Role Models

Ms Karen Booth

Consultant Cardiac and Transplant Surgeon at Freeman Hospital, Newcastle

What has been your route into Cardiothoracic surgery and what led you to choose your specialty?

I came into cardiothoracic surgery by accident, I was offered a placement in Cardiothoracic surgery as a core surgical trainee for six months and once I started, I couldn’t leave! I didn’t look back from that moment, having never seen the specialty before I was truly hooked.

What is something that you’re passionate about and what keeps you motivated to pursue this?

I am passionate about improving the treatment and access to complex aortic disease for our patients.  I really feel this is a treatment area underserved within our specialty and I love the long-term relationship you can develop with your aortic patients as you treat their whole aorta. It requires collaboration with vascular and interventional radiology, and I most enjoy the multi-disciplinary teamwork required.

What do you love the most about your job?

Serving patients as a team.  There is nothing greater than the whole theatre team coming together, knowing how important an operation is to each and every patient and striving to do their best for them.

What are some of the challenges that you have encountered? How did you overcome them?

Cardiothoracic surgery is an incredibly challenging specialty to both train and practice in. It is a subject not spoken about enough. We experience patient deaths more than any other specialty and yet we are not trained to cope with the anguish this brings or the dysfunction you sometimes train and/or practice in.

It is important to be resilient in this specialty, you need to have a strong and stable home life with a support network who value your career and ambition.  Ultimately in life all careers end and it is our friends and family who cherish us the most.  Enjoy you work, do it to the best of your ability but remember what is important and do not get lost in the hype that is Cardiothoracic Surgery.

Do you have any role models? Why are they role models to you?

I have many role models I have worked with or admired over the years.  My most cherished are my mentors and supporters who continue to keep in touch, keep me grounded and give me healthy discussion when challenges come my way.  You are never alone in this specialty even though you practice independently it is really important to always double check your decisions and be open and honest so that the care you provide is of the highest quality to the patients you serve.

What do you enjoy doing outside of work?

Spending time with my husband and children.  We love to go on holiday together, spend time cooking and exercising and also supporting one another in our hobbies and interests.

What is your favourite quote/mantra in life?

I am in Competition with no one. I have no desire to play the game of being better than anyone. I am simply trying to be better than the person I was yesterday.

What advice would you like to give (female) students/trainees?

Go for it! Don’t accept a life less than your male counterparts who all expect to have a career, family life and hobbies.  Remember to take support, you will need it and in return this support onto others who come behind you.

What can we all be doing to encourage and support women in this field?

Be honest about our experiences, it is okay to talk about them. We can only learn from sharing our experiences and helping one another.

Miss Rashmi Yadav

Consultant Cardiac Surgeon at Royal Brompton Hospital, London

What has been your route into Cardiothoracic surgery and what made you choose your specialty?

I grew up in a small town in India where my mum was an obstetrician. I was struck as a young child by the respect and admiration afforded to my mum in the community and was inspired to follow in her footsteps. I studied Medicine at Christian Medical College in Vellore, South India. I went through medical school wanting to be a physician but fell in love with surgery in my first surgical job as a house officer. I enjoyed working with my hands and found it rewarding to see the immediate impact of my work. I got married after my house jobs and moved to the UK. I passed the PLAB exam and started work as a SHO in Orthopaedic surgery. I was then appointed to the Hammersmith surgical rotation and as part of the rotation came to the Brompton Hospital. As a SHO at the Brompton, I was assisting for subclavian flap aortoplasty for coarctation of the aorta. As the operation unfolded in front of my eyes, I was mesmerised by the beautiful repair and the skill of the surgeon. I found the exacting technical expertise needed to be a cardiac surgeon, exciting and inspiring in equal measure. It also hadn’t escaped my notice that in Cardiothoracic surgery, I was surrounded by registrars, senior registrars and consultants who were highly skilled, very intelligent and high achievers. I wanted to be part of this elite group of surgeons. I also enjoyed being able to manage the haemodynamics of a patient on the Intensive Care Unit and this job took away my fear of the “sick patient”. For all of these reasons, I decided to pursue a career in Cardiothoracic surgery. On completion of my SHO rotation, I did a PhD and at the end of my research period, was appointed as a National Trainee on the North West Thames rotation in London. I was appointed as a locum Consultant in 2011, completed a fellowship in Minimally Invasive Cardiac Surgery at Robert Bosch Krankenhaus in Stuttgart and was appointed as a substantive consultant at the Brompton Hospital in April 2013.

What is something that you’re passionate about and what keeps you motivated to pursue this?

I am very passionate about two quite different aspects of cardiac surgery: the need for a high level of technical expertise and the ability to care for patients. I find my daily work to be a beautiful combination of both of above and love the fact that my job requires me to be skilful with my hands and gentle and caring with my heart. A constant pursuit of technical excellence motivates and also fulfils me. I find it fascinating and humbling that there is so little room for error in cardiac surgery. In the operating room, life can depend on a single decision or one stitch and in this specialty, one needs to be both quick and meticulous. Cardiac surgery has been described as “plastic surgery on the clock” and I couldn’t agree more. I am equally motivated and replenished by the surgeon-patient relationship. The trust and confidence patients have in their surgeon is truly humbling and motivates me to give my very best. It is a gift that my job allows me to be warm and empathetic and make a difference to peoples’ lives. I feel enriched by these human interactions, and find that being a surgeon is a great privilege.

As a cardiac surgeon, I am also always learning and never bored. I am constantly pursuing newer, less invasive ways of treating heart disease and it is really exciting that as an established consultant of 10 years I still have the opportunity to learn new skills – it indeed is a wonderful and rejuvenating job.

The other special aspect of my job is that I work with talented and caring professionals who are all passionate about their work. I also gain much satisfaction from teaching trainee surgeons, particularly talented young women.

What do you enjoy doing outside of work?

I love spending time with my two daughters, who are the light of my life. We go for long walks, cook and bake together, sing, dance, make tiktoks, watch TV (The Crown has been a recent favourite), crochet, knit, stitch, chat, walk a borrowed dog every Sunday and just have an amazing time together. I have always wanted to learn the piano and I am able to devote some time to it, now that my daughters are older. I have also recently discovered “hot yoga” and find it a great way to exercise and relax my mind at the same time. My husband is a foodie and as a family we love to travel and enjoy different cuisines and cultures.

What is your mantra in life?

I believe that genuine, honest and high quality relationships at home and at work, with friends and with colleagues are the key to happiness and fulfilment. I am also a great believer in hard work. When I had my second child, and was facing difficult choices as a mother of young children and a trainee cardiac surgeon, I received the following advice from one of my trainers. He said, “When you need help from someone don’t ask for it. Create an environment through hard work, effort and dedication that makes the other person want to help you”. This wonderful piece of advice became my mantra and has always helped me at the most difficult times of my career.

What advice would you like to give (female) students/trainees?

I would advise students and trainees to be excellent at your work, work as hard as you possibly can and be 100% reliable. Believe in your abilities and know that the rewards will be very worthwhile. Cardiac surgery is a truly fabulous job and those of us who started before you are here to help you along the way and make your journey easier. So go for your dreams! Never underestimate the value you bring to your profession as a woman nor the satisfaction and happiness professional excellence will bring to your life. Create networks at home and at work to support you and your family and find the work-life balance that is right for you.

What can we all be doing to encourage and support women in this field?

WiCTS is a great initiative and support system for women in Cardiothoracic surgery. The first thing for young women is to see what is possible, to realize that they don’t have to sacrifice family to have a career. With the right support and guidance, they can have both if they wish. It is equally important for young women to own all of their strengths including their feminine and softer qualities and know that they can succeed in this field just as they are, without the need to change the core of who they are.

They should be offered management and leadership coaching. I would encourage all trainees to do a strengths profiling and leverage their top strengths to succeed in this challenging but rewarding speciality. As a group of women surgeons, we also need to identify and speak out about conscious and unconscious biases we face. It is known that the conventional leadership qualities of ambition, confidence and authority may be viewed negatively coming from women. The first step to dealing with this dichotomous treatment is to call out these biases and work towards addressing them. It is also important to model different ways of leading, with empathy, kindness and collaboration and know that with time, these can be equally, if not more effective.

Another indispensable tool is networking with other women, and we should enable these networks and mentoring systems. Not all of these need to come from within healthcare. Some of my best advice came from mums at my daughter’s horse-riding class, an incredible group of empowered and capable women, civil servants and lawyers, who shared very insightful perspectives from their respective (maledominated) fields. I learnt some invaluable strategies and they became my informal support network outside work.

Miss Georgia Layton

Specialty Trainee in the East Midlands Deanery   

‘Dress for the job you want’

What has been your route into Cardiothoracic surgery and what made you choose your specialty?

I took a while to decide exactly what I wanted to do with my career. I was interested in cardiac surgery from medical school; the first surgery I ever watched was an open aortic valve replacement. I was hooked from the beginning. However, everyone I knew in surgery was academically gifted and had a large network of surgical colleagues. I didn’t see myself reflected in any of my fellow surgically minded colleagues and so I thought surgery couldn’t be the career for me. After trying many different specialties, I finally found informal mentorship in my FY2 year from an excellent General Surgery supervisor. She demonstrated to me that people like me could be successful in surgery. Within my surgical training, I explored a variety of subspecialties and I had a similar experience in cardiothoracics. My registrars and consultants at the time were lovely people and highly skilled surgeons. To me, cardiothoracic surgery was one of the most inaccessible specialties to ‘someone like me’. However, they showed me that cardiothoracic surgery can be for anyone who is willing to put in the work. I received excellent training and proved to myself that I did, in fact, have an aptitude for this specialty. Once I understood that and believed that I could succeed as a surgeon, I started to build my CV rapidly. The rest is history!

What is something that you’re passionate about and what keeps you motivated to pursue this?

The most important part of my early career was meeting people like me, and those completely different from me, to understand that preconceived ideas we have about surgeons are not true and actually, it is a career for all people from all walks of life. Without my experience of passionate, kind trainers I certainly would not have been brave enough to consider becoming a surgeon. As a result, one of my passions outside of the clinical work is championing diversity and equality in surgery.

As a woman in surgery, it is often considered cliché that we are underestimated or discriminated against in our regular practice. However, my experience is that it is very much a negative bias we face daily, whether conscious or not. I am regularly misnamed as any NHS team member, except for the cardiac surgery registrar. My patients regularly ask me when they will be seeing their doctor; even after half an hours intensive counselling about their upcoming surgery. This repeated misjudgment about my perceived role or ability is something that drives me to continue to succeed. I would not be here without several generations of surgeons, of all genders, who have role modelled non-discriminatory practice and training over the last decades. However, as one of the sub-specialties where females are still grossly under-represented at consultant level, I feel strongly that I should continue to move forward to make it easier for those who choose to follow in future.

Do you have any famous role models? Why are they role models to you?

Absolutely yes – Ruth Bader Ginsburg. The late US Supreme Court judge has been a source of interest and inspiration for me for many years. I have read all there is to know and seen all the documentaries there are to watch about her life, as well as exploring everything I could find on the topic of her landmark cases. For me, she is an icon due to her ‘atypical’ background for a ‘celebrity’; she became a fixture of pop culture at a time when reality TV stars, models and music artists dominated pop culture. Furthermore, despite her history as an objectively excellent lawyer, she was turned down from all New York law firms early in her career. She has therefore demonstrated intellectual resilience and a drive to advocate for what she believed is right, despite huge adversity. Her seemingly unimposing appearance and the generation within which she practiced meant she was frequently underestimated. Despite this, she became a powerful dissenting voice in the supreme court and made a huge positive impact towards equality of women’s’ rights. There is much about her constitution and drive which I hope I can replicate in future.

What do you think are key skills for someone working in cardiothoracic surgery?

I think one of the best skills is remaining calm even in the most stressful situations. Making quick, calm decisions (and communicating them quickly and calmly) is something I have seen be critical to ensuring patients have good outcomes. Early on in training, I realized that many aspects of our day to day in the NHS are out of our control… The time it takes for a scan to be performed, the time it takes for the fluids to be infused etc. Therefore, understand that everything takes a little longer than you hope. Use this time to think over your next steps. Be efficient where you can but don’t stress about the things you have no control over.

What do you enjoy doing outside of work?

Outside of work, I enjoy doing things that take my mind away from work and allow me to be present with my partner and family. Often this will involve nothing more good food with a game of chess or a documentary on the sofa. Sometimes this will involve an extra few hours of sleep after a long on-call. I also enjoy spending time with my dogs outdoors, taking pictures of my dogs outdoors and cycling.

What advice would you like to give (female) students/trainees?

‘Dress for the job you want’ is my most used mantra. My interpretation of this is to do what you want to do and what you think it right, regardless of what other people think. Almost always, we have nothing to lose by simply attempting what we wish to achieve, and everything tends to fall in to place afterwards. This would be my advice to other students/trainees. Do what you want to do, at the time you want to do it. Whether it is the ‘typical’ path or is an atypical route as long as it is what you want to do, and always remember that it is never too late. For cardiothoracic surgery specifically, many people believe that if they do not decide this is their path early on in medical school, it is too late. This is not true. Taking your time will bring you extra experience and the additional confidence that you are making the decision that is right for you. I did not decide for certain until my second year of working that I wanted to be a surgeon; much later than many. However, I understand now that this was the right time for me. I have never regretted taking my time to enter the training programme but I have definitely reaped benefitted from it.

What do you hope to achieve throughout your tenure on the WiCTS committee?

What can we all be doing to encourage and support women in this field? I recognise that due to the low proportion of female cardiothoracic surgeons, we are poorly visible to those in the very early stages of training. Younger, diverse members will soon represent the preponderance of the surgical workforce and representation is key in order to maintain this workforce. I hope that our work within the WiCTS group will model this representation. Being visible is one of the easiest ways I think we can support women in this field. Having women on conference panels, to speak at events, on social media and involved in routine surgical care for patients on a regular basis will slowly make things easier for everyone. For female surgeons, that means putting yourself into positions of leadership such as agreeing to speak at events, sitting on committees that make decisions about our specialties, taking part in the research etc. For everyone else, it means inviting female experts to speak and advocating for equality in your daily work.

Lorna Whitford

Clinical Educator (Nursing) at Royal Victoria Hospital, Belfast 

What has been your route into Cardiothoracic surgery and what made you choose your specialty?

I have along family history of heart disease, with my father having a heart transplant over 35 years ago. I have always been interested in cardiac surgery as I have seen first hand the difference it has made, and continues to make to people’s lives. It is not just about the length of the life, but also about adding quality to that time! My route into cardiac surgery was fairly straightforward – I requested a student place in the specialty and never really left it!

What is something that you’re passionate about and what keeps you motivated to pursue this?

I am passionate about providing high quality evidence based education to new nurses to the area. Nursing in Cardiac Surgery ICU has such a wide remit – from the enhanced recovery patients who move through our service quickly, to those patients who require high level interventions, the nurse must be safe and competent to handle all the patients that come through the doors! What do you enjoy doing outside of work? Outside work, I have 3 young children who keep me pretty busy!

What is your favourite quote/mantra in life?

The Navy Seals have a saying that you don’t rise to the occasion, you sink to the level of your training. That is why we train so hard. I think that for staff working in a fast paced, time critical environment high level training is key.

What advice would you like to give (female) students/trainees?

In nursing there is a predominance of female staff, but many senior positions are taken up by male colleagues. This is an issue that has persisted for years – as females we need to build each up, we need to work together to ensure our voices are heard and our knowledge and expertise shared. When working with the MDT, we need to be cognizant of what it means to promote females in cardiothoracics. This means acting as a role model and not being afraid to make your voice heard. It is only by challenging preconceived notions that we will continue to progress and ensure the specialty is representative and safe for all to work in. This may mean pushing beyond what we normally do and speaking up at times when it is hard, but with the support of colleagues and friends being brave is easier.

What do you hope to achieve throughout your tenure on the WiCTS committee?

I would like to shine a light on the preponderance of senior nursing roles carried out by men, despite a largely female workforce. More flexibility in working patterns and appropriate support for less than whole time working must be considered as many of the workforce take a step back due to caring commitments. This should not be a barrier to promotion and workforce development. I would also like to highlight ways junior surgeons in the service can be supported by nursing staff and how we can challenge the established status quo and perceived notion of the ‘old boy’ network.

What can we all be doing to encourage and support women in this field?

We can all be heard, we can all use our platform to support female colleagues, whether nursing, medical or AHP. We are all part of the same team and all can play our part in ensuring change is openly discussed and that inequity for female staff, be that open or insidious, is not swept under the carpet. We must shine a light on the issues and not be afraid to speak up and support ourselves and each other.

Miss Laura Viola

Senior clinical fellow, James Cook University Hospital 

‘Never give up’               

What has been your route into Cardiothoracic surgery and what led you to choose your specialty?

As far as I can remember I always wanted to be a cardiothoracic surgeon: I started to say it when I was 7 years old, despite none in my family was a doctor or had anything to do with hospitals. None even knew where I picked up the name “cardiothoracic surgery”...but I sticked with it.

I have always been really stubborn and persistent on my goals, but I had the confirmation cardiac surgery was my vocation when I have been for the first time in theatre and I had the chance to attend a heart transplant: when the donor heart started beating again, I didn't have any doubt this was going to be my life.

What is something that you’re passionate about and what keeps you motivated to pursue this?

I am passionate about my job and I believe teaching new generations how to be the best medical professionals they can be is one of the best way to spread that passion. I personally find extremely rewarding seeing juniors learning to perform procedures correctly or learning how to treat patients not only medically but also with respect and empathy.

What do you love the most about your job?

There are many aspects of my job I appreciate; I suppose one of the main reason why I find cardiac surgery fascinating is the chance to deal with an amazing organ. The heart has the ability to let you know what's wrong, even just looking at it; the way it moves, if it's too full, too empty; no other organs can do the same. It amazes me every time.

What are some of the challenges that you have encountered?

Cardiothoracic surgery is a demanding specialty: the amount of hours and commitment requested don't make it easy to find a work-life balance. Especially as women, it can be difficult to balance private life, family, kids with a job that is still considered to be by the majority a 24/7 job.

Do you have any role models? Why are they role models to you?

I don't think I have one specific role model. I respect and admire all the women in history who managed with big sacrifices to achieve small changes and allowed new generations to move forward another step towards gender equality.

What do you enjoy doing outside of work?

I like to keep active, swimming and kickboxing. I love to travel and discover new places. Living abroad from years, I also really appreciate going back home and spend time with family and friends.

What is your favourite quote/mantra in life?

“Never give up”. I strongly believe we always need to pursue our goals, even when it's hard. I personally prefer to try to achieve my goals, giving all I have, rather than to regret giving up too soon and wondering how it could have been.

What advice would you like to give (female) students/trainees?

I would suggest to consider deeply all the aspects of this amazing specialty: once you have done that if you are still convinced this is your path...GO FOR IT! Keep focused on your goals, give always your best and remember that to be a good surgeon and doctor you need to firstly be good to yourself, so try to find a balance between your job and your life and health.

What can we all be doing to encourage and support women in this field?

We need to share the beauty of this profession and try to limit the downsides. It's not a secret cardiothoracic surgery is still a male dominated environment and there are still gender bias. We really need to step into the 21^st century and demolish all the historical reminiscence that a cardiac surgeon is a gruff, grey-hair man.

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