>>WOMEN IN PSYCHIATRY: PERSONAL PERSPECTIVES

This is part of a series of biographies excerpted from the new book Women in Psychiatry: Personal Perspectives published by American Psychiatric Publishing. The book was edited by Donna M. Norris, M.D., Geetha Jayaram, M.D., and Annelle B. Primm, M.D. The book may be ordered here; APA members are eligible for a discount.

My Partly Planned Journey: What Has Worked for Me

by gail e. robinson, m.d.

As a child I wanted to be an actress, but my mother’s unfulfilled desire to be a doctor set me on the path to medicine at age 10, and I’ve never looked back. Today, I’m a full professor of psychiatry and obstetrics and gynecology at the University of Toronto and a leader in hospital and university programs involving women’s mental health.

All of this seems quite ironic to me because, like many women, I did not have a long-range plan with these goals in sight. Nonetheless, I learned things that have been helpful for me in my career and may be useful for other women seeking leadership positions in psychiatry.

Children and the Tenure Clock
I have two daughters, born within five years after residency. Fortunately, the University of Toronto’s Department of Psychiatry does not have a tenure clock, so I was not under the same intense pressure women experience in U.S. universities.

Still, there were pressures. After each girl was born, I took off only one month, and some of that was vacation time. I never even asked for more but was sure that if I did, I would lose all credibility as someone interested in an academic career. (Now, in Canada, women routinely take six to 12 months off after having a baby.)

Despite concerns about academic standing, I began taking two half-days off each week as family time. I have rigidly stuck to this system for many years, and it has worked well.

Find a Mentor
When I had been a clinician and teacher for 10 years, our department got a new psychiatrist-in-chief, and in our first meeting, he asked me if I might be interested in applying for research grants. Previously, no chief had taken any special interest in developing my career. I discovered I had good ideas about research into women’s mental health issues. I applied for and received a grant, and, unexpectedly, began to be seen as an academic.

That psychiatrist-in-chief played a key role in my development as a psychiatrist and leader. Many women look for female mentors to advise them about how to combine a career and family, but this is only one kind of mentorship. Women need to recognize that men can be valuable mentors in career development.

Find a Special Area of Interest
In the early 1980s, after my residency, my colleague Dr. Donna Stewart and I founded the University of Toronto Women’s Mental Health Program. This was the first such program in Canada and one of the first in North America.

Establishing this program wasn’t easy. We had to fight against the impression that we just wanted to talk about the victimization of women, and we had to establish this as a legitimate field of study by obtaining grants and writing papers. To further establish the field, we set up teaching courses so that all residents would receive this information as part of the regular curriculum rather than as an elective.

Acquire Special Skills
It’s not uncommon for women working in a department to be assigned to non-career-enhancing committees such as those that organize social outings. One way of being recognized in the department is to acquire skills normally attributed to men. Many years ago I became chair of the committee that manages the financial business of our psychiatry department’s large partnership. In this role, I receive a great deal of respect and have a voice in decision making.

Become an Advocate
Just after I delivered my first child, a social worker on my team showed me an article in Ms. magazine that described the establishment of a rape crisis center. We decided to establish the first such center in Canada. Through the center, we were able to provide important information and training about rape victims to emergency-room staff, judges, police, and the public.

Not everyone is interested in being an outspoken advocate, yet being involved in a charitable cause or community endeavor can be emotionally rewarding and can establish one as a leader in the community.

Deal With Your Insecurities
Many women struggle with an impostor complex. They constantly feel that they have fooled the world into thinking they are competent and at any moment will be exposed. This makes them hesitate to try to assume leadership positions.

I’ve been fortunate in that I have never hesitated to speak up and voice my opinions. I also learned a very valuable lesson from karate, which I continue to study. In karate terms, the message is that I know I can hurt you, so I do not have to fight with you to prove that I can walk away. In psychological terms, it means that I know who I am and what my strengths are.

Push for Promotion, Insist on Fair Income
In my quest for promotion to full professor, I noticed that the criteria seemed to keep expanding and the goal receding. I decided I needed to take control. I researched the best way to present my information to the promotion committee. Now I advise young women to keep files on teaching, housestaff they have supervised, and all evaluations they have ever received. By assembling a résumé and a teaching dossier that others later used as models, I was easily promoted. Had I not laid the groundwork in this way, this probably wouldn’t have happened until years later.

In my experience, women who learn they are paid less than peers for comparable work may encounter discriminatory arguments justifying this. It’s important to assert our rights and not assume that others are looking out for us. We need to insist on transparency about comparative pay and become better at negotiating up front.

Maintain Sanity
Though it’s challenging and rewarding to try to take on leadership positions, it can also be stressful and draining, especially in psychiatry. It is therefore essential that we find some ways to balance our lives. I have always been very inspired by my family. I spend as much time as I can with my two daughters and my new grandson. I’ve always kept active in things very different from my work, such as community theatre and karate training. There is no one thing that works for every woman, but it is important that there be some time for you in the day; otherwise, you’ll get burned out.

Conclusion
In summary, though my career came as rather a surprise to me, perhaps it can provide some pointers to other women. I’ve always felt comfortable speaking up. I was able to seize opportunities as they came along. I haven’t let my insecurities stop me from taking leadership roles. Sometimes I’ve felt overwhelmed and wondered, as my daughter once asked, why I was willing to “do homework my whole life.” But for the most part, this life has been gratifying, challenging, and exciting.

Gail E. Robinson, M.D., is a professor of psychiatry and of obstetrics and gynecology at the University of Toronto, and director of the Women’s Mental Health Program of the University Health Network, Toronto General Hospital.

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