Woman, mother, and scientist: Aiming to fulfill a career in research while maintaining a "good-enough" work-life balance.

Who are you?

My name is Lise Boussemart. I am 34 years old, half French—half Japanese, and the mother of three young children. I am also a dermatologist, specializing in melanoma (see Fig. 1). In addition to my medical degree, I completed a PhD in melanoma research (Boussemart et al., 2014, Boussemart et al., 2016). I am currently an Assistant Professor at Rennes University in France and pursuing an academic career as a clinician-scientist that allows me to live the life I love and participate in exciting discoveries that I hope will positively impact patients’ lives.

Fig. 1

Children with extreme sun-protection on the beach.… Their mother must be a dermatologist.

I am honored to have been selected as the 2016 European fellow in the Fellowship Program for Women in Dermatologic Research, together with American Fellow Dr. Tali Czarnowicki. This is the first year of this Fellowship program, which is strongly endorsed by both the Society for Investigative Dermatology (SID) and the European Society for Dermatological Research (ESDR). Our mission is to highlight the accomplishments of women investigators in our field and encourage young women, despite obstacles, to successfully pursue fulfilling long-term research careers.

What is the current status of women in dermatological research in France?

At the beginning of my dermatology residency, women represented the majority among the residents, but as I climb the ladder in the French medical hierarchy, women in equivalent positions become more and more scarce. Where have my female colleagues gone? They often tell me that one of the most important reasons not to aim for an academic career is the desire to have time for their families. Academic doctors often work at night and on weekends, and travel to scientific conferences for longer periods of time away from home and family. I suspect that equally important is the fact that when an academic position in dermatology opens up, preference is given to male doctors.

Moreover, I noticed that male physicians starting a PhD were often better paid than female physicians, a fact that is highlighted in published data (DesRoches et al., 2010, Ly et al., 2016). Perhaps employers assume, probably unconsciously, women do not need equal pay as their partner may already earn a full “male salary.” Furthermore, female employees tend to accept lower salaries because our society does not encourage women to actively negotiate a higher pay, or they may feel some “gender guilt” regarding past or future pregnancies. I recognize, of course, that such financial issues are not restricted to the medical field. They also exist in the corporate world and vary from country to country.

Having children can be a real burden for women aiming for an academic career in medicine because the years that critically determine one’s career overlap with those most compatible with childbirth and childrearing. Personally, I chose to have one child during my residency and two more during my PhD. During those times, I was still able to publish because I was allowed to work from home at night and during maternity leave, and because of my very supportive husband. Most mothers may be discouraged from pursuing an academic career because employers may indirectly imply that having children is not compatible with such a career or that it is indicative of a lack of strong ambition. Consequently, some women may decide to postpone childbirth or forgo having children at all and when they become employers themselves, they may ask female students or employees to make the same sacrifice. I believe this is one of the reasons why female employers do not necessarily understand women better than men do.

What kind of concrete steps can be taken by organizations to promote gender equality in clinical and laboratory based medical research careers?

I dream of a day when people will be surprised that the above mentioned issues were an issue at all. Currently, however, the reality is that gender inequality still exists. At a national level, institutions should aim to allow junior academic staff to develop their full potential, irrespective of gender. To this end, barriers to career progression should be removed, especially for female scientists, by establishing specific supportive policies and working practices. In addition, on a more general basis, targeted assistance should be available particularly to early career researchers, as well as efficient training, mentoring, and coaching throughout all stages of an academic career. Such policies should not only be developed and put into action locally but also through regional networks to help universities develop such policies and share experiences. Moreover, action plans should be recognized by specific awards, as is the case in the United Kingdom where the Athena SWAN Charter established in 2005 encourages and recognizes institutions for their commitment to advancing the careers of women in higher education and research (Athena SWAN Charter, 2016).

Here are a few concrete steps I believe should be taken:

Importantly, imbalances between male and female pay scales need to be corrected so that merit prevails over gender. The imbalances have to be corrected by institutions, not only during the hiring process but also regularly throughout the career path.

To present data to the research community and perhaps the general public, researchers must develop communication and public speaking skills. On occasion, women may be at a disadvantage in this respect compared to their male colleagues as they may be too shy to ask to speak in meetings or even dare to organize a meeting themselves. Institutions should be encouraged to offer appropriate training to achieve this goal.

Research and clinical facilities should create on-site daycare centers with sufficient coverage to minimize traveling and provide sufficient flexibility for mothers.

At the laboratory level, meeting times should be adjusted to family needs and not systematically be held at dinner time, for example, which may be great for networking but often shuts out mothers. Guidelines for promotions should take into account working hours and maternity-related leaves and the possibility of stop-the-clock arrangements.

Institutions should investigate and acknowledge unconscious biases in professional discrimination. Many believe we are more impartial than our historic predecessors, whether it be in matters of race, gender, or ethnic equality. Recent scientific discoveries by Harvard Psychology Professor Mahzarin Banaji, however, suggest that we are not. You can test your own implicit biases through Project Implicit, which Professor Banaji collaborated on (Project Implicit, 2011). Women are not free of gender implicit biases and awareness is the first step towards combating these biases. The second step is to actively help other women, such as Professor Barbara Gilchrest is doing right now for Tali and me. Consciously aim for gender parity in your laboratory, your organization, your international board, and do not forget to nominate women for awards.

Financial support within grants should be sufficient to support a family, to help parents manage their households including childcare so that they may spend more time on science.

What kind of concrete steps can be taken by individuals to promote gender equality in clinical and laboratory-based medical research careers?

On this topic, I learned a lot at the Women’s Dermatologic Society (WDS) Networking Luncheon that took place during the SID Annual Meeting. I had never attended such a networking luncheon before, and I thank the SID and WDS for offering me the experience.

Let me share with you some tips to remember:

Set goals for yourself. Whenever possible, decline extra-work duties that do not serve your goals, and ask for duties that will further your career.

If you enjoy both research and clinics like I do, focus on one specific disease. This will enable you to spend time on research and at the same become or stay a highly skilled clinician. Adhering to this advice, I personally focused on skin cancer.

Dare to ask for the responsibilities you seek and ask proactively. In the real world, no Prince Charming will present to you on a platter what you think you deserve. Stand up for yourself!

Take the time to proactively study the current salary landscape of your male counterparts and objectively ask for an equivalent pay scale. This may be more or less necessary depending on the country you currently live in, but this will serve both yourself and younger women.

Some obstacles are more difficult to overcome than others, but do not get discouraged when you lose out on occasion. You still learn from failures and will be all the more prepared for future challenges.

Expose yourself. Do not apologize for being a successful woman with an academic career. You will serve as a role model for younger women in need of inspiration and encouragement. Public exposure may also serve as an excellent career booster (this, I do not know yet but hopefully can tell you in a few years).

Do not give up your academic career within the first 3 years following the birth of your youngest child. The first years on tenure track are exhausting. They represent a critical period when women’s careers are at their most vulnerable, but remember that your children will get older and may later appreciate a mother who followed her passion and ambitions. If you suffer from a chronic lack of sleep (like I do), sleep when you are away from home to attend conferences (although preferably at night and not during the presentations!).

Try to keep some flexibility in your schedule for occasional spontaneity at home. This may be the best marker of a “good-enough” work—life balance, like the “good-enough mother” as described by Donald Winnicott in 1953 (Heard 1978) in contrast to the illusion of the “perfect mother.” As the saying goes, perfect is the enemy of good.

Delegate what and when you can at home (e.g., housekeeping, laundry, cooking).

Whenever you reach the success you deserve, do not feel like you must hide your children like a terrible secret for the sake of professionalism. I did sometimes, but I regret it. The more women show they can have a brilliant career and a happy family, the more young women will believe it is doable and the unconscious biases will become weaker. For that, I admire Dr. Maryam Asgari, who presented a brilliant state-of-the-art plenary lecture at the SID on the use of big data to answer clinically relevant questions in dermatology, and also acknowledged her children and husband at the end of her talk. When I talked with her after the lecture, she told me she is a dermatoepidemiologist and a mother, and never forgets both sides of her identity.

Choose the right partner who really loves the champion you are.

Finally, to build a better future, let your daughter know that you have as high ambitions for her as you do for her brother. Make sure her brother knows it too, and enjoy rewriting with them the fairy tale of Sleeping Beauty.

Conclusion

In summary, I wish for our societies and those in positions of responsibility to serve as role models and act proactively with regard to gender equality in academic research in general, so that merit and not gender ultimately becomes the defining factor for hiring and promoting in science.