Michelle Lin, MD, MPH, MS This week, we speak with the 2019-2020 President of AWAEM, Dr. Pooja Agrawal, an Assistant Professor at Yale who is an expert in global emergency medicine and refugee health. She talks about the rich, diverse membership of AWAEM, and gives great advice on reaching out to potential mentors and sponsors early in one’s career.
Tell me about where you are in your career.
P Agrawal: I’m an assistant professor at Yale. I’ve been there for about a little over 6 years now. My background is in global health and international emergency medicine as well as public health and so I’ve kind of transitioned over the years from doing fairly traditional global health work to more public health and domestic-based public health work with the global health kind of theme to it. I work mainly with refugee populations and settlement and how the whole process affects their health and their health literacy over time.
I’ve been very active with the residency and trying to get some of these themes involved in the didactic trainings and getting people aware of some of the non-traditional and populations that we serve, and also working directly with refugees and beneficiaries about helping them to promote their health literacy and create a curriculum so that they can understand and be a little more empowered to know more about their health and how to access it.
How do you feel like gender has affected your career so far?
P Agrawal: When, as a resident, I think I was very aware of it and then I would walk into a clinical shift and I would be mistaken for a student, a nurse, and I very quickly realized that while I was most comfortable wearing scrubs and a hoodie I kind of had to wear a white coat in order to kind of get that just even physical kind of acknowledgement of who I was or potentially could be in that room.
I’ve known counterparts that can walk in wearing cargo pants and a scrub top, I wear a white coat every single day. It doesn’t matter if I’m hot or cold or whatever it is, and that’s just, I think I was very aware of that early on, just as how I presented myself and how I was perceived by patients and nurses. And I think that that part of it, the second part of it, the non-physician staff and even sometimes the non-EM physician staff will treat women and men differently in the emergency department. And it’s probably not intentional and it’s not malicious, it’s just, I think, the way that people perceive others.
I’ve had experiences where as an attending I will listen to a female resident try to present a consult or ask for help from another service and be asked 15 questions as to why the consult is being called and why they’re being bothered while a male resident will maybe make a very similar call and will get a 3 minute conversation like, “Okay, sure, we’ll be right down to see the patient.” And so I think, in my own personal experience as well as observing trainees and other people within the department, I think gender is a huge part of how we deliver care, and how we are perceived, and how patients and other non-EM physicians and sometimes EM physicians as well perceive us.
Over time, I’ve changed the way that I carry myself. I’ve changed the way that I walk into a room, the way that I run a code, or I watch residents run a code, and some of it’s been conscious, and some of it’s I think has just been a reaction to maybe not the best interactions and not the best reception that I would’ve wanted to get. And so I think it’s huge. I think it’s a very big part of what we do. And I also think that being female I probably realize it more, right. So I have many male EM colleagues who probably have no idea about the multitude of things that I’m probably consciously and subconsciously thinking as I walk into a room, and they don’t have to think about any of those things.
P Agrawal: And that’s something that I think that we do, I think we have to do. I think as we’re trying to assert ourselves and an equal partner, as an equal member of a team, we have to work harder. I think that’s just what we have to do until we’re at a point where we’re just kind of automatically given equal say, and equal voice, and equal visibility. I think we’re going to have to keep working harder, and that’s just part of our jobs.
Why did you first join AWAEM?
P Agrawal: I’ve been part of AWAEM for, I think, probably 5 years now. One of my colleagues, and I would say mentors, Basmah Safdar, she was an AWAEM president a few years ago and she was just trying to get more people within the department to be involved within AWAEM and asked me to start as the global health committee chair.
Which makes sense because that’s my background, and as I became more involved with that part of AWAEM and sitting in on calls and meetings and kind of hearing the conversation as to really the kind of women, and the conversation struck a cord with me about how it is about advancement but it’s also about promoting each other and having a community, and having a network, and having people to kind of sound off ideas and talk about challenging experiences and I found AWAEM to be a very easy place to do that.
And so, I honestly I hadn’t really explored many other women’s groups within other parts of emergency medicine or outside of that, cause I didn’t really have a lot of experience and just as a person I tend to shy away from, I just, I don’t tend to join things that’s just not what I do, but I found that AWAEM was just a very easy place to feel like I have a voice and I have something to add, and I have now access to people who have been where I am, who’ve become very successful, and kind of help me navigate as I move forward in my career.
How has AWAEM has affected your career in particular since joining 5 years ago?
P Agrawal: AWAEM is constantly looking for new talent and new people to join and I was kind of pulled in by someone that I respect and that thought that I had something to add, and I think as I’ve been part and gotten more and more involved in different aspects of AWAEM I’ve realized that it really, you add a lot of skills by just being part of different aspects of what AWAEM does.
So I started off as the global health chair, and I was the liaison between GEMA and AWAEM, getting together for events and didactics and things, and I kind of got a sense of how it’s, how groups can really collaborate. And then I moved from there to being the treasurer for a year and I got a sense of kind of the numbers and the ins and outs of how things out and you really get a sense of what the mission of AWAEM is when you start to see where the money is allocated and I thought that was very eye opening and fantastic to see that we really are trying to promote women by scholarships, and grants, and inviting people to meetings and trying to help support people who need that support, and I found that to be very helpful.
And now as president, being involved in kind of all of the different other aspects of the committees, it’s just, it’s really helped in terms of understanding all the different kind of moving parts, and also how you keep a group like this moving forward and thinking about the future and as we’re moving towards another 10 years we’ve done a lot, but I think our current political climate would show us that there’s still so much more that we can do for women. And I think that’s what we’re trying to do with creating some of these new efforts around how do we promote women, right? And how do we, who creates kind of mentorship groups, and how do we really get our word and our colleagues out there and visible in a way that sometimes is not as intuitive or not as easy for women to do.
One– it’s given me this very fantastic leadership opportunity, and two– it’s given me a great network of other women who I can now turn to and say, “How did you do this? How did you navigate this difficult thing in your career, and what do you think about some other options that I have?” I had people to bounce things off of and that’s, it’s much bigger than just where I work, which is really wonderful.
How do you anticipate the professional needs of women in academic emergency medicine AWAEM members changing in the next 10 years?
P Agrawal: That’s a great question. Currently, I don’t think our needs are being met. As women, forget academic or non-academic, for women in medicine and emergency medicine I think our needs are not being met. I think, you know we, you know a theme from conversations we were having earlier today, I think we as women often, and to generalize a little bit, have a hard time promoting ourselves, right. We have a hard time sort of showcasing all of the amazing things that we’re doing.
We’re all doing them but we don’t really talk about it so much. We all have Imposter Syndrome, and I think we have a hard time getting past that. And so, I’m sorry I forgot the first part of your question.
P Agrawal: But I think organizations like AWAEM and being able, being part of a committee of women who have either acknowledged that challenge and passed it, or even gone over it which is amazing as well, I think being a part of that community and having other women kind of, you know, kick you in the behind and say, “you have done great things and this is amazing what you’re doing.” And kind of help promoting each other is a way that women can advance themselves and advance each other, and maybe in not ways that men do or even have to.
What career accomplishment are you most proud of?
P Agrawal: I don’t know that I have one yet. I think I’m too early in my career to know that I have one career accomplishment that I’m proud of. I think … I think being president of AWAEM is important I think, and that’s a very important thing to me. In terms of career accomplishments, you know I’m really, I’m very proud of some of the research that I’m doing, I’m proud of the population that I serve, and that I’ve chosen, I think it’s an important population to continue to acknowledge and affect.
And so some of the work that I’ve done around creating a curriculum for health literacy and understanding what impacts their health outcomes over time, I think that’s important to me and that’s something that I’m proud of. But I don’t know that there’s any one particular career accomplishment yet, but I’m young.
What advice might you tell a younger version of yourself or, for example, an AWAEM member at an earlier stage in her career?
P Agrawal: I think what I did not do enough of, and I probably still don’t do enough of now, is reach out to people who have been in my shoes in some way. I’m someone who kind of tries to keep her head down and kind of move forward and push through, but there are a lot of people who have accomplished a lot and to have a lot to share, and who want to share even though everyone’s super busy, but you know you find the time if you find a person, many people are willing to kind of sit and talk with you about either issues that you’re having or career trajectory, and I think I didn’t do enough of that.
AWAEM is really a fantastic forum to me to even just hear about other women who have done great things, that I would take better advantage of that. Reach out to people, pick their brains for, you know, recognizing that I may not get anything out of it, they may not get anything out of it, but at least you’re sharing experience, and you create a network. A lot of what AWAEM does is, kind of, promoting other women, and that’s the way to do it. It’s just to create a connection, and create a mentorship, or even just a community of people outside of your small circle. And I don’t think I did that enough, and I would, I’m working on doing that more, and I would probably would’ve liked myself to have done that more when I was younger.
Please name 3 other AWAEM members we should consider interviewing.
P Agrawal: Kathy Clem is someone who has walked in many shoes and has really accomplished a lot, and even just in the brief conversations I’ve had with her I think she has a lot to offer and is looking to offer that, and so I think she would be fantastic but I believe you’re probably already talking with her.
Eleanor Reed, she’s really just kind of someone who’s been, just kind of handles a lot with grace and really kind of is figuring out her balance and I think she’s doing a really good job of it, so that’s someone that I would recommend.
Anything else you’d like to add?
P Agrawal: I think I’ve said it. The strengths of AWAEM are in the members, and really in the spectrum of women from early to career to late career and everyone has walked a different path. Everyone’s had different challenges and different successes, and I think that really is the strength of the group. As we are looking at the next phase, thinking about how we can work together to promote each other, is really one, something that I’m going to look to do more of as when I take over the presidency in a few months.
We need to be supporting each other, we need to be promoting, elevating each other, and that’s really, I think the best thing that anyone can do so, thank you for doing this. This has been, actually, eye opening for me too. Because I’m talking about myself which is of course hard for anyone to do.
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