Michelle Lin, MD, MPH, MS Today, we feature with Dr. Tracy Madsen, the President-Elect of AWAEM in 2019-2020 and an Assistant Professor at Brown. We speak about how she herself as a medical student didn’t perceive the need for women-focused professional organizations, and how advancing in her career has demonstrated the critical need for organizations like AWAEM.
M Lin: Dr. Madsen, tell me about where you are currently in your career.
T Madsen: Hi. Thanks for having me. This is really exciting. I’m an Assistant Professor of Emergency Medicine at Brown University in Providence. I’ve been there since residency and did my training and my fellowship there, and I’m now faculty there.
M Lin: Tell me about how you spend your time at work?
T Madsen: Sure. I’m really enjoying my current kind of balance of roles and responsibilities. I have my clinical work, which I love. I’m at Brown in Providence, Rhode Island. But then I also do a lot of research, which I love, as well. I’m doing mostly sex- and gender-focused research. I’m part of the Division of Sex and Gender in the Department of Emergency Medicine at Brown. My particular research focus is on stroke with a little gender disparity work kind of fit in on the side. But most of what I’m doing is sex and gender differences in stroke, so we’re looking at differences in treatment in the emergency department. That’s really where it all started, because I work in the emergency department. That was the natural beginning, but now have really expanded to thinking about prevention. How can we take sex-specific approaches to stroke prevention? How can we take sex-specific approaches to improving stroke outcomes? It really goes kind of the whole gamut from prevention to outcomes. That’s what I’m working on right now.
M Lin: Great. How was it that you got to where you are right now?
T Madsen: That’s a huge question. I’m trying to think. There have been so many influences to get me kind of where I am. I would say mostly mentorship, and colleagues, and really just following the things that I’m passionate about, which is mostly sex and gender, and looking at things through a gender lens, which includes thinking about women in the workforce and women in academic emergency medicine.
M Lin: How did you first cultivate that interest?
T Madsen: It started a long time ago, probably all the way back to college. We don’t have time to go all the way back that far, but I’ve always been very interested in women, and caring for women, and how I can help improve the health of women. That really drove me to go into medicine to begin with, but I always thought I think I would end up in a field that was traditionally women’s health, so thinking about OB/GYN, and thinking about domestic violence, and all of those traditionally women’s health issues, but really just fell in love with emergency medicine. Then from there, figured out how I could incorporate my interest in sex and gender in women’s health within emergency medicine.
M Lin: That’s terrific. What motivated your initial involvement with AWAEM?
T Madsen: I would have to say mentors, again. My mentors have been wonderful and really pulled me into a leadership position, even before I knew that I was ready. I had mentors like Esther Choo, and Alyson McGregor, and Basmah Safdar, all of these leaders in AWAEM that kind of tagged me and said, “You should do the Didactics Committee for AWAEM. These are great ideas. You’ll get to work with senior people in emergency medicine and network.” That’s how it started. As a fellow, I joined AWAEM, and then started as the committee chair for Didactics, and started planning didactics for SAEM, and just had a great time thinking about didactics that would help other women advance in emergency medicine, and then, like I said, meeting people in the field.
M Lin: Tell me about some of the other projects that AWAEM has gotten you involved in?
T Madsen: Sure. One of the other committees that I have loved being involved with in AWAEM is the Research Committee. The Research Committee does great work, puts out a ton of papers, and really about very interesting and relevant topics. One of the papers that we put out when I was head of the Research Committee was a paper looking at gender disparities in salary in academic emergency medicine. That was another kind of pivotal point for my career that I think really got me engaged and thinking about how we can help women advance in emergency medicine, and that we can put information out there, we can start thinking about solutions and strategies, and that was really all through the AWAEM Research Committee, the opportunity to use the data, to write the paper, and to network with colleagues who wanted to think about the same issues.
M Lin: Now you’re President-Elect. Congratulations.
T Madsen: Oh, thank you. I’m excited.
M Lin: What prompted you to pursue that role?
T Madsen: Again, and this a theme through my career, is that mentorship with people, senior people, coming and saying, “You’re ready. Let’s do this,” knowing that this is my area of interest, and that it fits very well within my career trajectory. I love working with AWAEM in general, but having mentors say, “Tracy, I think you’re ready. Let’s do this.” That’s really how it happened. Something I’ve been thinking about for a few years and looking up to role models and past presidents, and thinking, “I would love to do that someday, but when will it be kind of my time? When will I be ready to do that,” and really having mentors kind of push me in that direction.
M Lin: That’s great, really important. Tell me about your vision for your upcoming term.
T Madsen: Sure. Really excited to learn the ropes and to learn from the incoming president, Dr. Agrawal, about the leadership of the Academy. My vision, really, is move forward from thinking about all of the disparities in medicine, in academic emergency medicine, that women face, and all the challenges and thinking about how we form solutions, because we’re seeing study after study that’s showing gender disparities in salary, advancement, ability to choose the tract that you want to go on. It’s issue after issue, but really thinking about how we can fix these solutions. I think that we’re ready for that. I think the field is really becoming more and more aware of the disparities and more accepting that these disparities are real and that they can’t be explained away, so now it’s time to fix them. I think that’s my vision for AWAEM, to really be the leading organization in emergency medicine that’s strategizing, and finding solutions to these disparities, and encouraging women to go into emergency medicine and know that they’re going to have… or hope that they have… more equality in coming years.
M Lin: Great. Can you describe any maybe current or future AWAEM initiatives that you think are going to support these goals?
T Madsen: That’s a great question. I think one is collaboration with other academies. Again, really finding strategies to disparities in emergency medicine. Part of that is based on getting other people engaged. We can’t do this alone. We have to have our male colleagues, and our female colleagues, and really everyone on the same page and understand that these disparities exist, and everyone at the point that we want to fix it. I think one of the things is collaborating with other groups and other academies and showing people that this really does affect everyone, not just AWAEM, and not just women in medicine, and that we need to work together to find solutions, whether it’s salary transparency, bringing this to light, talking about this in open forums, coming up with the white papers. Those are all things that we’re working on currently, I would say.
M Lin: Great. How do you anticipate the professional needs of women in academic emergency medicine will change in the next 10 years?
T Madsen: I think we’re going to just keep asking for closer, and closer, and closer to equality. I think for a long time women in medicine and women in a lot of professions have settled for less than equality, and settled for, “Well, I’m a woman. We’re going to have disparities. It is what it is,” and kind of accepting that. But I think, as I’m seeing trainees, or as I’m seeing my residents train, and faculty more junior to myself, just getting really frustrated with these issues, I think people will not accept it any more. I think the women that are coming up in the ranks are going to be expecting equal salaries, equal advancement, support for maternity leave, et cetera. They’re really going to expect equality in all aspects.
M Lin: With that lens, how do you think that leadership roles in women-focused professional organizations are considered for the purposes of academic advancement?
T Madsen: That’s also a great question. I think, for me, involvement in women-focused organizations, like AWAEM, AMWA, other organizations that I’m involved in that have really a gender focus have been critical to my career in providing the support that I need. As I mentioned throughout the interview, kind of the mentorship and those senior leaders in emergency medicine identifying younger women, saying, “You’re ready. You’re ready for this leadership position,” and really putting you into roles that maybe you wouldn’t put yourself into. Naturally, those leadership roles, papers, publications, that people kind of nominate you to do, all go toward promotion, and go toward career advancement.
M Lin: I’m going to transition a little bit more to questions about your career in a broader sense. How do you feel like gender has affected your own career development? I know it has always been an interest of yours, but has it impacted your career growth in any way?
T Madsen: That’s a great question. I’m not sure. I mean, I think when you look at your own career and kind of reflect, the natural thing is to think like, “Oh, I haven’t experienced any issues or any disparities.” But I think being a woman in emergency medicine, like all of my colleagues… or many of my colleagues… I know have experienced being called something other than, doctor, whether it’s nurse, or not being called, doctor, being called by their first name, where your male colleagues are being called Dr. So-and-so without any thought can be frustrating and difficult when you’ve worked so many years to get to where you are. But I think being part of organizations like AWAEM and the other organizations that I’m in, speaking with mentors and colleagues about this really just turns those frustrations into inspiration, and really makes you want to do something about these issues, and talk about it, and write about it, and change things.
M Lin: How do you feel like involvement in AWAEM has translated into greater gender equity in your own work environment?
T Madsen: As I was mentioning, when I was on the Research Committee, was the head of the Research Committee for AWAEM, and we decided that we were going to write a status update paper on the salary disparities in medicine issue. That really transpired into a lot of changes, even in my own department, and I’m hoping in other departments, as well. But it really brought to light that, yes, there is still a salary disparity in emergency medicine, even after adjusting for all of these factors that people typically used to kind of explain away any disparity, so maybe women work less clinical hours, maybe they’re taking longer leaves, maybe they are not as productive, et cetera, et cetera, which, really, it’s not true. There is a disparity despite all of these other confounding issues.
T Madsen: After we put out that paper, I think it really got people talking. Even in my own department about, one, is there disparity in our department? Do we need to look into this? What can we do to make things better? What can we do to make sure that we are doing regular audits of salaries? We’ve had multiple task forces and committees, even within my own department at Brown, looking into potential issues and making sure that things are as equal as possible. Really, just opening the conversation has been the first step, I think, in our own department. I’m asking our leadership to meet with us and talk about issues that we’re concerned about as women. It’s gone really well, I think.
M Lin: What career accomplishment would you say that you’re most proud of?
T Madsen: One of the things that I’m very proud of is becoming president-elect of AWAEM. It’s an organization that I’ve really valued for many years and has done amazing things for my career. To think that I could kind of pay back, and give back, and serve the organization as a president in a couple of years is really exciting for me, because there are so many amazing women that are part of the organization. I think our last count was over 500 people that are on our site. I think that I would be a leader of all of these amazing women is really just humbling for me. I’m very excited.
M Lin: Great. What piece of advice would you give a younger version of yourself or an AWAEM member at an earlier stage of her career?
T Madsen: I think the advice that I am still giving myself, so I would give to the younger version of myself, as well, is to put yourself out there, push a little bit, do things that you think you’re not quite ready for, because you’re probably ready for them. You have the skills. You have the knowledge. If you don’t have every little piece, you can learn on the job. I think that’s one thing that I know that I do, and I think other women probably do, as well, is kind of hold back in taking that next step in their career until they feel they’re 100% ready. But to really put yourself a little bit early, before you think you’re totally ready, because you’re probably ready.
M Lin: Anything else I haven’t asked you about AWAEM or about yourself that you’d like to share?
T Madsen: When I think about women-focused organizations, and this is actually something I’ve thought about for several years, for even through medical school, I was very involved in gender-focused and women-focused organizations like AMWA. I think there are a lot of trainees and junior people in medicine that feel like we’re in 2020, we don’t need this. Everything is fine. I don’t need to be part of women-focused organizations. But, really, it’s critical. I think as trainees go through the process, they realize that there are issues with disparity in medicine and that forming networks and bonds with your women colleagues, and really learning more about these disparities and how we can fix them is critical. That’s been something for my career that I’ve really cherished over the years.
M Lin: Great. All right. Then, okay, last question. Please name three other AWAEM members you think we should interview, maybe one around your career stage, one slightly more junior, one more senior.
T Madsen: I would say the one that’s slightly junior to me that is amazing, and I am amazed the more I get to know her, Taneisha Wilson. I don’t remember if I recommended her last time, but she’s at Brown. She was a junior resident to me when I was in residency, and just to see kind of her career trajectory has been great. She’s working at Brown still and working on diversity and inclusion in emergency medicine. I think she’s just amazing and really an up-and-coming star in emergency medicine. That’s the junior.
T Madsen: Then you said one around the same stage and one more senior. I don’t recall if you’ve interviewed… have you interviewed Libby Nestor or Catherine Cummings? They’re both amazing. They’ve been my kind of women in emergency medicine role models since I started in emergency medicine. I can remember starting as an intern at Brown and having these strong female role models clinically that were just like amazing clinicians and were some of the first women in our group at Brown when there were very few women in our group in emergency medicine. Just seeing them and learning from them about clinical care in the E.D. has been spectacular. They’re also great mentors. They’re sponsors. They’re amazing. I don’t know what I’ll do when they leave, or if they leave, Brown. I would say those two for more senior people.
T Madsen: Then around the same career stage, Naz Karim, who is great. She’s part of the leadership of GEMA this year. She’s great. She’s doing lots of international work. Again, kind of up-and-coming in leadership in emergency medicine. She would be a great interviewee.
M Lin: Perfect. Well, thank you so much, Dr. Madsen.
T Madsen: Thank you.
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