Women in medical leadership: Where to now?

Dr. Carolyn Snider, chief of Emergency Medicine, on why women still lag behind men in medical leadership and what can be done about it.

How did you take on a leadership role? 

About two years ago, I was asked to facilitate a discussion on Women in Emergency Medicine at a conference. One hundred people wanted to be part of the conversation, both men and women. I separated it into topics, and one was leadership. We talked about hiring, scheduling, work-life balance, education, all kinds of things. At one point I said I felt like a bit of an imposter talking about leadership as I didn’t actually have a leadership position. My division head at the time was in the room and, in front of everyone, he remarked that of course I was a leader. In reality, I was an informal leader with a lot of small, unnamed leadership roles. After that we talked about how in his mind, I was his ‘succession plan.’ We both learned from that. I realized that I needed to be more deliberate in my career steps toward leadership, and he realized how important it was to formally recognize junior leaders. I knew I wanted a job as chief of a department, and I wanted to do it in a place where I could live my values. When the St. Michael’s chief of Emergency job came up, it felt like it was written for me. Colleagues from across the country who had sat in on that session sent me the posting.  

How are you approaching the issue of women not getting leadership roles in Emergency medicine?

More than half of our residents are female. But there are issues around how people are evaluated. If I stand up and ask everyone to be quiet so I can take charge, how am I perceived versus a male saying the same thing? There’s research showing that people consider the statements differently based on gender. I may be seen as aggressive, and my male colleague as confident. And that is from both women and men. So I say, let’s stop whispering and start talking about it. We need to be aware of gender biases in order to change them. 

What methods do you use to change the status quo?

Research shows that women don’t apply for a job unless they can tick 100 per cent of the boxes, but men will apply with just 70 per cent. I see that all the time, so I might tap a person who has 85 per cent and say, ‘Please put your application in!’ My job is to encourage women so they’ll think, ‘Well, maybe I should.’

Women in leadership is a passion of mine. While we do a lot of mentoring of women in their careers, we don’t do much sponsorship. There’s a difference between giving people guidance on how to build their resumé or take on new tasks and identifying someone who’s been doing a lot of work and should have a title. Or advocating on behalf of them with senior leadership. Those are the traditional ways people end up in leadership positions. 

Is there an example of sponsorship in your department?

I saw two physicians, both women, who were really passionate about doing more for the population we serve at St. Michael’s. They were doing a lot behind the scenes but weren’t being paid for it. Yet we were all relying on them for their knowledge and expertise. I was able to put in place a leadership position for them. Dr. Michelle Klaiman and Dr. Evelyn Dell are now co-leads of our equity and diversity committee. That leadership title allows them to make a lot of the changes they’ve been talking about. 

Do you have specific projects for community outreach?

I’d like to see a patient navigator program, where people with lived experience help our patients navigate a system that is really complex for those who are disadvantaged. Getting to an appointment on time is difficult when you don’t have a phone to find out your appointment slot, or an alarm to wake you up. That is just a small example – the issues our patients face are complex.  

We’ve been trying to engage with the community, because we believe that a big part of improving our patient care experience at St. Michael’s is understanding that our diverse population has exceptional needs. We need to be out in the community, working with them and making patient care a team-based effort.