Michelle Lin, MD, MPH, MS This week, I’m thrilled to speak with Dr. Megan Ranney, a leading researcher and advocate on the intersection between digital health and violence prevention and Associate Professor at Brown University. We speak about her achievements in research and violence prevention, and how her gender has affected her career.
M Lin: Tell me a little bit about where you are currently in your career, and how it was that you came to be here.
M Ranney: I am an associate professor at Brown. I’ve been at Brown since I was an intern, so for about 15 years. My focus is on using technology to prevent violence, particularly gun violence, and related sequela like mental health and substance use.
M Ranney: I made my way to where I am now, other than the fact that I had stayed at the same physical location for the last 15 years, I’ve had a little bit of a wavy path. I always knew that I wanted to do public health, but wasn’t sure in what capacity. I actually came to emergency medicine in order to do global health, because I did Peace Corps before med school. Very quickly during residency I realized that global health was not going to work for me and my family, and did this period of a couple of years of being like, should I do ultrasound, or critical care? Trying to figure out what the right fit was.
M Ranney: I landed on a fellowship in injury prevention, given that a third of ED visits are injuries. Huge global burden to injuries, so I figured that I could someday go back overseas and work globally. And it’s closely linked to many of the things that I care most about in our vulnerable populations.
M Ranney: So I chose to stay at Brown for the injury prevention fellowship, and then from there, have just, sometimes intentionally, sometimes less so, made my way through various career development grants, both from SAEM and then from NIH, and have created a career for myself using research to try to transform the care of our most vulnerable populations.
M Lin: Tell me how you first got involved with AWAEM.
M Ranney: Gosh, I first got involved with AWAEM, it had to have been when it first started, 10 years ago. I remember sitting in a room with it would’ve been Gail D’Onofrio and Michelle Biros and Kathy Clem, talking about the importance of women supporting each other. And at that point, I was a brand new mom and so my primary concern was lactation rooms, and how do I do this whole mom doctor balance thing. I started to learn from the women ahead of me how they’ve managed their career, some of them took me under their wing, which was wonderful.
M Ranney: And then as I moved forward, I got to start to take other folks under my wing, some of whom were only a couple years behind me, but then obviously as the years have passed, there has been a larger gap between me and the junior members of AWAEM. So it’s been a nice experience in transmitting learned wisdom through the generations, and just sharing the joint experience of being a woman in emergency medicine. It’s also been really neat over the last few years in particular, to see how far we’ve come, from where we were in those first meetings, nine and 10 years ago.
M Lin: Tell me a little bit more about that, how AWAEM has evolved.
M Ranney: Early on, it was almost revolutionary to just be talking about being a woman in emergency medicine. The mere fact that we were meeting was crazy, and that we were talking about things that were women’s issues was kind of crazy, I think, because for the generation ahead of me, so much of their success was about being seen as being able to keep up with the guys, being just as good if not better. So to kind of openly acknowledge that was really a big deal.
M Ranney: And then watching as AWAEM has matured, not only is it acceptable to talk about women’s issues, but we’ve matured into a group that talks about a lot of other issues too, that talks about diversity and inclusion in a thousand ways, and that talks about not just what do we do to support our young moms, but what do we do to support our senior women, and our women who are trans, and our women who don’t have kids, and our women with disabilities, and how do we support our women who are researchers, and our women who are educators, and as we’ve matured and grown, we’ve been able to focus in on some of those populations that maybe were ignored, or not purposely ignored, but just not so much of a focus at first, which is really neat.
M Lin: Yeah. So important. Tell me a little bit perhaps about specific AWAEM initiatives and projects that may have impacted your own career development.
M Ranney: Oh gosh, there are so many. I mean, seriously, just the fact that AWAEM was there was huge. I cannot quantify the impact of knowing that there’s a community of women who have my back, and who I can go to with honesty, about whatever challenges I’m facing, and get honest feedback. I remember having a lunch with Gail D’Onofrio, and talking about raising kids, and her warning me about what was coming as my kids entered school, and her telling me very explicitly, sign up to be a room mother, but never bake the cupcakes yourself. It never would have crossed my mind. She’s like, that way, your kids get to see you being present, you don’t have to slave around in the kitchen, you can still go into your awesome career work, and be a terrific mom, and kind of giving me tips on how to do that. And that, I don’t know if it would’ve been possible without AWAEM.
M Ranney: So to me, it’s not a specific initiative, but rather the larger entity of AWAEM that’s been so fruitful.
M Lin: How do you perceive that leadership in women-focused professional organizations might be considered for the purposes of academic advancement?
M Ranney: So I think 10 years ago, it was not perceived as something that would advance your career. I think it was seen as taking yourself apart as a women’s thing, as a way to advance when you couldn’t advance along the traditional routes. I think that has changed. I think that leadership in a woman-focused organization for a woman or a man, is now seen as a huge strength and demonstration of leadership ability.
M Lin: How do you anticipate the professional needs of women in academic emergency medicine will change in the next 10 years?
M Ranney: How do I anticipate the professional needs of women in academic emergency medicine will change in the next 10 years? I think that some will be the same. I think with every generation, as you first get out of residency, first get out of this purely merit-based advancement that we all kind of thought we were part of, up through med school and residency and maybe even fellowship, when we first confront the realities of gender inequity, there will still be an important place for an organization like AWAEM to hold those people close, and say, it’s okay, it’s not you, it’s the system, and then to give them tools to combat the system.
M Ranney: I think that hopefully we will see a rising proportion of emergency physicians who are women, and a rising proportion of women in leadership positions in emergency medicine, hospitals and academic medical centers. So I think that AWAEM’s role may not be as much about showing people that it’s possible to have women in those positions, as much as helping develop them into those positions in a much less, I don’t know what the right word is … that it won’t be as unusual for that to happen.
M Ranney: I think that in the next 10 years, AWAEM will have to continue to expand its focus on diversity and inclusion, and intersectionality in every way, and I think that’s a really important thing for the organization to do going forward. We’ve been good, but we can be better, we all can be better, in recognizing all the ways in which we have implicit biases.
M Ranney: And I think that AWAEM can also play a big role in advocating for continued research on sex and gender in emergency medicine, and on biases in every form.
M Lin: I’m going to pivot a little bit to your career, but when did you first notice gender inequity to be an issue?
M Ranney: In retrospect, it had been there for a very long time, but it really wasn’t until I was a mom that it became blatantly apparent to me. There certainly had been sexual harassment in med school and residency, some of which I called out, but to me, that was just, I didn’t identify that as a systemic issue. It was really when I was a new mom and couldn’t figure out how to make it all work together that I first felt the unfairness. That my guy friends who had new babies were able to go back to working 50 and 60 hour weeks, and I physically couldn’t.
M Lin: And how has your involvement in AWAEM perhaps translated into greater gender equity in your own workplace?
M Ranney: I’m very lucky. I’m at Brown and our chair for over a decade was Brian Zink, and he came in with a mission of creating better equity. At the point when he came in, we had huge issues in my residency, and in my department in general, around sexual harassment and gender inequity. And Brian, the reason he got hired, was with the goal of facilitating greater equity. I think at that point there were three women, maybe four, now we’re almost 40% women. He put women in many positions of leadership across the organization, and had an awareness of the issue.
M Ranney: And AWAEM was part of what helped push him there. It was also of course the fact that I shared a faculty group with, at that time, Esther Choo was there with me for eight years, I have Tracy Madsen, I had Neha Raukar, I had Jess Smith, I had Laura McPeake, I had all these amazing … Catherine Cummings, Libby Nestor, all of these amazing, strong women who also helped push, but AWAEM gave us a bit of a framework by which to do so.
M Lin: Really important. What career accomplishment are you the most proud of?
M Ranney: Man, that’s really tough. So there are two things. One is I’m super proud I have an R01. I’m like, really proud of that.
M Lin: You should be, that’s huge.
M Ranney: Thank you, now I’ve got to get the second, right? But I’m super proud, I think because especially as a woman, it allows me to do cool science that I think is going to transform care, but it allows me to sit at the table with more senior men and feel confident that I can hold my own.
M Ranney: The other thing that I’m really, really proud of is starting AFFIRM, the American Foundation for Firearm Injury Reduction in Medicine, which is a new 501(c)(3) that is aiming to privately fund firearm injury research. That, to me, I’m incredibly proud of because it has been a chance to overcome partisan divides. My co-founder is a gun owner, and our conversation, I hope, will change the national conversation about what we can do to stop the American epidemic of gun violence.
M Lin: That’s incredible, and definitely things you should be so proud of.
M Ranney: And then of course, my kids and my husband. I’m still married, and I still love my kids, so that’s good, too.
M Lin: Also important. What advice would you give a younger version of yourself, or an AWAEM member at an earlier stage of her career?
M Ranney: Two things. One is, I think, I was actually talking about this at dinner last night, I think you should always say yes, and I do subscribe to Judd Hollander’s view that you need to take things on, because that’s how you develop skills and prove yourself and get known. But I think that probably there are times where I could’ve been a little more focused, and that it would’ve served me better.
M Ranney: I would also say to aim high. To not say, well, I’m not good enough to do X. Say, I want to do X. The younger women, there’s one woman who’s like, I want to be a hospital president. And I look at her and I’m like, you are so cool for labeling that now, when you’re a few years out of residency, because that means you’re going to get there. If you wait until someone says, maybe you should be a hospital president someday, you’re not going to get there. You have to identify that goal yourself, right, so that’s the other thing I wish I’d earlier, was be much more intentional.
M Lin: Please name three other AWAEM members we should interview, perhaps one around your career stage, one who’s more junior, and one who’s more senior.
M Ranney: Okay. So most of the women I would name around my career stage I imagine you’ve already interviewed, or have … so, let’s say … Kinjal. She would be … I know you just interviewed Esther, so Kinjal. Or Basmah, would be my two around my career stage. I also think Liz Samuels. And then, someone more senior, again, I imagine you’ve interviewed Gail D’onofrio.
M Lin: Great, those are wonderful recommendations. Thank you so, so much for your time, Dr. Megan Ranney.
M Ranney: My pleasure, thank you.
Listen to the complete podcast here.