Dr Fiona Pavan is a Fellow of Endocrine Surgery in Melbourne. Fiona exudes kindness and enthusiasm in all that she does. She works in a way that flattens the traditionally vertical hierarchy that exists in medicine, regularly staying back to order routine bloods and imaging to help the interns and residents get home on time. Here, she shares some reflections from her journey through training in the highly specialised and typically male dominated field of surgery.
If I was told 10 years ago that I would be where I am today, I wouldn’t have believed them. My path to surgery was somewhat atypical. Throughout medical school I had wonderful surgical mentors at Monash Health but always thought I was destined for physicians training. I enjoyed physiology more than anatomy, I was terrible at getting up early for surgical rounds, and I loved having a good chat to patients and using my stethoscope. I thought I had it all figured out, until I became an intern and the orthopaedic rotation I was dreading became one of my favourite rotations. I enjoyed looking after patients perioperatively, so much so that I was convinced I would become a perioperative physician.
I quickly realised that I enjoyed the operating theatre a bit too much for an aspiring physician and that perhaps I was a future surgeon. “How daunting!” I recall thinking. I worried that I wouldn’t have time to do anything outside of work, that I wouldn’t fit in, and that surgery would be a boys’ club, as I hadn’t met many female surgeons at the time. As a surgical registrar, I worked with many wonderful surgeons in different departments at Monash Health who encouraged me from the very beginning. I never felt like I had to fit a surgical mould or become the typical ‘surgical personality’ that we’d always been warned about in medical school. I often chose fashion over rounding in scrubs and embraced the high heels. The only people really bothered by it were the patients before 7am as I ‘clicked’ onto the wards waking them up (tip toeing in heels is something I do very well now!). I recall being told I was ‘too nice’ to become a surgeon, but I believe being approachable, friendly and patient is now the minimum standard for all doctors, regardless of their specialty. Similarly, I believe it is not taboo for a surgeon to use a stethoscope every once in a while, and that the best surgeons have a good understanding and play an active role in the medical management of their patients.
The journey has not always been easy, with my fair share of ups and downs along the way. As I reflect on the difficult times, there were always surgeons who encouraged me and shared their advice with generosity and empathy, many who have walked similar paths before me. Graduating students and junior doctors are reluctant to pursue careers in specialties like surgery or intensive care because of some of the same misconceptions I initially had, however I have found my training to be enriching and senior colleagues to be extremely helpful and flexible over the years. It goes without saying, a career in surgery requires a lot of hard work and commitment. It wasn’t always easy or consistent, but throughout my training I’ve continued to travel, cook, keep fit, spend quality time with family and friends and hangout with my gorgeous dog. Gone are the days where the theatre change rooms are the only place a female can breast-pump or times where female trainees are told not to get pregnant during training because they won’t be ‘employable’. Much is still to be done to improve gender equality in medicine and surgery, but part time and job-sharing roles are now much more accessible which is a step in the right direction.
My advice to all medical students and junior doctors is to stay true to yourself and the kind of doctor you want to be, try everything and keep an open mind during your rotations, and don’t be afraid to overcome the stereotypes in medicine.