How to be a strong female leader in medicine

The future of medicine is female—and there’s data to prove it. According to the Association of American Medical Colleges, women comprised 28.3% of the medical workforce in 2007, rising to 36.3% in 2019.^[] AMA also reported that during the 2019 to 2020 application cycle for MD-granting med schools, women comprised 53.7% of matriculating students.^[]

That’s good news in general, but especially for female physicians aspiring to leadership roles. Medical boardrooms may soon skew female, too. MDLinx spoke to two physician leadership experts to glean insight on how female residents can prepare to fill these seats at the medical leadership table.

Where leadership begins

Jacqueline Huntly, MD, is a physician coach and CEO of Athasmed, a consulting firm that helps doctors with burnout, career growth, and leadership development. In an interview with MDLinx, she said that leadership starts with leading yourself.

“Self-leadership is the foundation of leadership, because if you can’t lead yourself effectively, you’re probably never going to be able to lead others in a way that’s most productive,” Huntly said.

To Huntly, self-leadership is a commitment to self-reflection, self-awareness, and self-respect. All contribute to emotional intelligence and a grounded assertiveness.

"When assertiveness comes from that place, it’s a formidable strength,” she added.

Sasha Shillcutt, MD, is an anesthesiologist, professor, and vice chair in the department of anesthesiology at the University of Nebraska Medical Center. She’s also CEO of Brave Enough, a physician coaching firm that helps women doctors with burnout, work-life balance, and time management.

Similarly, Shillcutt told MDLinx that self-knowledge is the bedrock of leadership.

“I think you have to have a really strong sense of who you are authentically as a woman and a leader, and as a woman physician to not just survive, but thrive, in a male-dominated environment,” Shillcutt said.

The antithesis is not sustainable.

“You may start to push down or hide parts of your authentic self, which can lead to burnout,” she said. “On top of doing the hard work that it takes to be a physician, you are also struggling with who you are in the workplace and how you can show up as your full self.”

Finding support

So how does an aspiring female physician leader develop an authentic sense of self, and self-leadership skills—along with the requisite hard and soft skills? Huntly and Shillcutt said mentorship helps. But find the right kind of mentor.

She added that mentors often serve different roles. They can be teachers, advisors, emotional support, and sources of motivation. With so many seemingly divergent demands, availability is key in selecting a mentor.

Consider having multiple mentors, Shillcutt suggested. Junior residents, for example, may need someone to discuss decisions, opportunities, and academic development with. But later in their lives and career, those former residents may need insights on work/life balance or starting a family.

“That’s a very different mentor than someone who helps you get published,” Shillcutt said.

One of those things may be how to overcome the adversity that is unfortunately inherent to being a woman in medicine.

Overcoming adversity

As Shillcutt explained, female physicians often face a different power dynamic. Whereas male physician leaders may be perceived as assertive, female physician leaders can be unfairly labeled as “bossy.” In 2017, she wrote a blog post on the subject that went viral.^[]

Shillcutt recalled leading resuscitation codes in a manner similar to that of her male colleagues. They were perceived as authoritative and praised for their leadership style. She, on the other hand, was called rude, bossy, and aggressive. Afterward, she would do what she calls “bossy cleanup”—small talk to smooth any ruffled feathers.

“My male partners never had to do that because they were actually applauded for their leadership. … I applaud the residents that I’m training when they’re aggressive or authoritative because they need that opposite feedback. They need to be told, ‘That’s your job.’”

Outside of emergency situations, Huntly said this type of adversity can be overcome by refining your understanding of leadership.

“If you define leadership as being able to inspire and positively influence others, aggression will not do that,” Huntly said.

According to Huntly, the skill of inspiring and collaborating stems from a critical question: Why are you called to leadership?

Knowing your why

“Why and what is motivating you to aspire to that leadership position? Really get into your core motivators,” Huntly said.

Is it status or power? Did an influential person tell you to do it? Huntly said this is not a matter of judgment on her part or anyone else’s. Clarity of motivations is integral to self-leadership, she said, and you cannot lead others if you cannot lead yourself.

According to Shillcutt, this specificity and clarity produces authenticity, an essential leadership quality. That means being honest about failures, apologizing, and being approachable.

“Those are the leaders that inspire me to be transparent and walk that same line,” Shillcutt said.

Communication is key

As they progress through training, female residents should also strive to refine their communication skills. Good communication requires not just talking, but also active listening with genuine curiosity.

“I typically talk to my colleagues from a stage like I would talk to them if they were standing next to me in the operating room,” Shillcutt wrote in her blog. “This means I generally have a lot of friends; it also means I am going to communicate very directly and openly whether we have shared a meal or only a handshake.”