when cancer touched the life of my family. Seeing the work of the oncologists I met at The Christie during this time inspired me to dedicate my career to improving the lives of those affected by cancer. Oncology has a unique way of bringing together really complex science and the very best in holistic care, that’s why it’s so special to me.
Please could you describe your journey to becoming an academic trainee in oncology?
My journey started, as for most of us, with science A-levels and an application to medical school. My first application was rejected, and as devastating as it was at the time, the next three years spent at Keele University studying human biology with international relations were exactly what I needed. I grew into a ‘real adult’ and affirmed my desire to pursue medicine over global health. I also had my first taste of cancer research; my dissertation looked at repurposing drugs in leukaemia cell lines. Here, I had an amazing personal tutor who, as a woman in academia, inspired me to pursue science with rigour, confidence and kindness. She believed in my dreams and supported me throughout.
After this, I completed my medical degree at Leicester Medical School, taking opportunities to get involved in cancer research along the way. I knew in the future I wanted to both treat patients and be at the forefront of research, so applying to the Specialist Foundation Programme was the next step. I secured this and throughout my F2 year worked on research both in mesothelioma and melanoma. Through this, I found a great mentor, and my passion for academia kept growing. I initially didn’t believe in my ability to get an Academic Clinical Fellowship (the academic branch of speciality training), but with encouragement from my supervisor, I applied, and now I am an ACF in medical oncology! This means I will be doing internal medicine training with dedicated time for research; it also means I am now on a run-through pathway and on my way to becoming a medical oncologist at the end.
What are key features of the academic training pathway? What are you most excited for?
Key milestones in the academic pathway include SFP, ACF, PhD, ACL (Academic Clinical Lecturer) and eventually Professor. I have completed the SFP, and after completing my ACF, I am most excited to dive deep into one area of cancer for a few years, studying for my PhD as I take time away from my clinical work. After completing a PhD, the next step is to complete clinical training as an ACL- the academic equivalent of a senior registrar. After completion of training, consultants take on various roles depending on their interests and build their portfolio to become a professor in their chosen niche.
Which areas in oncology are you most interested in?
I am yet to find my specific niche in oncology, but currently I am interested in melanoma and thoracic oncology, in particular looking at markers of resistance in immunotherapy.
What challenges do you think women in oncology face regarding career progression?
I think overall oncology is a speciality which allows women to progress well in their careers. At oncology conferences, I have met many female professors who are a constant source of inspiration to me. Less than full-time training in both clinical and academic roles has made progression much more accessible. I know this was not always the case, and the role models who we look up to now had a much more challenging journey to the top. Having spoken to many clinical-academic trainees in all specialities, many find that having a split of their workload between academic and clinical time sometimes allows for an even better work-life balance than being fully clinical, although no doubt, the role still has challenges. Something I have found to help me on my journey is understanding my life in seasons and adapting it to that; for example, I know when specialty applications were due, this was my main focus, and therefore my extracurricular work took a back seat. This is the same for exam season; when you are grinding towards a goal, it’s important to know that sacrifices have to be made. However, your whole career cannot look like go, go, go.
Over the last few months, I have intentionally not taken on any new projects because I knew I was in a slower season and that doing any more work would be a disservice both to myself and my supervisors. Knowing when to prioritise what is a skill you learn along the way through trial and error.
What kind of characteristics do you believe makes a good leader, particularly in academia?
Some of the best leaders I know possessed two important qualities: they are kind, and they are very knowledgeable in their field. My favourite supervisors always listened to my needs and were guided by what I needed to develop. When a leader knows the needs of the trainee and listens to their goals by providing good mentorship and support, it becomes a symbiotic relationship where you can produce high-quality research. I think this is particularly important in academia, where sometimes trainees can be exploited for the goals of the supervisor. Therefore, I think what makes for good leaders is that crucial ability to listen and work with their trainee by sharing their expert knowledge.
What were the valuable experiences in your early career/medical school that enabled you to develop your leadership skills?
In medical school I took part in various extracurricular activities that helped me develop those leadership skills. Being part of clubs and societies helps you to know how to take on board the ideas and opinions of a group of individuals and come together to achieve a common goal.
Looking to the future, what do you think should be done to make leadership positions as equally accessible for women as they for men?
Historically, as we all know, many women have found it difficult to come back to work when they have taken time out to have children. I think this is changing slowly, but we need more support for trainees when they are back from maternity leave. This doesn't just mean a few days of shadowing or more meetings, but most importantly building clinical confidence again after taking time out. I welcome the most recent change to ARCP progression fought for by the BMA. The BMA, in our new deal with the government, has agreed that trainees who train less than full time will now be eligible to progress to the next stage of training every year if the competencies are met. This will allow women in particular to be credited based on merit rather than simply the time they have spent working. I hope that across our lifetimes we will see many more women in positions of leadership in oncology.
Dr Emilia is very happy to hear from aspiring trainees who can reach out to her via social media @milia.med or via LinkedIn – Emilia Postaleniec.
Hopefully in the coming years, oncology as a specialty will progress toward a more balanced representation of both men and women in senior positions. Enabling bright and passionate early career oncologists such as Dr Emilia to enter positions of leadership and pave the way for other women too.
Sources:
- https://www.gmc-uk.org/news/news-archive/more-female-than-male-doctors-for-first-time-ever-in-the-uk
- Banerjee S, Dafni U, Allen T, Arnold D, Curigliano G, Garralda E, Garassino MC, Haanen J, Hofstädter-Thalmann E, Robert C, Sessa C. Gender-related challenges facing oncologists: the results of the ESMO Women for Oncology Committee survey. ESMO open. 2018 Jan 1;3(6):e000422.
- Berghoff AS, Sessa C, Yang JH, Tsourti Z, Tsang J, Tabernero J, Peters S, Linardou H, Letsch A, Haanen J, Garralda E. Female leadership in oncology—has progress stalled? Data from the ESMO W4O authorship and monitoring studies. ESMO open. 2021 Dec 1;6(6):100281.
Comments