Having it all—a stellar career in orthopaedic research, a thriving clinical practice, and a fulfilling personal life—is a challenge, regardless of who you are. For women in the still male-dominated world of orthopaedic research and medicine, having it all is even more complicated.

At the 2014 annual meeting of the Orthopaedic Research Society, three women of accomplishment—Nancy Pleshko, PhD; Cathleen Raggio, MD; and Michelle Ghert, MD, FRCSC—explained that, although wanting it all may be a human desire, the goal should be to strike a “work-life balance” that yields optimal professional and personal fulfillment.

Achieving that balance is not easy and may involve setting limits and making sacrifices. But success is attainable by focusing on the important things, working collaboratively by reaching out to and supporting others, and using organizational techniques and tools to manage work and family.

Parenting and practice
“I have been struggling with managing the work/life balance my whole career,” said Dr. Pleshko, a professor of bioengineering at Temple University. “I thought it would get easier as the kids got older and they would need me less. Of course that didn’t happen, because at the same time, my career was advancing and more things were going on at work. Now, I hear people saying that things get easier when the kids go off to college.”

Noting that “not everyone has the same situation, and there are many balancing issues besides kids,” Dr. Pleshko said that her overall goal in life is “to be happy.” For her, the recipe includes three general components: a happy and healthy family, “work that I enjoy!” and minimizing stress, which she admitted was “easy to say, difficult to do.”

Her practical tips included having a predictable schedule whenever possible, setting aside time for family dinners together, and establishing a homework start time and a set bedtime, something she has come to accept as “likely impossible as kids get older.”

One way she fosters open communication is to have each person at the dinner table share one positive and one negative thing from the day. “This has worked well,” she said. “Although kids tend to want to talk more about the negatives, I don’t let them do that. This is better than the ‘How was your day at school? Fine’ conversation.”

The conversation may include her children’s friends. “Know and welcome their friends,” she said, “especially as the kids get older.” She also uses social media, becoming friends with her children on Facebook. She advised parents to tell their children that “they can tell you anything. Tell them, ‘If you’re in trouble, I’m here for you. If you need a pickup from a party and to get out of a situation, I’m not going to judge you for it.’”

However, she warned that this full-disclosure policy can backfire. When the kids act up, she advised, “Pick your battles. When they get in trouble, deliver consequences.”

Scheduling and predictability at work is also important, said Dr. Pleshko. “I schedule weekly meetings with my students. People who walk in can eat up your day. This lets me have blocks of time when I can do my work.”

She said that she tries not to let stress “creep into the work day,” adding, “We are fortunate to get up and go to a job that is pretty awesome. But it can be difficult.”

Her closing advice was, “Practice the word ‘no.’ You don’t have to say yes to everything—committee chair, book chapter, whatever it is.”

Pioneer woman
Dr. Raggio provided the perspective of an orthopaedic surgeon who entered the field when women were true rarities. She was just the third female resident to train at the Hospital for Special Surgery (HSS) when she began her career in the late 1970s, when “there were maybe 50 women orthopaedic surgeons in the whole country.”

Noting that many in the audience were women in the early stages of their careers, Dr. Raggio, who focuses on pediatrics at HSS, observed that the life-work balance is “all about conflicts. It’s also about how to treat conflicts like they are bumps in the road. If you know where you are heading, it will be better. And you will have the energy for the big bumps because you didn’t sweat the little ones.”

Her theme was to focus on what is truly important and to do so resolutely. “You shouldn’t be a wimp if you are a surgeon,” she said. “You shouldn’t whine; you should have a sense of humor. Make sure you work hard and be really honest. Don’t feel entitled. The reason you’re here is the patient; if you always keep the patient in front of you, you will always do a good job. People will want to work with you.

“People want to work with people who do good work and are willing to share,” she continued. “You have to be in control and take charge. Don’t be afraid to make decisions, but be humble. As surgeons, we make our mistakes in front of others, and it’s very humbling.”

A collaborative frame of mind is essential, she said. “If you want to be a surgeon and a researcher, you need to have some great PhDs who are interested in the same questions you are. You can be a mentor and bring up clinical questions to the lab. And they will be a mentor to you. Be loyal and be grateful. Advance the field. Pick work that nourishes. Don’t expect to receive something. Do something because you want to and you will never be left unhappy.”

Dr. Raggio said she likes to give herself a “creative gift,” noting, “Mine is always the ORS meeting. I love coming here.”

She advised, “Never compare yourself to anyone else with a ‘grass is greener’ perspective. I consider myself successful because I am doing what I want. This is a career. Reassess your goals regularly.”

Finally, she pointed to the need for friends and family. “Life gets in the way of living,” she observed. “If someone gets sick or you are stuck in traffic, you don’t want to become crazy. You want to mellow out and handle it. You need a really good friend—five or six if you are lucky. You need people you can call any time who know right away what you are talking about. Have a date night with your spouse, and take it seriously. It’s easy to grow apart.”

Life of pie
Dr. Ghert, an orthopaedic oncologist at McMaster University in Canada, spoke of “slicing the pie of life”—deciding “what are the elements of your life that make you ‘you,’ and then listing and prioritizing those elements.” For her, the pie consists of spouse and family, social time, athletics, research, and clinical work.

Like Dr. Pleshko, she spoke of the importance of “compartmentalizing” and trying to singlemindedly focus on the activity at hand, whether that’s being with the family on weekends or caring for a patient during clinic.

During her clinical time, she said, “The only thing that exists is the patient. I can’t be distracted. I have an overall balance. I can always do more, but I am happy with what I can do. You have to accept that you will not be the best at everything. If you don’t set boundaries, it won’t work. But leave a door open.”

Of being female in a male-dominated profession, she said, “Women who do get into orthopaedics and research have a passion for the fields. What’s hard is getting to the top echelons.”

The session was moderated by Robin Queen, PhD.

Terry Stanton is a senior science writer for AAOS Now. He can be reached at tstanton@aaos.org