By the CSA Women in Anesthesia Committee
In recognition of the many major accomplishments by women in anesthesia, CSA will be highlighting a variety of women leaders who practice throughout the state, bringing their diverse backgrounds and life perspectives into their work, taking purposeful steps to create pathways for mentorship and sponsorship, and helping support the clinical and research work that is being driven by an increasingly diverse field of anesthesiologists.
Below are two profiles on women making great things happen in anesthesia:
Sue Carlisle, PhD, MD
- Vice Dean, University of California San Francisco School of Medicine at Zuckerberg San Francisco General Hospital
- Professor of Clinical Anesthesia, University of California at San Francisco
- Board of Directors, San Francisco General Hospital Foundation
- Member, California Society of Anesthesiologists
Can you tell us a little about being a woman in anesthesia?
It was difficult for women in science and medicine when I first started my path toward becoming a doctor. My professors discouraged me from attending medical school, so I went on to pursue a PhD. Only about four percent of PhDs in the country were earned by women at the time, so that should say a lot about the challenges I faced; however, I persevered. I went on to do my post-doctorate at Rice University where I was the only woman post-doctoral fellow in the department of biology. I then moved to Philadelphia in search of a teaching and research job that brought me to the Lewis Katz School of Medicine at Temple University where I ran the research lab and taught anatomy. I later attended the Perelman School of Medicine at the University of Pennsylvania. Out of 180 people in the program, I was one of 30 women. I then trained in Internal Medicine, Critical Care Medicine, and Anesthesiology at UCSF and subsequently became a faculty member in Anesthesia and Critical Care. Prior to becoming Vice Dean, I served as the Chief of Anesthesia at ZSFG.
What does the industry look like now?
At the University of California, San Francisco (UCSF), 52 percent of the incoming class are women and 52 percent are underrepresented minorities, showing remarkable progress. There are so many successful women in science and medicine that it has lifted the awareness of the need and the desirability of having more gender diversity and more overall diversity in medicine.
We’ve come a long way with the specialty but there is still work to do to raise awareness about the difficulty experienced by women and people of color, especially women of color. Many women of color have had a very difficult time being accepted into programs for which they are highly qualified. They have to earn trust and acceptance in those positions once they are there. I want aspiring anesthesiologists to know that it’s not only the responsibility of all women who have been successful, but everyone’s responsibility to raise awareness of women’s issues and issues of equality.
How would you advise someone who is looking ahead at a potential career in medicine?
Understand what your ambitions and strengths are, and then fashion a career around that. I have found that one can be exceptionally good at something, and not truly enjoy it. I have also seen people who were not so great at things but they enjoyed what they did. The trick is to find something that you’re both good at and enjoy. Being good doesn’t equate enjoyment.
When it comes to women rising in their careers, people often talk about the glass ceiling, but they don’t see the power of the glass cliff. The glass cliff concept is about how women are often brought in when there is a crisis and they are expected to fix things when it’s almost too late. Many times, throughout my career, I have been among some of the women chosen because of that phenomenon. When there is crisis, that’s when our talents are needed and recognized, so you have to rise to the occasion it seems.
Don’t undersell yourself. As woman, we do not self-promote enough. Men tend to be more confident in their skills and abilities. Women will not apply for a job unless they have 80 percent of the qualifications, but men will apply if they have 40 percent. It’s important for us to know our value and learn how to negotiate our salaries. For young women starting a career, if a door opens, don’t be afraid to take a chance. Be willing to do things and learn on the job and be willing to stretch. When you stay in your comfort zone, that’s where you will stay.
Eugenia Ayrian, MD
- Associate Professor of Clinical Anesthesiology, Keck Medicine at USC
What inspired you to pursue a career in medicine?
I wanted to have a career in medicine for as long as I can remember. I grew up with a certainty that I would be a doctor, and there were a few factors that contributed to that sense of certainty. I was raised in the former Soviet Union, where there were few professions to choose from and where that decision was largely guided by a sense of familial legacy. It felt natural that my career would follow that of my maternal grandparents, who were both highly regarded physicians. I was fortunate, however, to also carry a personal passion for medicine, and the right disposition for it. After graduating from medical school I came to the United States, got married and started a family, so it took me longer to get through my exams, adjust to the new culture, and take the next steps with applying for residency. My initial interest was with endocrinology, so when I got accepted into an anesthesia residency program I thought I would start there and eventually switch over to become an endocrinologist. But an unexpected love and interest in anesthesiology emerged in me, and I found myself making the first of many career-defining decisions. I like the immediate gratification of caring for my patients, helping them recover and feel better, and how it’s truly a very in-the-moment field of medicine that requires here-and-now problem solving.
To medical school applicants, I say – if you come to medicine to make money, you’re in the wrong place. The level of commitment and hard work required in this profession is not comparable to the reimbursement. Being a doctor is one of the most respected professions in this country – you have to be willing to stand up in the middle of dinner and leave your family or friends to go to the hospital for an emergency case. You have to love the profession to do that year after year – you can’t do it for the money. Long hours of work and dedication to patients can lead to resentful burnout which is a destructive force that unfortunately too many doctors are hit with. On the other side, if you’re drawn to medicine, excited by the work, motivated to grow and learn, it is inexplicably gratifying. The work exhausts at times, but the pay-off is immense.
What has it been like to practice medicine in the U.S. after growing up in another country?
It was tough at first, but despite the challenges, the journey of self-discovery and growth was incredible. Most importantly, I have gained a level of confidence I didn’t have in those early years.
I came to this country with a rudimentary knowledge of English, which made certain processes more difficult than if I spoke natively, it made studying for exams so much more challenging.
And when I reached fluency in English, my accent continued to be very noticeable, and this, combined with being a “petite” woman, contributed to a sense of inferiority. But with time and experience, I gained a sense of confidence, and am able to discern what does and does not genuinely define me today.
Thankfully, the medical field, and particularly anesthesiology, has grown more diverse, and I’m proud and glad to be a part of that diversity. I see it happening in my own department development! My advice for anyone walking into professional contexts feeling lesser-than because of who they are, where they are from, the way they look is to believe that how people perceive all these things about you isn’t actually what defines you. So do whatever you can to get to a place where you can walk into the room and know that you are no less than anybody else in that room based on how you present. Dealing with it has also given me a lot of strength and resilience.