“How to balance your career.” With Penny Bauder & Dr. Maria Clarissa

I think one myth that women in STEM face is that there is an easy or a ‘one size fits all’ answer to the dilemma of balancing career with family. I have received both what I believe to be overly cautious and overly optimistic advice in this area. On one hand there are people who […]

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I think one myth that women in STEM face is that there is an easy or a ‘one size fits all’ answer to the dilemma of balancing career with family. I have received both what I believe to be overly cautious and overly optimistic advice in this area. On one hand there are people who believe it is impossible to be a good career woman and mother, while on the other, there can be insensitivity to the inevitable sacrifices that will go into trying to be both.

As a part of my series about “Lessons From Inspirational Women in STEM and Tech”, I had the pleasure of interviewing Maria Clarissa Tio, MD.

Maria Clarissa Tio, MD, a clinician-scientist training in the combined nephrology fellowship program at Brigham and Women’s Hospital and Massachusetts General Hospital in Boston, was recently distinguished with an American Kidney Fund Clinical Scientist in Nephrology fellowship. After graduating from the University of the Philippines in Manila and the Duke-National University of Singapore Graduate Medical School, Dr. Tio completed her residency in Internal Medicine at the University of Texas Southwestern Medical Center in 2018. She is also pursuing a Master of Public Health degree from the Harvard T.H. Chan School of Public Health.

Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?

I volunteered to help out in the Philippine General Hospital (PGH) during my junior year as a biology major in the University of the Philippines Manila. It was then that I realized that I was certain about pursuing a career in medicine. PGH was both the premier academic medical center and safety-net hospital back home. It was inspiring to witness the best and the brightest doctors in my country forego many of life’s comforts (sleep, regular meals, salary, social activities, etc.) so that they can serve the underserved.

I became interested in kidneys as a medical student after completing a nephrology elective at Duke University Medical Center. I loved the cerebral and analytical aspects of the field and how kidney function related to every other organ in the body. My experiences in residency at UT Southwestern further solidified my interest in nephrology. I had the privilege to work with many excellent nephrologists who were not only leaders in their field but also incredible internists, mentors and educators. For someone who enjoyed kidney physiology and pathology, and who did not want to give up internal medicine, the field of nephrology was an easy choice for me.

Can you share the most interesting story that happened to you since you began at your company?

When I started at Brigham and Women’s Hospital and Massachusetts General Hospital as a first-year nephrology fellow, I was able to pick up asterixis (flapping hands) on a physical exam which lead to the rare but life-threatening diagnosis of extreme hyperammonemia, or an excess of ammonia in the blood. Because of the early diagnosis, we were able to institute the necessary treatments immediately, including dialysis, and the patient was able to survive the hospitalization and do well. This really brought home the importance of seeing and examining my patients conscientiously.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

During my pediatric rotation in medical school, my first patient was a 2-month-old infant, and I was perplexed as to what to do. Having grown up without any siblings, I did not know how to approach an infant. Clearly, I could not just say “how are you” to the baby, which I almost reflexively did. It was part funny, part embarrassing, and part humbling to ask my professor to teach me the basics, starting with the proper way to carry a baby. While medicine can be a very academic and abstract field, common sense and practicality can be as important as book knowledge on the ground.

What do you think makes your company stand out? Can you share a story?

Massachusetts General Hospital and Brigham and Women’s Hospital are both known for their rigorous academics and excellent clinical training. Lately, I have been impressed with how my institution has handed the COVID-19 pandemic both from a clinical and research perspective. On one hand, our division volunteered to do extra clinical work to help with the surge in patient cases. On the other, we have collaborated to pursue new research projects and ideas relating to COVID-19 to try to better understand and fight the disease.

Are you working on any exciting new projects now? How do you think that will help people?

One of my main projects, which is funded by my American Kidney Fund Clinical Scientist in Nephrology fellowship, is investigating oxalate as a modifiable risk factor for chronic kidney disease. While the word “oxalate” may sound obscure, it is a substance found in many common food items like spinach, rhubarb, and nuts. We have more and more evidence showing that increased oxalate in the urine may be a risk factor for kidney disease. My projects involve studying dietary oxalate and how this impacts patients with kidney disease.

Chronic kidney disease is truly a worldwide epidemic. In America alone, there are 37 million people living with kidney disease and millions more at risk. Having kidney disease puts you at a higher risk for heart disease and death. Unfortunately, in most cases the ability to reverse kidney damage is limited, and medications are geared toward maintaining remaining kidney function. This makes it important to find ways to prevent kidney disease in the first place. I am very excited about my project because I see oxalate as one such opportunity, and it is my hope that the results of our studies can guide effective dietary measures to reduce kidney disease.

Ok super. Thank you for all that. Let’s now shift to the main focus of our interview. Are you currently satisfied with the status quo regarding women in STEM? What specific changes do you think are needed to change the status quo?

There is room for improving the status quo regarding women in STEM by not only increasing the number of women in this field, but also women in leadership positions. I think that as more and more women join STEM and rise through the leadership ranks, this will positively impact the system by creating more role models and support systems. I have been fortunate to have met many inspiring women in medicine — colleagues, attendings, mentors — who have demonstrated that it is possible to be an excellent physician, productive clinician-scientist and caring mother/wife.

In your opinion, what are the biggest challenges faced by women in STEM or Tech that aren’t typically faced by their male counterparts? What would you suggest to address this?

One of the biggest challenges that women face in STEM is the expectation that women need to prioritize raising children over their career aspirations. There are only 24 hours in a day but I work with amazing female colleagues who seem to push that limit. Whether it’s using phone apps to check on their sleeping babies during their grueling 80-hour work weeks or taking their children to daycare after an overnight call, it is truly inspiring to witness their grit and tenacity.

What are the “myths” that you would like to dispel about being a woman in STEM or Tech. Can you explain what you mean?

I think one myth that women in STEM face is that there is an easy or a ‘one size fits all’ answer to the dilemma of balancing career with family. I have received both what I believe to be overly cautious and overly optimistic advice in this area. On one hand there are people who believe it is impossible to be a good career woman and mother, while on the other, there can be insensitivity to the inevitable sacrifices that will go into trying to be both.

What are your “5 Leadership Lessons I Learned From My Experience as a Woman in STEM or Tech” and why. (Please share a story or example for each.)

These are the things I learned on the job during residency training, when I was a resident running my own team of interns and medical students, managing the 20 patients under my ward, answering to my attending, and coordinating and working with other members of the healthcare team. The advice that I would give to other female leaders in STEM is informed by the following lessons that I have learned:

  1. Know your team members well. Know their strengths and their weaknesses (we all have them!), address their needs. Know your team members’ personalities and build camaraderie.
  2. Be fair, but also be kind. It can be frustrating when a team member starts to act unreliably, or dumps work onto other members of the team. There may be a temptation to get angry but a close friend from residency told me this: always be kind to others because you don’t know what they are going through.
  3. Know the negotiables and non-negotiables in any situation. Medicine is a wonderful but highly imperfect system. Be flexible enough to be able to compromise on the negotiables.
  4. It is okay to not be good at something or to make a mistake. It is what you do with the information that matters.
  5. Acknowledge your mistakes. “Pride grows in the human heart like lard on a pig” (by Alexander Solzhenitsyn).

What advice would you give to other female leaders to help their team to thrive?

Always keep in mind that every medical team is made up of talented but imperfect individuals. It’s important to manage your team in a way that views mistakes as teachable moments to build on skill sets.

What advice would you give to other female leaders about the best way to manage a large team?

Take the time to get to know your entire team in order to know everyone’s strengths and weaknesses and build the most beneficial framework. I think it is important that the leadership encourages autonomy from the junior members of team while still providing guidance. Asking for help for clarification should never be treated as a sign of weakness.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

It’s not one person really, but rather, a whole lot of people who have been instrumental to whatever success that I have achieved. Family — from my parents who, without any hesitation, supported my education and career; to my husband (who is also a clinical and research fellow in nephrology) who has supported me through many challenges. I am also very fortunate to have met amazing mentors who have helped me in my career. In fact, I would not have been able to receive the American Kidney Fund award without the guidance and support of my mentor, Dr. Sushrut Waikar. I am also very lucky to have found a support system in my colleagues in both residency and fellowship training. We have so many ups and downs in our line of work, and these colleagues who are friends have been important in getting me through the downs. It really ‘takes a village’ and I am very grateful for that.

How have you used your success to bring goodness to the world?

I do hope that I am positively impacting my patients’ lives with each of my interactions with them! Right now, in Boston, we are in an ‘all-hands-on-deck’ situation especially with our surge of COVID-19 cases. Moreover, being an AKF Clinical Scientist in Nephrology fellow opens up opportunities for me to join their initiatives to help fight on all fronts for kidney patients, from patient screening to patient education and to advocating for legislation that supports kidney patients. I am very excited about these opportunities!

You are a person of enormous influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

It would be a movement to make “compassionate dialysis” — which is emergency dialysis for people without regular access to healthcare — unnecessary. Despite its terminology, “compassionate dialysis” can be brutal. Patients with end-stage renal failure (ESRD) require regular dialysis, usually 2–3 times a week. However, there are still many parts of the U.S. where ESRD patients do not get access to regular dialysis due to their immigration status. Because of this, these patients have to wait until they develop symptoms before going to an emergency room to receive a session of “compassionate dialysis.” It is really terrible, because each episode is akin to playing Russian roulette with their lives. I have personally cared for many patients in Texas, who suffered repeated hospitalizations, complications, and even death due to not being able to get regular dialysis. Whether it is in the U.S. or in any other country, I would want a movement that will take care of all kidney patients to ensure that they regularly get the life-sustaining dialysis that they need.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“You can’t make footprints on the sands of time by sitting on your butt… and who wants to make butt-prints?” by Bob Moawad. I came across this quote when I read The 7 Habits of Highly Effective Teens by Sean Covey when I was in elementary school. It has stuck with me since then. The principle of this quote has guided me from my college years in the Philippines, to moving to two countries for medical school, and throughout my post-graduate medical training as a full-fledged physician and clinician-scientist.

We are very blessed that very prominent leaders read this column. Is there a person in the world, or in the US with whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them 🙂

Dr. Anthony Fauci — at a table length >6’ or only after the restaurants have reopened post COVID-19. Not only is he the man of the hour, but he has been an important and enduring leader working in the interface between government and medicine for six U.S. presidents. I would love the chance to learn from his experiences of navigating the chaos of multiple large-scale crises.

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