{"id":2207,"date":"2019-09-09T19:42:53","date_gmt":"2019-09-09T19:42:53","guid":{"rendered":"https:\/\/www.mc.vanderbilt.edu\/vanderbiltmedicine\/?p=2207"},"modified":"2021-08-11T19:36:00","modified_gmt":"2021-08-11T19:36:00","slug":"a-class-act","status":"publish","type":"post","link":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/a-class-act\/","title":{"rendered":"A Class Act"},"content":{"rendered":"
\"\"<\/a>
(left to right) Silky Chotai, MD, Danika Paulo, MD, and Heather Grimaudo, MD. Photo by John Russell.<\/figcaption><\/figure>\n

The glamour of being a neurosurgery resident is a yarn. It\u2019s a world of busy calls, sharpening skills, the occasional moments of doubt, and seemingly more obligations than unlimited coffee could fuel \u2014 even if time stretched to 30 hours in a day.<\/p>\n

Somehow, though, it all gets done for the three third-year neurosurgery residents, just as it has for the residents who came before, and just as it will for those who will come after.<\/p>\n

One milestone that distinguishes this trio from previous residency classes is that they are all women. In 2017 \u2014 for the first time in the Vanderbilt University Medical Center neurosurgery department\u2019s history \u2014 each physician who matched is a woman: Silky Chotai, MD, Heather Grimaudo, MD, and Danika Paulo, MD.<\/p>\n

There have been a handful of all-women residency classes in other neurosurgery departments across the U.S. in recent years, but they are unusual \u2014 and therefore remarkable. There are a greater number of programs with few women as residents or staff, said Lola Chambless, MD, associate professor of Neurological Surgery and residency program director.<\/p>\n

Reid Thompson, MD, William F. Meacham Professor of Neurological Surgery and chair of the Department of Neurological Surgery, announced the demographics of the class proudly at an orientation in 2017, recalled Paulo. Others called the group revolutionary when they arrived, particularly because the department didn\u2019t set out to find a groundbreaking class.<\/p>\n

\u201cI did not plan on being a \u2018female neurosurgeon.\u2019 I just wanted to be a neurosurgeon, so learning I was part of the first female class was surprising. I thought it would have been done before me. Now it\u2019s something I\u2019m proud to be a part of, and it\u2019s created a bond of solidarity between us,\u201d said Grimaudo.<\/p>\n

\u201cIt was an amazing feeling when I found out. Knowing that I will be working along with two other women who have achieved a lot in their careers was a great feeling,\u201d said Chotai, who also trained in India.<\/p>\n

Chambless and Thompson are in lockstep about the benefits of perspective that stems from a team made up of diverse life experiences, thoughts and gender.<\/p>\n

Thompson grew up in India, Malaysia and Indonesia and is better for it, he said. He loves being around the increasing diversity of younger people in the department. It keeps him learning and young \u2014 and the ideas that get tossed around about care and research have more texture.<\/p>\n

\u201cPeople talk about diversity \u2014 it\u2019s not a box to check. It is beyond gender, too. We\u2019re better because we\u2019re diverse. I would argue that we\u2019re the most diverse in the country in terms of our residents. They come from all over the world,\u201d said Thompson.<\/p>\n

Nationally, 6% of board-certified neurosurgeons are women, and 15% of residents nationally are women. The VUMC department is now more than 25% female, and Thompson, whose pride for his colleagues is contagious, is quick to show off a photo of the group in scrubs on campus. One is a woman from Pakistan who placed best in math in her country one year.<\/p>\n

Not only do women match at a lower rate than men, but being female is the No. 1 risk factor for attrition during residency, said Chambless, senior author on an analysis of neurosurgery residency attrition in the November 2018 Journal of Neurosurgery. It\u2019s been the theory for years that the pipeline of younger, entering physicians would close the gender gap, but that\u2019s not happening, which points to underlying issues.<\/p>\n

\u201cI think the majority of female attrition is happening when you\u2019re a one-off and not part of a larger female group,\u201d Chambless said. \u201cThis isn\u2019t just an issue with residents. We see it all the way up the career ladder.\u201d<\/p>\n

Her theory \u2014 yet untested \u2014 is that programs with more women will have less female attrition.<\/p>\n

There\u2019s no mission to have a 50\/50 split because Thompson and Chambless are looking for the best minds that are the best fit for the group\u2019s culture. In the future, the majority of residency program could women if they are the physicians who fulfill what the department wants and choose to be there.<\/p>\n

\u201cIt\u2019s not an easy path, so you can\u2019t oversell it, but there\u2019s a way to do it,\u201d said Thompson. \u201cIf you have a department where young people can see themselves in a role model, then they can see themselves as a role model.\u201d<\/p>\n

The residents pointed to seeing women in the field as a reminder that \u2014 of course \u2014 it\u2019s possible. Chambless said balance is different for everyone and it\u2019s vital for all residents to recognize what works for one person could be a misalignment for another.<\/p>\n

\u201cIncreasing female prevalence translates into more role models that will inspire future female neurosurgeons and eventually close this gender gap. We can demonstrate that it is, indeed, possible to be a neurosurgeon, wife, mother, have hobbies, a healthy work-life balance, and be whatever you want to be,\u201d said Paulo.<\/p>\n

The changing demographics of the field is concurrent with rapidly advancing technology and a deeper understanding of the brain that wasn\u2019t possible even a decade ago.<\/p>\n

There are better outcomes and people often survive and need follow-up care, which necessitates surgeons have people skills that weren\u2019t always required when the field began, said Thompson. The female resident trio is excited to be entering the field at a time of accelerated change \u2014 it\u2019s part of the specialty\u2019s allure.<\/p>\n

Three years into a seven-year residency, the sheen of being a milestone residency class for the department is mostly worn off, which is fine since none of them set out to change any demographics. They want to change lives.<\/p>\n

Yet, they recognize they are breaking boundaries and shifting perceptions for co-workers as well as patients. Paulo said they are frequently mistaken for nurses, and the residents must often reassure patients of their credentials and training.<\/p>\n

\u201cWe\u2019re on the rise and I\u2019m proud to be a part of that movement. On a daily basis, we are changing patients\u2019 and co-workers\u2019 expectations of what a neurosurgeon \u2018should be,\u2019 adding our own flair, taking a new angle, seeing things through a different perspective, breaking the mold,\u201d said Paulo.<\/p>\n

Chotai said she\u2019s been \u201clucky to receive equal treatment\u201d as male colleagues, and that having an all-female class in this program and in others should not be an outlier, but a norm.<\/p>\n

\u201cI want us, as the first all-female class, to be known as an effective, cohesive group of neurosurgery residents that provided excellent patient care. I want us to show the strength of female-driven medical care and the strengths of diversity within a team,\u201d said Grimaudo.<\/p>\n","protected":false},"excerpt":{"rendered":"

The glamour of being a neurosurgery resident is a yarn. It\u2019s a world of busy calls, sharpening skills, the occasional moments of doubt, and seemingly more obligations than unlimited coffee could fuel \u2014 even if time stretched to 30 hours in a day. Somehow, though, it all gets done for the three third-year neurosurgery residents,…<\/p>\n","protected":false},"author":231,"featured_media":2211,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_links_to":"","_links_to_target":""},"categories":[13,14,15],"tags":[],"class_list":["post-2207","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-fall-2019","category-vm-features","category-vm-homepage-highlights"],"acf":[],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/cdn.vanderbilt.edu\/t2-main\/medschool-prd\/wp-content\/uploads\/sites\/82\/2019\/09\/slide4.jpg","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/pcDnub-zB","_links":{"self":[{"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/posts\/2207","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/users\/231"}],"replies":[{"embeddable":true,"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/comments?post=2207"}],"version-history":[{"count":1,"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/posts\/2207\/revisions"}],"predecessor-version":[{"id":2959,"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/posts\/2207\/revisions\/2959"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/media\/2211"}],"wp:attachment":[{"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/media?parent=2207"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/categories?post=2207"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/tags?post=2207"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}