Thank you guys. This is amazing. So I am so honored and I have to give 100% credit to well, actually, first of all, I'm going to ask, I'm going to introduce everybody with our full names. And then is it okay with you all if we use first names after that? Yes. This is the first time in history that we have had this many national and international organizations in pulmonary critical care and sleep medicine that have leadership that are women. So in order to honor that today, we started this panel. So my first panelist is Dr. Doreen Idrizo-Harris. She's a professor of medicine, associate director of clinical and academic affairs for the division of pulmonary critical care and sleep medicine at NYU Grossman School of Medicine. She's the program director there of the pulmonary and critical care fellowship and co-director of the NYU LH bronchiectasis and NTM programs. And finally, she's just president. Next up, we have Dr. Sorry, I have to see who was next in line. We have Dr. Patricia Rivera. She's a professor of medicine. She is a CJ, sorry, C. Jane Davis and C. Robert Davis distinguished professor in pulmonary medicine. She's chief of the division of pulmonary and critical care medicine at Rochester School of Medicine. And she's the associate director of DEI at the Wilmot Cancer Center and the president of the American Thoracic Society. And our final panelist is in leadership in the largest organization of the three. Dr. Monica Gapa is a professor of pediatrics and a director of the Children's Teaching Hospital in EBK Dusseldorf. And she is a European Respiratory Society president-elect. Oh, you're president now. Oh, I'm so sorry, president now. They need to update your website because I did check yesterday. Congratulations. So the intent of today is to be a little bit informal. My thought was I would just give you their titles and then I'm going to give each of them five to eight minutes to sort of talk about their path. And then I have some topics that I thought would be really interesting to hear, but I really want to have this be super, hopefully, oh yeah, there's a mic back there and we'll bring it up. If you guys have questions or stories, so this whole concept is to sort of build community because part of the problem is we're getting really good at having women in pulmonary and critical care medicine. We're not quite as good yet at getting them to leadership. So we are finally starting to break that barrier. All right, so I'm going to start, Doreen. Oh, and I'm Anissa Doss, the program chair at Ohio State University. I guess I should have introduced myself. Well, let's start with you. Wouldn't you mind just telling us a little bit about your story? Okay, I go first. Let's see, where should I start? I think the best place for me to start to give you a little bit of my background and how I kind of looked at my career path is to talk about my upbringing. So I was the first of four children to a pulmonary critical care physician. And I think my dad really wanted a son, but unfortunately he got three girls first. And then 10 years later, he got the son. So I was kind of his son, I think, because he taught me everything to hunt, to fish, how to take care of farm animals, how to use a chainsaw. He needed help. So it was me and my two sisters who did a lot of the work until my brother came along. And I think with that, you know, I never realized it. I look at it now, but there was nothing he thought I couldn't do. It didn't matter that you were a girl or a boy. You were there to be part of the team, to work, to learn. And that's the outlook I had on life as I started to decide on what I wanted to do. I never wanted to be exactly like him. So I was a chemistry major in college, and that was a mistake as I got through the more complicated courses. I thought I was going to be an organic chemist, and then I went and saw what the jobs looked like. And I was in a room with no windows, and I was like, oh no, this is definitely not me. So a little bit late, senior year of college, I decided I was going to switch my path and do medicine. And I was lucky enough to end up at NYU for medical school and fell in love with working at Bellevue Hospital, which is where most of our training was back in the 80s. And from that point forward, I just, you know, really thought that there was nothing that you couldn't achieve. I was very lucky to be in a phenomenally diverse institution with leaders. We had several women leaders. Roberta Golring, who is a very renowned physiologist and has received a number of ATS honors. She runs our physiology lab still in her 90s. I didn't tell you that. We had Ann Davis, who was a prior ATS president. And we had a few professors who were female. So I was in a great environment to start. Did I know any of that was important? No. I had no idea when I was looking for a place to work. I just, you know, when you look back, you realize that's why things were, I guess, easier for me, because I had a lot of great role models. And then as you move up, I think the important thing, at least for me, was it's important to get mentors not only from within your institution, but it's very important to network and have mentors who are outside so that you can really see, get somebody's opinion on a different perspective. And as I've grown and gone up the pathway, and of course, being a program director for 22 years, I've had hundreds of fellows out there that I continue to mentor. And now I'm in charge of the clinical faculty, which is about 70 clinical faculty. I love to mentor. I love to communicate. I love to be honest. Sometimes it's tough, but who better to get honesty from than someone who cares about where you're going? So I've tried to, you know, make those important parts of what I do. But it's also important, I think, and I didn't realize this, is to look to others. I think having a coach, or that could be in many forms. It could be a mentor who helps you. It could be a coach who's experienced in mentoring physicians. But have someone who can work with you, too, on things that you need to improve upon. Sometimes we forget about that. We're so busy doing all the things that we're doing to work and our family that we forget about. It's like, you know, take time to meditate, take time to work, work out. Also, I think it's important to take time to look at yourself, see what you're doing well, and what you could improve upon. And so I've been lucky in my career. I got involved with many organizations early. ATS, CHESS, program directors. And I think, as Anissa keeps saying, find those mentors here. Reach out. It just takes one or two to introduce you to the right people and get you involved. And then your career just takes off after that. You could say yes, yes, yes at the beginning. And then as you get a little bit up there, start saying no and start picking the things that are important. But I think the most important thing is to communicate and to network and to be positive at every obstacle that you find. Negativity doesn't help. But being positive can really, as I said yesterday, our speaker, for those of you who came, one door closes, three will open. And remember that. It's all how you look at the situation. Thank you, Doreen. And before Patricia speaks, I just need to acknowledge that the entire reason, so mentorship and modeling is important, the entire reason that I'm involved in CHESS is because I grew up watching you lead at CHESS and be in rooms that you couldn't get into because every seat was taken. And so just identifying mentors and models are important. And now I'll let you share your story. But if she's too humble, I'm just going to tell you that there's been many people who have followed in her footsteps because there she is. Thank you. So I am an immigrant. I am half Cuban, half Colombian. I came to the United States with my family when I was 10 years old. My mother is a dentist, was a dentist in Cuba, but was never able to practice. My father unfortunately passed away shortly after we moved to the States. I come from a family of a lot of healthcare professionals. My grandmother, my mother's mother was one of the first women to graduate from the School of Pharmacy in Havana. And my mother is a dentist, sisters that were nurses, and her brother was a physician. But I never really wanted to go into medical school. I actually, before Oprah existed, I wanted to be Oprah. I really, I wanted, I was a communication arts major. I love to talk. I love to talk to people. And I envisioned myself sort of having this show where I would interview women. I would interview these women who were like astronauts. And I had a full scholarship to university and I took a biology course and I got pulled aside by the professor and she said, have you ever thought about a career in medicine? And I said, oh no, no. I, you know, my family, no, no. And she said, you're really good at this. And I went home, my grandmother who had decided I was going to be a doctor, she picked all of her children's careers and most of her grandchildren's careers. And she said, yes, I knew you'd come around. So I applied. I went to medical school. I was very fortunate to have met Harry Fritz, one of the, you know, giants of the Bellevue Hospital who was very inspirational when I was a medical student. But it was really as a resident when I met Dorothy White, the late Dorothy White, an amazing pulmonologist and mentor at Sloan Kettering. And Diane Stover, Diane Stover was the division chief. I think she was one of the first division chiefs in pulmonary medicine. I don't think people recognize that. She built the pulmonary division at Sloan Kettering in the late, I think 1978, maybe 1980. Well, I mean, a pioneer did it all on her own for five years until she hired Dorothy and then hired all these women to be faculty. So I had very strong mentors and I started out with an interest in drug-related pneumonitis because of all of the chemotherapeutic and radiation, obviously at a cancer center. Unfortunately, Dorothy became very ill. I took a year off from fellowship to be a chief resident at Sloan Kettering. You had to be a GPGY5. And my, as I was coming out of my chief residency year, Dorothy got very ill and needed a heart transplant. So that sort of, she was gone for about a year. And my research, I had applied for a grant. I got the grant, but things got behind. And because you don't have a mentor, if your mentor is no longer there. And then I met my husband, my future husband. I proposed to my husband. He accepted three months after I proposed. And then, so he was finishing his surgical oncology and he said, oh, you know, I'm graduating and I want to, I'm leaving. And I was like, oh, shoot. Can we get married and move? And we moved to North Carolina. They had recruited Ben, but they didn't have a position for me until about a year and a half later. There was really no one interested in drug-related pneumonitis. There was no lung cancer program. Lung cancer patients weren't being treated. So it was an opportunity to pivot. I figured, hey, I know lung cancer. Come to think of it. Yeah. Because I'd been working with mitomycin, which at the time was the drug that was being used in lung cancer. So I built one, I helped build one of the first multidisciplinary, the first multidisciplinary lung cancer program in the country, along with a thoracic surgeon, Frank Detterbeck, and a medical oncologist. And so that allowed me to pivot to a whole area of interest that turns out I was quite passionate about because most of the patients I was caring for during my research were patients with lung cancer. So it's, it was hard because there were really no mentors. No one was interested in lung cancer in the pulmonary division. It was a very small division, but like Anissa said, I was very fortunate. I get very involved in CHESS and ATS as a fellow. Dorothy and Diane made it a point that we had to be on committees as fellows, which it would insist that our fellows be on committees, either at CHESS or ATS. And I built a network of people outside of UNC that really helped foster my research career, my clinical growth, my clinical expertise, participating in guidelines. And that was, that was very rewarding because sometimes you don't find it in your own backyard, so you have to really look elsewhere. And I was fortunate enough that through my involvement, I was part of the group that helped create the thoracic oncology assembly at ATS. And I decided to, you know, run for chair and I got elected and that got me a foot in the door at the board of directors, where I met all these amazing people and leaders, colleagues. Irina and I served as chairs of our assemblies together and I began to think about, you know, I think I could do this. And the staff at ATS encouraging me, you'd make a great president. Like you get all this positive feedback and mentoring and sponsorship, but especially sponsorship, it comes from everywhere. We think that it has to come from the person that's my attending or my lab. It comes from, you know, my administrative assistant at UNC was my biggest shield. You can do this. You can do it, Dr. Rivera. Go, oh, you should apply for that position. It's everywhere. And I think it's, you have to, you know, recognize it, accept it, and also be willing to pay back and pay it forward because we can all be sponsors. I think the challenges are real, but they're real for everyone. I think we all have individual stories that we can tell. I think it's what we do with our stories that are really the interesting part, right? The bridges that we can build to get us to the other end. So I encourage all of you to reach out to individuals that you think could help you and foster you because it's everywhere. Thank you. Well, you've heard two stories already. Mine is a bit similar and a bit different, of course. I'm from Europe and Europe is different as we have different countries with different societies. I grew up in Germany as the first of three daughters, and I was the first going into medicine in my family. Both my parents were teachers, and I got a very good education, got opportunities to do everything, and was actually thinking about becoming a professional musician, playing the cello, and at some point had to decide whether this is something I would do for the rest of my life. And then being fascinated by biology in school and getting into depth of problems, I decided maybe medicine could be a combination of my love for humans and my love for being with other people and doing something for other people. So I decided to go into medicine and leave music as a leisure time activity, which I continued and which actually gave me a very good balance through most of my career. At the moment, I do more sports than playing music because this is more flexible in time. So I went to medical school in Hanover, and Hanover still is one of the best universities for medicine or medical schools in Germany, and I actually stayed there for quite a long time. I did my studies there, started my pediatric training, did my pediatric pulmonology training, allergology, and neonatology all at the same place. However, I think the most important bit for my career was a research fellowship which I took in London at the Great Ormond Street Hospital for Children and the Institute of Child Health in the beginning of the 90s. This was at the end of my third year of pediatric training, so quite early actually. And I stayed there for almost three years, and there I found a great mentor. So this is a story I think that we all share. She was Professor Janet Stocks, or she is Professor Janet Stocks, who's now retired, and she led the Department of Pediatric Respiratory Physiology, and I started doing infant lung function with her. And she was actually a great mentor. She had a nursing background, so she actually wasn't a medical doctor, something that was unheard of in Germany, where I came from. And she had a department with lots of young women, mainly from nursing background, doing their PhDs with her, but she also had medical doctors and working very closely with the Great Ormond Street Children's Hospital. So I got to learn a lot about pediatric pulmonology while I was in London, and a lot about pediatric respiratory physiology. And I also got the experience of international networking, because this department was visited from colleagues from Australia, from colleagues, by colleagues from Canada, from the U.S., being active in pediatric respiratory physiology. And it was a great time to get to know all these people, get the network, and that Janet Stocks really pushed us, being in the department, to take responsibility not only for our research, but also to join committees, as you've just heard from Patricia and Doreen. I was still a research fellow when I was asked to take the co-chair of the ATS-ERS infant lung function working group, which was something I thought I could never do. But they told me, yes, you can. And that's with one committee after the next, taking responsibility, networking with people. That's how I got really involved in this, and got very much involved with the ERS, and have been since. I've been doing or setting up the education program for the ERS. I've been secretary for the Pediatric Assembly. And, well, there are so many things that are possible for women in the ERS, something that I didn't experience in Germany. In Germany, I still had to fight being a woman in a senior position. So the ERS was always very helpful, very supportive, and told me, yes, you can do that. I don't quite know how I got into the position of the ERS president, but here I am. And it's also a great experience. So I have a, yeah, it's, the story is really ERS from the very beginning of research, then taking this experience to my clinical work, becoming director of a children's hospital. This is my second position as director of a children's hospital. I'm still doing research, building up a research team. Have lots of young women doing their pediatric training in my department. Yes, and I'm talking about mentors. I'm most grateful to my mentor in London that made me do the first steps to go into international networking and pursue this as a passion besides caring for patients. Thank you to all of you. So I'm going to ask you a bit of a difficult question, but I prepped you that I would ask it. If you're willing to share a particular barrier that you came up against in your career and or life, and then because we don't want to just talk about negativity, what tools and things that you did to overcome it and how you overcame it? Because I think we can all learn from our experiences. Well, I was the last, but maybe I can continue. I think the biggest barrier was being in Germany and I had a head of department, chief of department who thought I should rather have a family and look after my children than applying for more senior positions. And when I did, he didn't support this. So it was a small drawback, but not for a long time. I decided to go ahead despite this. And I actually have two very nice daughters and a very nice husband. And it was always a sort of double challenge or maybe triple challenge. And many of you will have experienced the same, but I think it's worth it to really pursue your own career, do something that's different from the family. And sometimes it feels like you have a shared life or a split life, but in the end it comes together because now my daughters who are grown-ups, students, one is doing actually medicine and the other is doing law like her father. They understand now what we have been doing all the time and they appreciate that we do have a career and we're still there when they needed us the most. So pursuing this despite there are other traditions and still are in Germany. I just want to echo I think for me probably being a woman was the biggest barrier because I do think that the biases, although have lessened, I do believe this is true. And I think in part because of having many more women in leadership, women at the table that can help direct the conversations. That wasn't the case, you know, when I started at UNC. And it was actually the case at Sloan Kettering. I just didn't, I just thought it was like that everywhere. You know, I'm married to a surgical oncologist who was recruited and it shortly after being recruited became the division chief so he was very busy. He had a lab and I had three children, one right after the other. I said I got to get this over with, check. All three of them in diapers. I had a very wise mother who hired my first live-in nanny without me ever meeting her and put her on a train to North Carolina. She lived with us for six years and then hired the second woman that lived with me for 20 years. And these two women, along with my mother and my in-laws, were the people who helped me raise the three most important individuals in my life, my children. But it was challenging because it was, oh well, you know, I was always an advocate for equality in positions and salaries. I was always barking at someone's door about salaries. And I once was told you don't need more money, you're married to a surgeon. You know, to which I responded, you know, Ben Calvo did not go to medical school for me, did not do my residency or fellowship and he certainly doesn't do my job here. But, you know, things like that, these biases that, you know, I don't, people don't mean, like they don't even know that they're saying these things. But it was, oh well, you can't do that because, you know, is it gonna, can you do that? You've got three kids. And I was always at the 7 o'clock meetings. I was always at the 6.30 meetings in the morning, in the evening. So those were barriers that we had to, there was no maternity leave when I started at UNC. We made sure I put together a committee. There was no place to nurse other than the bathroom. So those were barriers for women and it took a lot of effort and time to make sure that those were made better for the people behind. It's all about what are you gonna do for those behind you, eh? Because you can't go back and say, oh I wish. You can only start now and make a new ending. So it was, okay, what am I gonna do for the women? I was pregnant as a faculty member when one of our fellows was pregnant. They were going to give me six weeks maternity leave. They were not going to give her any. And I stormed into the division chief's office and said, listen up, you know, this is, I think, illegal. And if I'm getting six weeks, she's getting, and he said to me, and I quote, do whatever you think is best. I am afraid of you. Whatever you want, just please, I'm so afraid of you, I said, okay. And, you know, so these are the things, these are, you don't realize that these are barriers. But, you know, I remember being at a conference and I was pregnant with my second son. It was a combined thoracic surgery, pulmonary radiology. And I was tired, I sort of dozed off. And one of the surgeons said, oh, they asked me a question, oh, you know, ignore her, she's something or other because she's pregnant. I paused and I turned to him and I said, so what's your excuse? And, you know, but those are the things that people would say out loud, right? Like, no, I'm not having, you know, I don't have, you know, whatever mushy brain because I'm pregnant. I just was thinking about something else. And we have to, respectfully, those are barriers that we have to appreciate, we have to recognize. And then we have to think about how do I just work through so I can make it better? So similar to what Patricia said, there are gonna be barriers like those all around, but it's how you approach it and how you make it better and how you do, sometimes going around, you know, depending on the situation is good, sometimes right out there saying something is the right thing to do. But I mean, I've been lucky because, at least at our institution, at least the last 15 years, we've had very, a lot of male leadership at the highest levels. It is getting better. But an appetite to really look at how to make things more equal. I ran our task force on promotion of women and equity about 10 years ago. And then our chair put in a new female dean to really primarily work on that, not only for females, but for men as well. But we were seeing that men were, you know, at three years, they're like, oh, can I get promoted? I'm like, no, it's usually five to seven for that position, right? But the women at 10 years weren't asking. And why was that? We didn't feel like we deserve to be promoted, right? So empowering the women, especially in our division, was very important. And we got them all promoted. So I do think, you know, there are gonna be those barriers, but there are ways to handle it. And most of the time, you can overcome them. Once in a while, you might have to leave your institution. But usually, especially now, with things being much more open. I think the other barriers that I came up against, though, are like Patricia's. I married a cardiothoracic surgeon who was doing cardiac surgery primarily. And initially, I thought I wanted to be a thoracic surgeon. And my mother said, oh no, not two thoracic surgeons. You will be divorced immediately. And she probably was correct. So that's why I went into pulmonary, because I liked thoracic surgery. I was doing my thoracic surgery sub when I met my husband. And so that's been a bit of a barrier, how to balance a family. And I definitely wanted one. I wanted five children when I first got married. I only have two, which thank God, I can handle the two. After having my son, who was the second, he was a very good form of birth control. We weren't having a third. But I think that was the barrier, how to balance that and not let it affect your career trajectory. As Patricia said, I had my two in residency. So I wanted to get them done with and have them. I had to hire two nannies at one point. I had a daytime nanny and I had a woman who was a senior in high school who kind of helped with homework and did projects. And she still is part of my family 32 years later. And she has got her own children and they're kind of like my nephews. So these people that help you and become part of your family really help you with that balance. And so finding that right person, if you're lucky, is really, really helpful. But I think for me, more of the barriers have been on the balance of work-life balance than at work particularly. That actually leads perfectly into my next question. However, I will pause and say, so I have a question for you guys. But if you guys have questions, there's a mic back there. I will pause on mine and just have you guys ask questions because I don't want, I mean, I'm happy to keep asking questions. But I'm officially opening it up. So if you guys have things that you wanted to either say or ask, go up to that mic. But I'm going to ask mine first. So you both all touched a little bit on work-life balance. Two of you had live-in nannies. Did all three of you? Not live-in, but I do have, I did have nannies all the time. Are significant, yeah. So, and so to talk about that, and I think, so I always tell everybody there's a million ways to do it. There's no wrong way, right? So my kids were daycare kids. People have nannies, people have au pairs, people have multiple. So A, there's no right way to, this is my, this is my, I have a mic, so I'm going to say that. So there's no wrong way to do it. And it changes with time. I think what you need at different times changes. I actually am 80% FTE, mostly so that I can do free work for chest, but also so that I can be the mom that I need to be at this point in my career. And that's really important to me. And I'm going to, again, since I have that mic, it's not a sacrifice. I hate when people say that. It's a choice. It's not a sacrifice. I'm not sacrificing anything. I'm choosing where to put my priorities. And so when you say a sacrifice, you're acting like you gave something. No, I'm choosing what I'm doing. And you know what? It might be a slower trajectory, right? I did get promoted in eight years versus five years, but I chose that because it was important to me. Okay, so that's my statement. I have actually learned from you guys about work-life balance. Do you have any tips on, like what is your work-life balance at this point? Has it evolved over time? And do you have tips? And I know, Patricia, you have some, because your tips literally come through my mouth to my fellows on the regular. So they're being passed on. So if you could give us that knowledge. So I think it's critical to remember that they're going to change depending on the stage of your personal life. By that, I mean your children, how old they are, or what your partner is doing in his or her career. And also what you're doing in your professional life. So you have to sort of, these are three very important things you balance at all times. I learned very early on that you can have it all, you just cannot have it at the same time. And it is okay to wait. There's this, sometimes there's fear that it's okay. If you want it, and it's meant to be, I mean, I know that sounds kind of goofy, but it really, it will happen. You just can't have it all. My mother, when I got married to a Latin man, said, all right, this isn't, you gotta take the cape off. You are not a superwoman. You gotta start delegating. And that's when I, because I, you know, I wanted to do everything. No, you need people around you. And it's okay. We're so sometimes afraid to ask for help. Like, we're programmed by our societies. And biologically, to think that we have to do it all. And in reality, you don't. And I learned that very early on. And that was probably one of the best things that helped me balance my work and my personal life and my professional life. And appreciating that it was ebbs and flows, and it was all gonna fall, but it needed, you know, at the right time, it would flow. And obviously now, it's different. My kids are grown up. You know, my husband is no longer a division chief, so he's not as busy. So again, there are different needs. But I think, remember, there's a time and a place. It can't happen all at once. And it's okay to say, I need help. I think we have a question. Good morning. Shreeja Viswas, one of the lung transplant fellows from Phoenix, Arizona. Just wanted to get your thoughts on, you know, Dr. Das addressed some of those topics, but any tips on time management as an early career professional with young kids, and also a husband that's, you know, in the healthcare profession, full-time worker? The second question I had is leaders in medicine and women leaders in medicine, you know, what suggestions do you have? Because, you know, women leaders are way different than, and this is, I'm not saying this just because I'm a woman. This is something that I've noticed as a professional, like working with women leaders. You know, it's, sometimes we encounter, like, conflicts in the workplace with women, and how would you recommend handling those conflicts? Thank you. I'll start with the balance, I think. How do I balance, it's very, very hard, and it's different for all of us, right? Because our personal lives and our professional lives are very different. It isn't a cookie cutter. I think it's priorities, right? What are your priorities? And for me, my children, as much as I love my career, my children were a priority. But again, I had women who lived with me, literally live in nannies for, you know, 26 years, and my mother and my mother-in-law, I would import people, people are always coming. Every time I traveled to a chess meeting, my mother-in-law or my mother, if I went to ATS, in addition to the nannies, so I built that for myself because I knew it was the only way I would have peace of mind. So you build these, you know, strategies, and then you make a decision. Be careful about saying yes to everything. Choose your, the committees that you're being asked to, to represent carefully. You have to say yes a lot when you're in early career, but you don't have to say yes to everything. That's a mistake. And if it feels overwhelming, it is okay to say no. It is okay. No one is ever going to, I'll give you a perfect example. I was invited to do year in review at ATS in 1998. It's a big deal. I was doing the lung cancer year review. It was going to be six weeks after, I thought it was, Sophia was gonna be born before, but it was, it turned out to be six weeks after my daughter was born. I had a C-section, I had a complication, I had three little kids, and I called David Schwartz, who I think, who organized it. I was told by three people, if you do this, if you don't show up, you will never have a career at ATS. And I called and I said, this is my situation. I can't, I have a new, it was in San Diego, I think, or San Francisco, I can't travel. And he said, don't worry about it, it's gonna be fine. I was invited to do year in review twice after that. So my career was, and here I am, I think I did pretty well in ATS. But you see, that was, those things, it's okay. Sometimes you've gotta have the courage to, I cannot do this right now. And those are stories that often we're not willing to share, but we have to share those stories. And I wanna reiterate, you have to be not, not asking for forgiveness when you go and you say, whether it's to your division chief, and say, listen, I'm only gonna, I really only can work a .8 FTE for the next two years, having a child, whatever, as long as the money is okay, whatever, go there proudly. You're making a decision that's best for you and your family, it'll probably be better for you at work as well, you'll be more focused. You know, you have to make those choices. I chose to live two blocks from work and haven't moved from that building, because for me, it was important to have that efficiency. I couldn't afford to commute an hour each way. I wanted to be near my children and near my work. And yes, probably I'd have a little more in the bank right now, or, you know, we had to give up things. We lived in a very small space, one bedroom apartment, till the kids were, you know, five and seven. But what made those choices, because they mattered to me, and you have to just feel good about them and stick up for yourself, and people will respect you. And I don't look at any, I recommend to some of my female fellows as they're graduating, we keep a lot of them on, are you sure you wanna take a full-time position? Do you wanna start out as a, you can get benefits for anything above a .6, so do you wanna just start with a .6 this year? We love you, we'll add more when you're ready, right? I don't look at them any differently than a male colleague who says, you know, he wants to work a full FTE and five extra moonlighting sessions a month or whatever. Equal, that's fine. So you really don't have to feel bad. I will say, just to counter that, when they, not counter, but tell you how you can, other things you may address, when I told them I was gonna go at 80%, my division chief at the time said, that will be fine, but don't expect to be promoted. And I said, watch me, that was exactly what I said. And then, you know, again, it took me a few extra years, so I was like, yeah, I don't accept that. I think you had another question, and that is, you encounter difficult, sometimes you have difficult issues at the work, at work. As a women professional, like how do you handle workplace conflict, especially among women at workplace? Can you give us an example? Because, for example, like if, as a fellow, if I'm working with a female leader, sometimes it's hard to negotiate a conflict, like a difference of opinion, when, you know, because as women, we are all multitaskers, and we kind of tend to micromanage occasionally, and with a female leader who is very in control of the situation, if I'm trying to express an opinion that is different from her opinion, you know, have you ever encountered situations like that, and how would you recommend handling those situations? I think you're gonna encounter that all throughout your career, and I've learned over my career that the best thing is just transparency and honesty. I think if you're having those, it's one-on-one conversations, and sometimes a conversation with a third party. That's what, I've done that many times. Yes, you can, if that's a continuous problem, it's often good to find another mentor within the circle that you can speak to about it, and sometimes can even often be helpful to get a group together to have discussions, because you will encounter that over and over, and not just with a female faculty, but with male faculty, et cetera. Hello, my name is Irina Petrachi, and today's a wonderful day, not only because we have three of the largest respiratory societies in the world represented by three women presidents, but also I've learned this morning that the Nobel Prize for Economy was awarded to a woman. She was the single winner ever for really identifying the origins of gaps in compensation and economical growth between men and women, and how, you know, for every dollar a male gets paid, 80 cents go to the woman, especially after the birth of her first child. So with that in mind, and congratulating you, I wonder what can we do besides increasing the visibility of the women's involvement in our societies and in our field, what can we do as leaders, and do you have any items on your agenda in your individual society to promote women's interest in our field of pulmonary glial care and sleep medicine, and how can we help? And we should recognize that you are the, is it president-elect for ATS as well. Yes. I will start. One of the things we're doing is we renamed our women in pulmonary section to women in chest medicine, just because I didn't want to exclude critical care and sleep specialists. And it doesn't even just include physicians, it should be any allied health professionals. And we certainly welcome men who want to be sensitive to the issues that we have. Their perspective is also extremely important in helping us navigate the future. So strengthening that group within chest, and all that it does, today there's going to be a luncheon, and a number of initiatives that are coming from there, whether it's funding for women's health projects, et cetera, diversity grants that go particularly to women. We hope that that will get a good group together. We were even talking about doing a seminar, whether it be a virtual one or at the next meeting on issues, particularly like we're discussing today, but navigating your environment, conflict resolution, work-life balance, but focused around women's issues. So that's something that we were thinking of. Well, I think it's, if I look at the history of the ERS, I think it helped a great deal that we really have a policy of balance, gender balance. Now we have age balance as well, and other balances, but gender balance certainly helped. We really had to look out for ERS members, female members who could help in the committees. And as we've heard before, women sometimes come, don't come, or don't speak for themselves. So you have to find them, and I think it's very important through the balance helps to really build networks, and these networks that have been existing for men for ages. It's very important to have these so that you know other women who are interested in working in the field and working in leadership positions. And if you are in a leadership position, make sure that there are other areas, maybe your work environment, or I can only speak for Germany, to take this forward to other institutions and other committees you are in. Ask for the balance, ask that this is really worthwhile to have a balance between men and women, and that this way you can make sure that there will be opportunities for other women to show their, what is it? Strength. Strength. Yes, their strength, their voice. To hear their voice. Irina's question is, what are the initiatives, what are you doing? So I started a women's, it was the pulmonary critical care women's book, what is it when you read books? Book club. Book club. I never read the book. No, it was a Funster book, it didn't have to do with medicine. But some of the women came with highlighted books. I never read the book. I just wanted it to be, you know, I had gone through my career as sort of the one of two women and then the only woman for several years, and seeing these young, early career women struggling, I was always fighting for salaries for all the women, and no, she can't be on that committee, but I decided I would put together this women's journal book club. But it was really intentional for us to come and gather at someone's house on an evening to talk about issues that we're struggling with, you know, child care, the lazy husband or the lazy wife, you know, they're real, they're out there. And it evolved into a session where we met every month, it had a theme, we met at somebody's house, we got to know each other's homes, and sometimes there were painful discussions, people who were feeling they were being treated differently, but out of that emerged, okay, I need to take action, I need to go talk to so and so about. But the women residents at UNC got wind of this, you know, they meet to get, you know, Dr. Rivera and all the, and all of a sudden there was a lot of interest in pulmonary and critical care medicine as a fellowship, and I thought, you know, I think sometimes women need to know that there is an infrastructure of support, and it's important, and we started, you know, I don't know if it was directly related, we had a very strong female presence, you know, nine of us in the division, and all of us, you know, were excellent teachers, so maybe that's probably what did it, but I remember getting, you know, can the women residents come, we started inviting women in internal medicine to join us, and I think that was important. Now I'm at the University of Rochester, and our chair is a woman, and we have four division chiefs, and we meet quarterly all the way, and we're thinking about, like, we need to have, be inviting women in the residency program and in fellowship to join us, because we're talking about things that are very important to women's health, career, you know, networking, so that you have the support, especially for people who are just moving to the area, so I think, you know, we lead by example, I think the best way that we can encourage people to go into a profession is because, I can just tell you, at UNC and at Rochester, you know, I mean, the women rock, I mean, they just, they're so freaking good, so who wouldn't want to be like that, right, like, so leading by example is the best way that we can get women in internal medicine and medical students to want to be, like, especially in pediatric pulmonary, because that's a field that, at least in the United States, fewer and fewer people are going into, so at UNC, we had a phenomenal chair of pediatric pulmonary, and we had a phenomenal group of women, they inspire others, but I think, you know, we need to be thinking about ways to encourage people to pursue training in pulmonary and critical care, and then, once they do that, to have a voice, you know, what do you do to be able to empower everyone to have a voice? So in our last five minutes, I'd like each of you to reflect on your careers and think about two or three pearls that you think really have helped you lead to success, and it can have nothing to do with gender, it can have everything to do with gender, but sort of your pearls for everybody here for tips for success in their career. Stand up for what is right. Always do the right thing. It's sometimes, oftentimes the hardest thing to do, but it'll pay off. And take off the tiara early on. Nobody is going to ask you and come knock on your door and say, you are so good at what you do, I want you to apply for this position. Just do it. Take off the tiara and say, I am really good at this. I don't have all, I don't meet all the check boxes, but I'm going to apply for that position. Okay. Well, I would say, I guess everybody sitting here really is passionate for, or has passion for pulmonary medicine or for your profession. I think that's one very important thing to really like what you are doing. Of course, you have to want to be excellent in what you are doing. And then automatically you want to be an example and lead your profession or your field to where you want it to be. And that makes you automatically want to be a leader. And then you have to say, you can do it. And I think that is something that we are, that many women still have to learn that they can stand up for themselves and say, I can do it. And for that, you need the network. So yes, with people, look for a mentor. I think that's very important. Look for somebody who you think is a good example for your life. And then you have to find your own balance, how you get family and clinic and your own education and your career under one roof sort of, and then just do it and like what you are doing, be passionate about what you are doing. I think that's very important if you want to have the strength all the way through. One thing you shouldn't do is get laryngitis when you're supposed to be talking all week. I echo both Monica and Patricia. I think you want to be that person so that others want to be just like you. And so for me, it's be positive, work hard, nothing is below us to do. I like take off the tiara, that's a good one. Be a team player, be honest and loyal and people will want you to be on their team and people will flock to you. So you just have to remember that every day when you wake up. And yes, do something that you're passionate about because then you'll be good at it and you'll be happy. And it's okay to make those hard decisions. Stick up for yourself. So with that, first of all, I would like to thank all three of you. Number one, for just being your fabulous selves. Number two, for sharing your stories with everybody and letting us sort of all celebrate together where we have come over the past several decades. So thank you.

panel discussion

women leaders

pulmonary critical care

sleep medicine

mentorship

gender bias

advocacy

gender diversity

success tips