“The more I age, the more I advance. The more I advance, the more I realize how living my life in the constraints of other’s opinions or wants or desires for me is not an option. This leads me to be lonely at times and on an uncharted path. It is great. It is exciting, freeing, fun, and quiet on this path. It is also terribly arduous. I have to cut down the branches myself. I have to clear the path step by step and navigate through weeds and tall grass. I have scratches. I am thirsty. I am tired. I want to stop. I want to turn back and get off the road less traveled.” 

Sasha Shillcutt, MD was midway through her budding career as a cardiac anesthesiologist when she shared these words about burnout online for other physicians to read in August 2018. She had already published research in more than 40 peer-reviewed articles in respected scientific journals such as JAMA and NEJM by then. Now in academic medicine as a professor of anesthesiology at the University of Nebraska Medical Center, she actively works for several national organizations, committees, and medical boards, and presents as a TedX and national speaker at medical conferences on the subject of burnout specific to women in medicine (WIM). In her personal life, Shillcutt is married to a physical therapist and has three sons and one daughter. 

Despite the aforementioned impassioned, optimistic op-ed that championed perseverance — with pleas such as “we must not grow weary” — Shillcutt herself was unconvinced she could lead others while experiencing disconnection. It took her a while to find her own voice and style of leadership, growing from rejection and self-criticism. She imagined there must be other women physicians besides her who are experiencing burnout and social isolation.

What helped, she said in an interview with Doximity, was learning that such workplace transgressions are not uncommon among practicing physicians. It is commonplace among modern women physicians who are expected to “have it all together” — balancing the roles of clinician, academic, researcher, mother, wife, etc. Women physicians at the top of their field often experience loneliness as well as a fear of authenticity that can become debilitating. Giving up is not an option for such a high-achieving group, Shillcutt says, that is continuously growing in numbers while lacking representative leadership.

To help connect with other women physicians willing to share their personal interests outside of medicine, Shillcutt started a networking group on Facebook in 2015 called StyleMD. She would openly share posts about how women physicians can be both feminine and formidable on StyleMD. The group quickly grew from 30 members to nearly 10,000 women physicians worldwide. The goal was to empower WIM by creating a community that embraced being a leader as a woman. It eventually inspired her to launch another organization called Brave Enough in 2017, which to-date has united more than 10,000 women physicians looking to find resilience through self-care, community-building, and career advancement.   

According to Shillcutt, her biggest purpose is to empower other women physicians and physicians-to-be, having already coached hundreds of WIM through Brave Enough programs on how to deal with career burnout and personal challenges and become leaders. For many years, she has called for more diverse leadership in medicine, diligently working to increase opportunities for pay, promotion, and leadership for women physicians. Earlier this year, for instance, she addressed the gender gap issue within anesthesiology at the Society of Cardiac Anesthesiology annual meeting, where she revealed a newly dedicated interest group within the organization that promotes women physicians as leaders.

What is the best way to get more WIM to become leaders? Doximity caught up with Shillcutt to discuss an overlooked solution capable of breaking the glass ceiling: sponsorship.

Doximity: How does sponsorship compare with mentorship? 

Sasha Shillcutt, MD: Women tend to be over-mentored and under-sponsored. Sponsorship is when someone offers you opportunities that directly affect your promotion in your career. It’s unique because it actually results in you leveling up. It’s important because it means your sponsor typically has skin in the game, so it’s going to reflect on them in a positive manner if you excel. They sponsor in that way is biased: if you do well, they are going to look good. They want you to excel. 

Dox: Who makes a good sponsor? What qualifies and disqualifies them from becoming a sponsor or being sponsored? 

Shillcutt: A good sponsor is someone who is well-connected in your area of expertise. They are doing something that you want to try, so their connections allow them to be privy to opportunities that come up behind closed doors. They’re someone who’s at the table, either making decisions or hearing about opportunities that they would be able to nominate you for. If you have a sponsor that’s at the table, they can suggest to promote you or educate you on opportunities that you otherwise might now know about.

Dox: What is the best way for a woman physician approach another physician and ask to be sponsored?

Shillcutt: You have to ask. You can’t wait — I think that’s a common misconception among women and men. Men will typically ask, just like they’ll ask for raises and promotions, they’ll ask for sponsorship, saying “I want to do that, can you help me do that?”

Women won’t ask as much—it’s multi-faceted why and may be several reasons. First, a lot of time, women are told they’re not ready for something. That creates a negative feedback loop where they then feel they’re lacking something and will be less likely to ask for it in the future, like sponsorship. A lot of times, women don’t even have a network to access a sponsor.

There are a lot of reasons why women physicians don’t ask, so it’s a bit of an upfront barrier, figuring out how to get women to do sponsorship. Women have to be bold in asking for what they want.

Dox: Who makes a great sponsor for women in medicine? 

Shillcutt: I think anyone can be a sponsor. If you are involved in something, either at a committee or organization, you can be a sponsor. Another way to be involved as a sponsor is through assessing your role and realizing that you want to “pass the baton” to younger women physicians.  

Men can be sponsors to women too — it’s important that they do since they’re already the dominant leaders. 

Dox: What does it mean to be a leader? How is leadership being defined in medicine?

Shillcutt: I think that sometimes, we realize that we can all be leaders. We need to remember that we all, in some way, have some type of leadership skills in a specific area. Specifically, in the first five years of practice, most are assuming some type of [leadership] role. It doesn’t have to necessarily be to a C-level role; it can be sponsorship for a seat at the table. 

Dox: Can you tell me about a time (personal or not) when sponsorship has successfully led to leadership?

Shillcutt: In my first year of practice as a cardiovascular anesthesiologist, I submitted a very short presentation to the annual meeting. It was accepted and I was able to present six slides. Doing that allowed me to see my peers and meet a lot of leaders within the organization. 

Then, I actively [approached] some of the leaders and asked them if they would basically sponsor me. I don’t think those exact words existed at the time for what I was doing, but I knew I needed national sponsors. I asked a few different sponsors, from other institutions, to put my name into the hat. After I showed up, did those tasks, doing that for several committees, I was able to finally pay it forward and sponsor others. 

It’s important for WIM to show that we are brave enough. Even if we don’t necessarily feel like experts who can ask, we have to be brave and ask for sponsorship.   

Dox: What’s an ideal time for WIM to seek sponsorship? Is there an ideal window of opportunity for when to ask?

Shillcutt: As early as possible; I don’t think they should wait. Seek sponsorship at every level in your career.

Dox: If a medical student, for example, wanted to seek sponsorship, what is the best advice you would give them?

Shillcutt: It’s OK to have more than one mentor. Be very clear with your mentor with what you want from that relationship; you’ll get more engagement from them if you do.    

Dox: Are there any barriers to be aware of around sponsorship in medicine?

Shillcutt: To make sponsorship work, we need buy-in from male physicians. We need more male allies to sponsor women they identify as leaders since they themselves are in leadership positions.  

“Men out there, we need you.” In session on #bullying #discrimination #harassment #sexualharassment , 13/75 attendees are male. #HeForShe #ACGME2019 pic.twitter.com/r60j2klbIY

— ACGME (@acgme) March 9, 2019

Dox: Sponsorship seems to be more commonplace and successful among male physicians. Why?

Shillcutt: It’s one of the barriers to gender equity; men tend to sponsor other men. People usually sponsor their friends and colleagues, so men usually sponsor other men. The majority of our leaders are men, thus we need their support to also be invited to the table.

Dox: What plans does Brave Enough have in store related to sponsorship?

Shillcutt: There’s a lot of things! We’re working on connecting more sponsorship opportunities to women in medicine. We have a database where they can go look for other women who speak on specific topics and approach them. 

We actually already have it going on in our private Facebook group—it’s really awesome and we’re thinking of releasing it publicly later on. We also will have a mentoring and sponsoring session at The Brave Enough Women’s CME conference this year which is going to be targeted to metrics that we measured pre-conference, so we can specifically mentor and sponsor women in ways most helpful to them.

[Brave Enough] is trying to promote each other by really amplifying each other’s work. I’ll try to highlight meaningful work that other women are doing. We know that women aren’t always the best at branding their accomplishments; many see it as “bragging” instead of “branding” sometimes. One of the ways Brave Enough is directly mentoring women is through our online classes called the Brave Enough Master Class, where we do a 12-week online intensive on self-reflection, confidence, and professional growth. 

This interview was conducted by Sri Ravipati, assistant editor at Op-Med.

Illustration by April Brust