You’ve had a very distinguished career as an international leader in lung cancer research and clinical trials, which has changed how patients receive care. Can you talk a little about your research and trials?
I’ve been doing clinical trials for over 30 years – large clinical trial research groups, for the most part. It started originally with the lung cancer study group, which was an NCI US funded cooperative that looked at adjuvant trials in lung cancer. We made major contributions to those studies and that really lead to my appointment as the Chair of the National Cancer Institute of Canada Clinical Trials Group, Lung Cancer Site Chair. And that’s really where the major advances were made. In particular, the trial of adjuvant chemotherapy that lead to a change in practice around the world – trials of the first molecularly targeted agent ever to be approved in lung cancer. These were done on my watch as the Chair of the NCIC Lung Site. I did that for 19 years, and I stepped down seven or eight years ago to hand the reigns over to someone else. The NCI was coming under new leadership and it was time for the new leader to appoint his own Chairs for the groups.
I’ve also been at the forefront of new drugs, so I’ve worked with industry a lot to bring new drugs to the bedside for cancer patients. Many of these drug trials were successful, some of them not so successful. Someone once said to me, “Why are all your trials positive?” And I said, “All my trials aren’t positive, you only focus on the positive ones.” We’ve had a greater share of positive trials, for which I’ve been really directly responsible. I’ve changed patient care for end-stage lung cancer patients and I’ve changed patient care in the surgical adjuvant setting, and that’s where the cure rate changed. There was a really definitive trial that we did through the NCIC, and it was a difficult trial. It was one of the first trials ever to have a prospectively collected tumour bank, one of the first trials ever to stratify by an oncogene marker. It was really a landmark trial, but the most important part of it was that it was a positive trial, and it changed the practice. The trial wasn’t just barely positive, it was really positive. It was definitive.
How would you describe your experience as a female leader in academic medicine at the University of Toronto? Would you say that being a woman in medicine has changed the trajectory of your career?
Well it hasn’t changed the trajectory of my career at all. I’ve never really approached my career as being a woman, or not being a woman. When I started in medical school there were 120 in the class, and every year there were 20 girls, no matter how many qualified applicants there were. That, of course, has changed now and more than 50% of the medical school class is women. When I joined the staff at Toronto General Hospital, I was the only married woman with children in the Department of Medicine. There were three other women, not married, no families. Back then there wasn’t maternity leave – I took two weeks holiday and two weeks sick leave with each child. So a lot has changed. There was no doubt about the fact that the women in the Department of Medicine were treated differently from the men. In fact, 20 to 25 years ago because of the differences in equality, a Women’s Issues Committee was developed at TGH. I was on that committee. It really unearthed inequities in salary, in other less tangible support that the women faculty members were getting, and probably some inequity in the promotion processes. Now for me personally, in terms of my promotion and my career path, I trundled along at the same rate as the men. So it had nothing to do with being a woman or not being a woman. My career path and my progression through the academic ranks were based on my productivity and my academic merit, and it had nothing to do with gender. As it should be. The main discrepancy that was unearthed through the Women’s Issues Committee was salary. All of us were being penalized, and there were some actions to address that.
Given that approximately 50% of medical school students are women, but approximately 36% of our DoM faculty members are women, it’s assumed that female physicians are not neccessarily choosing academic medicine. Why did you choose academic medicine?
I guess I’m just academically driven and intellectually driven. I’m not sure that community practice is any easier than academic practice, truth be told. I think some women work part-time. I think it’s almost impossible to be a part-time cancer doctor because cancer isn’t part-time – it’s full-time, 24/7. But within our academic community we have the supports of a whole house staff and fellow support. And when I work, I give one hundred percent to the job. I’m here at 7:00 in the morning and I leave at 6:30 at night. I’m not off having lunch, I’m not having coffee breaks – I’m working that whole time. I’m very disciplined. People say I’m organized, but organization is not organization, it is discipline. I make myself do the things that have to be done, whether I want to do them or not. And I make myself do them on time. I’ve brought that discipline to my entire life. When I’m working here I’m one hundred percent for work, when I’m at home I’m one hundred percent for the family. I see things through to completion; I don’t start something that I can’t finish.
Do you think it’s important to create that balance between male and female clinicians in academic medicine?
No, I think it’s more important to have excellence in academic medicine. If you want an academic career you have to deliver the goods.
What advice would you give to female trainees or junior faculty who want to pursue a career in academic medicine, and would that advice be different than what you would offer their male counter-parts?
My advice would be the same for men and women in medicine. Seek out mentors, of any gender, who can help you. Look at people you admire and try and understand why you admire them and why they have achieved. Emulate those characteristics. And be a finisher. You have to make choices, and you have to focus on what you want to do. You also have to learn to delegate and get the help you need.
