On the shoulders of giants: inspiration for aspiring physician leaders

Vanessa E. Zannella and

Liza Abraham


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Although the number of women in medicine has increased dramatically in the past two decades, this has not been reflected in physician leadership positions. The disproportionately fewer women in positions of leadership and administration has meant fewer opportunities for mentorship. This article presents words of wisdom and inspiration from 10 female physician leaders.


KEY WORDS: medical education, work–life balance, family, well-being, professional relationships, gender bias, mentorship


Medical training  is a unique period in one’s life. It’s a time to become your own person, to grow into a professional, to conquer your craft, and to develop meaningful relationships with your patients and peers. It is the greatest time of your life, but also the most difficult. We’ve all had conversations with our mentors — about burnout, managing uncertainty, remaining humble — but for female medical trainees interested in leadership, talking about family planning, work–life balance, and job advancement may be more difficult. And the disproportionately fewer women in positions of leadership and administration has meant fewer opportunities for mentorship.  Top


Although the number of women entering a career in medicine has increased dramatically in the past two decades, this is not reflected in physician leadership positions. New research studies investigating the underrepresentation of women in academic medicine have revealed important themes, including experiences with gender bias, a lack of role models, and concerns about finances and work–life balance.1,2


Despite these challenges, trainees continue to be motivated to participate in leadership endeavours. To explore the perspectives of physicians on medical leadership, we sought the wisdom of 10 female physician leaders across various subspecialties — surgery, internal medicine, psychiatry, obstetrics & gynecology, family medicine, emergency medicine. Their words and stories offer inspiration that is worth sharing.  We hope you find what follows as transformative as we have.


On time and work–life balance

  • Worrying too much about [work–life balance] undermines the tremendous amount of joy you get from your work as a physician.
  • We often categorize work as bad and life as good. I love my work and work is part of my life.
  • Early on, you will say yes to more! But if you don’t like something, you shouldn’t stick with it. The only reason to do multiple jobs is because the outcomes are important to you.
  • Balance comes over a month, where one week I focus intensely on one thing and then the next on other things. If you’re going to be a high-level, high-functioning professional, you won’t have balance every day.


On family

  • My husband is a physician leader too. We didn’t bake cookies together, but look how great our kids turned out!
  • I think if you love your family and they know that you are doing something important, they will understand and love you anyways. I don’t think that my children doubt that I love them.
  • Have your baby now! Fertility is a feminist and a leadership issue. Biology is something you can’t control. The perfect anything is never going to happen; don’t put fertility on the back burner. Top


On personal well-being

  • Remember that it’s a long career and you don’t have to do everything all at once. You can have everything, just not all at the same time.
  • Can you be at every car pool and soccer practice and be baking? You can’t! Decide what is important to you. It’s all about your long-term goal. With everything you do, think “why am I doing this?”
  • Learn how to say no.


On professional relationships

  • Some women need to learn how to speak out, but are afraid of being labelled aggressive. It’s your personal responsibility to overcome that fear if you want to be a leader.
  • Taking a leadership role changes your professional relationships. It’s hard to be friends with someone who is reporting to you.
  • As you mature into your profession, you learn to carry yourself differently and command the room, especially as a surgeon. If I am not calm and in charge, then everything in the room feels off balance. That came later for me than some of the guys. Top


On gender bias

  • There are differences in how men and women present and promote themselves. Men are more self-assured. Women are more introspective. If you are introspective enough, you will find reasons why you are not good enough for a leadership position. If you can’t turn that voice off, you won’t ever apply for the job.
  • Most gender bias frequently comes from patients. You go through a whole spiel about the surgery, obtain consent from the patient, and, as soon as you walk out of the room, they turn to the nurse and ask, “That’s the surgeon? Is she going to do the surgery?”
  • As women, we don’t promote ourselves very well. Men are more competitive in the workplace, and they are more comfortable doing things because they are right for them. Women are, generally speaking, more concerned about the whole team. Because of this, we sometimes do ourselves a disservice.


On mentorship

  • Everyone you meet — every teacher, every shadowing experience, every clinical experience — take a few minutes to reflect. Is this someone who could be a mentor and in what way?
  • I’ve had great male and female mentors. No question that female mentors have an intuitive ability to understand kids, family obligations, menstruation. But you don’t need a gender-specific mentor. You need multiple types of mentors.
  • I don’t subscribe to the traditional model of mentorship — that you should get everything from one person. We all have people who we are close to and who can champion us. It’s important to have a group of people in your life whom you can call for certain types of problems.



What we are sharing is honest and humble opinions of some of the most ambitious, kind-hearted, and loving female physicians we could find. Although this is certainly not a scientific, rigorous list, the advice is genuine, truthful, and thought-provoking.


What was so intriguing about this process was that these women — clinicians, administrators, researchers, teachers, mothers, daughters, sisters, and friends — could offer such a plethora of optimistic, enlightening, and hopeful reflections to young female physician leaders in training. Moreover, the opinions demonstrate that our unique strengths as women position us perfectly to learn from and alongside our male colleagues. Top


If nothing in this piece resonates, remember to always embrace the fear, exhaustion, joy, and uncertainty associated with your unique path toward leadership. Consider physician leadership a privilege, an honour, and a blessing presented to few; it can either define you or be defined by you. So go on, enjoy the journey.



1.Edmunds LD, Ovseiko PV, Sheppard S, Greenhalgh T, Frith P, Roberts NW, et al. Why do women choose or reject careers in academic medicine? A narrative review of empirical evidence. Lancet 2016;Apr 19. DOI: 10.1016/S0140-6736(15)01091-0

2.Wehner MR, Nead KT, Linos K, Linos E. Plenty of moustaches but not enough women: cross sectional study of medical leaders. BMJ 2015;351:h6311. http://dx.doi.org/10.1136/bmj.h6311



We thank all the physician leaders who offered their time and advice in the creation of this article.



Vanessa E. Zannella and Liza S. Abraham are medical students in the Faculty of Medicine, University of Toronto.


Correspondence to: vanessa.zannella@mail.utoronto.ca or liza.abraham@mail.utoronto.ca


Author attestation and disclaimer

VZ and LA contributed equally to this work and are co-first authors. We did not receive any support or funding from any public, commercial, or not-for-profit agency for this work.


This article has been reviewed by a panel of physician leaders.