The Reality of Women in Retina

Historically a male-dominated field, retina has seen a narrowing in the gender gap among physicians.¹ Retina Today (RT) spoke with several prominent women in retina, who discussed the challenges they’ve faced and the changes that are necessary to promote a more inclusive and equitable field.

RETINA TODAY: WHAT ARE SOME OF THE CHALLENGES OF BEING A WOMAN IN A HISTORICALLY MALE-DOMINATED FIELD?

Laxmi Devisetty, MD: Many people do not understand or appreciate the dual roles women often have to (or are expected to) play, specifically when it comes to running both the office and the home, an often-impossible task without help. Even then, help can be unreliable and complicate matters even further. These challenges don’t even account for the ones we face every day at work itself. Women usually must work twice as hard and prove twice as much to earn the respect of colleagues, who are typically more likely to question a female physician than a male physician.

Avni P. Finn, MD, MBA: Based on the American Society of Retina Specialists' (ASRS) directory, only 17% of practicing retina specialists in the United States were women in 2020.¹ Having female mentors enables female mentees to see themselves in certain roles. One of the biggest challenges to women in a male-dominated field is the limited opportunity to imagine what your life as a retina specialist would look like. If you see other women balancing their clinical/research demands and personal and professional lives, it can bolster your confidence to achieve your goals and surpass them.

Kristen Nwanyanwu, MD, MBA, MHS: The challenges are also opportunities, but they are numerous. I have lost count of the number of times I’ve been mischaracterized as anything but a surgeon. I no longer wonder if my male colleagues receive as many comments on their hair or clothes as I do. Nothing was designed with women in mind—think operating while pregnant and going on maternity leave. There are tremendous opportunities to add to the diversity of thought in our field to build innovation.

Ashvini K. Reddy, MD: Research shows that female physicians perform better relative to males in some major outcome measures.² Despite this, women generally earn less than men and are more likely to experience harassment and prejudice in the workplace.^3,4 Women are generally also underrepresented in leadership positions.

RT: WHAT ADVICE WOULD YOU OFFER TO YOUNG FEMALE RETINA SPECIALISTS LOOKING TO ADVANCE THEIR CAREER?

Dr. Devisetty: Never settle. Find the career that’s worth working for. Everyone can do a job, but a career is something you build. Let go of the pressure to always be the best of the best and acknowledge how far you have already come. Never wait to have kids on some magical timeline; if family is important to you, make it a priority.

Dr. Finn: Don’t be afraid to seek out mentors. Our field is supportive, and there are so many leaders invested in the next generation of retina specialists. Seek out those who you admire or who inspire you—both women and men—and engage with them. You never know who might be able to offer sage advice or open a door for you.

Dr. Nwanyanwu: Picture what you want being a retina specialist to look like. Find your flexibilities and non-negotiables based on what you want your life to look like. Learn how to effectively communicate, negotiate, and advocate. Identify how best to use your skills and find places that allow you to do that on your own terms.

Dr. Reddy: Choose a job that makes you happy and allows you to care for patients who bring you joy in a field you love and a practice environment that allows you to shine.

RT: WHAT CHANGES ARE NECESSARY TO IMPROVE DIVERSITY IN RETINA?

Dr. Finn: As an educator and an established retina surgeon, I view mentorship as one of the most important roles I have. However, I am learning that sponsorship is equally, if not more, important. While a mentor provides guidance, a sponsor advocates. Improving sponsorship opportunities can improve the diversity in our field as we intentionally work on promoting equity and inclusion.

Dr. Nwanyanwu: Allowing ourselves to conceptualize a diverse field is the first step. We need bright humans who understand that diversity of thought is the key to usher our field to the next level of innovation. To do that, we must build inclusive environments that welcome historically excluded individuals. This is the focus of the ASRS mentorship program, the Vit-Buckle Society mentorship program, and Women in Retina. We must design better systems and interrogate these systems if we want different outcomes.

Dr. Reddy: Transparency about workloads, representation, and compensation drive diversity in our field. Many institutions are making changes that enable women to benefit from progressive family leave policies, flexible work hours, and leadership opportunities.

RT: WHAT ARE THE MOST IMPORTANT THINGS THAT YOU LOOK FOR IN A JOB?

Dr. Devisetty: I look for the opportunity to create something that is sustainable. In my previous jobs, I was successful in building a practice that enabled me to make a difference. There needs to be reliable support staff and willingness of administration to implement changes that optimize efficiency. If something is not the right fit, do not wait to get out. Sometimes, you must cut your losses early.

Dr. Finn: I look for the opportunity to cultivate personal and professional growth, a collegial community, and leaders who are inspirational and supportive.

Dr. Nwanyanwu: When I was looking for a job, I solved for what I wanted. My coworkers are collegial and kind. I work in a community that is interested in advancing equity and understands the history of racism and injustice. I have the intellectual freedom to approach challenging problems from many different angles.

Dr. Reddy: The culture of the workplace makes a huge difference. I look for work environments that are patient-centered and equitable.

RT: WHAT MAKES A PRACTICE FEMALE FRIENDLY?

Dr. Devisetty: Flexible start times. Sometimes, women specifically may need to come in late or leave early because of our kids. It is also important to have career advancement opportunities and equitable compensation. Studies show that women often get paid less for equal or more work.⁵ Jobs that value diversity, experience, and leadership skills and are willing to overlook the traditional compensation model will make for a more productive organization.

Dr. Reddy: Most women today are looking for work environments that allow them ample clinical and surgical opportunity, good pay, and some flexibility with work hours, maternity leave, and childcare. As an example, my office has a room set aside where employees’ children can play during work hours. This has drastically improved absenteeism.

Dr. Nwanyanwu: What makes a practice female friendly usually makes the practice better for everyone. Transparency and good communication are important. Prioritize job structure, organization culture, and colleague compatibility. Listen to that voice of truth inside you that keeps you safe when a situation isn’t right for you.