Women in Medicine: Cultivating a Healthy Disrespect for the Impossible

Carrie Byington, M.D. has been said to have a healthy disrespect for the impossible.

It’s what drove her to pursue academic medicine with little outside guidance or encouragement. And it’s what she instills in students and the junior faculty she mentors today. “What drives me is potential, and what frustrates me more than anything is wasted potential,” says the accomplished pediatrician, researcher and associate vice president for faculty and academic affairs at University of Utah Health Sciences.

In recognition for her commitment to inclusion and diversity—specifically, mentoring programs she developed to grow the nation’s physician-scientist pipeline—Byington was awarded the Association of American Medical Colleges’ 2015 “Women in Medicine and Science Leadership” award.

Reflecting on the honor, we asked her to share a bit about her own career path and the obstacles she overcame as a Mexican-American woman growing up in south Texas with no physician role models. “It’s not about success. There are successes and those are great. There are failures and those are hard,” she confides. “It’s about how you spend your time. In the amount of time you have here, how are you going spend it, how are you going to make a difference?”

On choosing medicine

I think I always knew I wanted to be a doctor. I started saying it when I was four years old. I didn’t have experience with it. No one in my family is a doctor and no one had ever gone to medical school. In fact, it was a very scary aspiration for my family, for many reasons. I just knew it’s what I wanted to do.

On becoming a pediatrician

I didn’t realize that I wanted to be a pediatrician until much later in the process, though I will tell you that when I went and interviewed at medical school, almost everyone told me, “You’ll be a wonderful pediatrician.” I did not take that as a compliment at the time. I interpreted that as being, “You’re a small woman, therefore, you’re best suited to take care of infants and children and that’s all you’re suited for.”

But now, with maturity, I recognize that people have characteristics and traits that do make them better suited for one thing or another, and one of the best things that can happen is when your skills are well aligned with the work that you need to do. Then it’s no longer work. Then it is just joy. 

On the joys of working with children

I went into medicine because I wanted to help people and hopefully make the world a better place. And what I found was the place where you could make the most difference was in the life of a child. If you could prevent a serious infection, if you could prevent a serious disability, you change their life for the next 80 years.

Children have such a vibrancy. Everything is new for them. Everything is exciting for them. And so it gives you the opportunity to still see the world through a child’s eyes and to see how special things are and how great things can be. It’s wonderful. I’ve heard people say they can’t even walk into the children’s hospital, that “it’s too hard. It’s too depressing.”  To me it’s a wonderful place filled with hope and I love being there.

On overcoming barriers

I have always felt like an outsider in this profession, and probably always will. I didn’t have any physician role models, male or female. I grew up in a very strong and supportive household and they were very concerned for me as I began the endeavor to become a physician, and I would say they did everything they possibly could do to dissuade me from that path, not because they didn’t believe in me, but because they wanted to spare me from hurt. When it became clear, especially with my father, that I was likely to get into medical school and when I did get into medical school, he wept and became my biggest supporter.

Going to medical school was extremely intimidating to me. I did not have the social and cultural experiences as some of those in my class. I felt very intimidated by things like these individuals had been to operas, they could speak French, they had traveled. I did not have those experiences.

When I was young, I thought that was a deficit, and now that I’m older I realize I had many experiences that they did not have, growing up in a culture that was different. And I think that those experiences have informed how I practice medicine and the specialty I chose.

On teaching and mentoring

I see potential in these young clinicians and investigators who are so bright, so enthusiastic, and who have so much to contribute. If I can help them to be successful, they’re going to be out there for many years longer than I can be out there. They’re going to train more people, and what we can do through our respective fields to advance health is going to grow and continue to improve.

As an individual clinician I can only do so much. As an individual investigator I can only do so much. But when I am able to work with young people to help them be successful, it just magnifies what one person can do. It’s really exciting. Potential, I guess is the most exciting thing that I see.  

On the importance of diversity and inclusion

Inclusion is vital and I would say it’s vital for one reason, because we get the best ideas when we are inclusive. Our patients are not all the same and it’s really important to be able to have physicians that reflect that diversity so that we better serve our communities.

What keeps me up at night is the worry that as a country we are at a tipping point with a decline in physician-scientists. And an untapped solution is to broaden the pipeline by recruiting the talent of underrepresented minorities and women. Young physician-scientists can do any number of things and do them very well. They can go into clinical practice and be paid two or three times more than they’re being paid in the academic setting. We need to still show them that academic medicine is a viable career by investing in them. 

Words of wisdom for tomorrow’s health leaders

I believe lots of things are possible, because I’m a living example of what’s possible. One of my colleagues told me that it is my healthy disrespect for the impossible that helps me get things done. That’s one of the things that I try to share with my trainees, that it doesn’t matter where you come from, or how your road has been. Every one of those experiences is valuable to getting you where you are today and it informs where you want to go. And we have to find ways for you to be able to contribute that experience because it helps us all.

• Associate Vice President for Faculty and Academic Affairs & H.A. and Edna Benning Presidential Professor of Pediatrics.
• Authored more than 160 original publications.
• Implemented evidenced-based care process model for treating infants with fevers that improved infant outcomes and saved $1.9 million at four Utah hospitals.
• Co-inventor of the FilmArray (BioFire Diagnostics, Salt Lake City, UT) diagnostic tool for viral and bacterial pathogens.
• Implemented policies to improve the climate for women, including the option for part-time status while on the tenure track and paid parental leave.
• Modernized the University of Utah’s retention, promotion and tenure guidelines to recognize excellence in clinical practice advancement, education, entrepreneurship and team science.
• Through her Matrix Model for Mentoring, has mentored more than 100 trainees and junior faculty members. This model for new investigators has increased the participation of women and minorities in the research enterprise and resulted in extramural funding rates of 92 percent.

By: Kirsten Stewart

Kirsten Stewart is a senior writer for University of Utah Health Sciences