The following post is part of a year-long online campaign highlighting #WomenofPenn. The campaign, developed by FOCUS on Women’s Health and Leadership and Penn Medicine Communications promotes the work being done by women at Penn Medicine and aims to inspire early-career women in academic medicine through the examples of successful women role models.
Kristy L. Weber, MD, FACS, wears a lot of hats. As Chief of Orthopaedic Oncology at Penn and Director of the Sarcoma Program in the Abramson Cancer Center, Dr. Weber treats patients with bone and soft tissue tumors, as well as metastatic bone disease. On March 14, 2019, she was named the first female president in the history of the American Academy of Orthopaedic Surgeons, the world’s largest medical association of musculoskeletal specialists. Recently, she sat down to reflect on her education, career, and this new leadership opportunity with Amulya Sreekumar, a postdoctoral researcher at the Chodosh Laboratory. Dr. Sreekumar’s focus is on understanding the mechanisms by which residual breast cancer cells survive first-line therapy, in order to inform interventional strategies to eliminate these cells and prevent lethal breast cancer recurrence.
Q (Sreekumar): Could you tell us about your background and motivations to enter the field of Orthopedic Oncology?
A (Weber): Orthopaedoc oncology is a little bit of an unusual subspecialty. I’m an orthopedic surgeon, who did extra training in orthopedic oncology, which is the removal of bone and soft tissue benign and malignant tumors. I’m not a medical oncologist but rather an orthopaedic surgeon, focused on cancers in the musculoskeletal system.
I decided on a career in medicine very late. A lot of people know what they want to be early on, but I actually wanted to be a veterinarian. That was my path as a young child. I worked in wildlife rescue centers, caring for rescued raccoons and possums and other wild animals. I volunteered at a number of veterinary clinics. I thought I wanted to be a zoo veterinarian. I had read the James Herriot book All Creatures Great and Small as a child, and that’s really what I wanted to do. I lived in St. Louis, Missouri, and I ended up attending the University of Missouri in Columbia to become a veterinarian.
I pursued that path through my junior year of college. I took the exams, and was accepted into the University of Missouri veterinary school. And then I changed my mind. It was a last minute change. At the time, I had a few influential people talking to me about medicine, but I hadn’t even remotely considered it. I ultimately changed my mind and spent my senior year getting more of my prerequisites completed like chemistry, physics, and calculus, while everyone else seemed to be taking easier courses I don’t regret it. I think it’s ironic that I get to interface with the veterinary school here at Penn now. It feels very much full circle.
My path in orthopaedic surgery seemed to fit my personality type as I liked the idea of helping to fix people and create more mobility. Also, when they told me women couldn’t get into orthopaedics, that sealed it.
Q: Could you tell us about your research program, and specifically your collaboration with the Vet program?
A: One of the great things when I came here, 5 or 6 years ago, was knowing that they had a top 10 veterinary school on the campus and that it was just a quick walk away. I reached out to Nicola Mason, PhD, BVetMed, a veterinarian and researcher, who has done amazing work in osteosarcoma. It’s a deadly cancer that affects the bones of larger dogs. They can lose legs from the disease, and it spreads to their lungs. It’s very common and often fatal. Dr. Mason, in collaboration with others, has come up with an immunotherapy treatment that uses a vaccine and is prolonging the lives of these dogs. This is something that we are now hoping to adopt for use in children someday. This work with dogs, people’s pets, is going to impact children with this disease. We have a collaborative group that gets together frequently to write grants and to hear about research from Penn Medicine, Penn Vet, and CHOP. Sarcoma affects children, adults, and dogs, so we have a really powerful partnership here.
Q: For those who plan to maintain an active role in medicine, while also maintaining academic research, can you tell us how you balance the two?
A: Everybody is unique in whether or not they have an interest in research. I came into research inadvertently. I did a little bit of research in my residency, and I did a year of research in my fellowship, but I wasn’t initially headed in that direction. What I found is that I really enjoyed the science and applying it to relevant clinical questions. I tried to understand the science, to think of questions that would advance our field, to have a laboratory presence, and to write grants. I have an understanding of the current cancer research in my area that allows me to better understand the clinical questions we have in the field. There are so many unanswered questions, and I find it a privilege to work with incredibly smart people to look for answers.
If you are trying to find clinical and research balance these days, it’s going to be super hard. To think that you’re going to receive NIH funding for your science while also being an amazing doctor, that is really challenging. You have to come down primarily on one side or the other. Most orthopaedic surgeons are clinical, but some have an appreciation for science, and may be able to help provide human samples to a scientist. They can come up with clinical questions that a scientist can help answer. It can be difficult to get funding these days, and you will find yourself competing with people who are spending 100% of their time in the lab.
Q: Why do you think there is a disparity between the number of men in orthopedic surgery and the number of women?
A: That’s a great question, and many people are interested in understanding this. The stats right now are that this field is 94 percent male, and 6 percent female. Those who are underrepresented racial and ethnic minorities are even less than 6 percent. It has the lowest percentage of women in all of medicine.
Why? There have been a lot of hypotheses about this. The stereotype is that this field is for big, strong, athletic men. You must be strong in order to perform hip replacements and spinal surgeries. That’s a myth, and we know that people of any size can manage orthopaedics. It’s about leverage and about understanding the tools. Any person, large or small and of any gender can manage this. And it’s not just hip and knee replacements. There’s trauma surgery, hand surgery, pediatric orthopaedics… there are a lot of aspects of the field that you can tailor to your particular interests and lifestyle.
Because there has been a lack of women in this field, younger women don’t see those female role models. There’s an old adage that, “you can’t be what you can’t see.” So from there it can be a self-fulfilling prophecy that women don’t want to enter this field. So we need more women in visible roles in national societies and in leadership roles.
Finally, the piece I’ve been focused on the past few years has been about the culture. I believe the culture of orthopaedics has not always been conducive to women or underrepresented minorities. There have been stereotypes about this field, which might have prevented both men and women from pursuing it. There have been biases, whether they are explicit or unconscious, although I would these are often unconscious.
Q: Congratulations on becoming the first female president of the American Academy of Orthopaedic Surgeons. Now that you’re in a position to be a role model, did you have any role models that inspired you to achieve what you did?
A: One of the reasons I agreed to take on this national role is to show that women can be in leadership roles in this field. The opportunity to be a role model and be someone women can see and say, “yes, we can do this” is very important to me. My role models have largely been men. I have pictures of the men who taught me orthopaedics and tumor surgery on the walls in my office. Throughout my career I have sought after role models, and they have not been limited to doctors. They have included other members on the care team such as oncologists and health system leaders. Here at Penn we have amazing female role models, people like Deborah Driscoll, MD, Lynn Schuchter, MD, and Amy Gutmann. They are all visible and doing great work here.
Q: What words of wisdom would you offer your young colleagues and peers who are aspiring to leadership positions?
A: My advice to young folks in the field of orthopaedics, both women and men is simple. Work incredibly hard, be nice, and don’t complain. Work needs to be considered in the context of wellness. Being nice does not mean being walked on. Whining does not get you anywhere and is particularly unattractive from a woman. I also think you have to a very clear understanding of what your goals are.
Today people want more balance in their lives, so you can’t achieve all of your goals right away. Careers are long, so you don’t have to be president of everything the moment you start your career. I encourage people to build a strong clinical practice. Be a good doctor and a good surgeon. That is paramount to achieving respect in this field, and our primary focus should be on caring for patients.
Once you’ve established a strong clinical practice, what is your interest in research? How are you building your research program? Administrative and leadership roles as well as your family or community obligations are important. You need to be very intentional about what you do with your time.
Q: So what steps did you take to become president of the AAOS?
A: It wasn’t a goal of mine to become president. My goal has been, first and foremost to take excellent care of my patients. As I’ve developed more capacity, I’ve wanted to make a bigger difference in the field. I wanted to be a leader. I wanted to contribute to the research and knowledge of the conditions I treat; bone and tissue cancers in children and adults. I wanted to make a difference in the organizations that are in the field, whether that’s through role modeling or leadership. My motto is to always be excellent in any role that I play. I started with the AAOS at the lowest volunteer level, and I’ve been asked to take on bigger roles based on my performance. That continued over many years until I was elected to be the president.
Q: Could you tell us about any obstacles you have faced along your career path?
A: Everyone faces obstacles. I’ve had challenges with clinical care situations, difficult cases, interpersonal relationships with colleagues or team members, and difficult clinical diagnoses. Laboratory science is also full of challenges from creating a hypothesis to reaching a conclusion. These are typical challenges that many deal with in this field. I think being a woman in this field has its own challenges. I am a strong woman. I am not a wallflower, and so I am going to push the envelope a little. I think the social norms that stereotype men and women can be difficult. Women are expected to be more gentle and warm and kind and comforting, but not competitive, decisive, authoritative, and bold. I’ve had a mixture of those traits, and I’m not afraid to move forward and say what I think.
Q: Since you work with sarcomas, and that really isn’t as well funded as some of the other solid cancers, how do you plan on using your new position to advocate for increased funding for these rare diseases?
A: The AAOS has a formal effort to advocate for funding for musculoskeletal related research. We go to the NIH every year, and we meet with institute directors and their staff. As you know it’s not the directors that determine funding, but Congress, so we also talk to our representatives on the need for increased funding for the NIH. Finally, although we are advocating for more federal funding and foundation funding, philanthropic funding is very important. We try to work with grateful patients, who understand the importance of research programs, and hopefully they can make contributions.
Q: You wear so many hats here. Would you say that you have a work-life balance?
A: I certainly don’t have a balance on a day-to-day basis. I work really hard, and then I play really hard. So when I take a vacation, I am 100% on the vacation. I turn off the phone, and I really try to let go and enjoy what I am doing. If I’m doing something that isn’t work related, I try to be as present as I can. The days are really long, but I catch up later. I tell people entering the field to farm out the things they can have others do. Being able to delegate and focus on what matters to you is key. Once you can achieve that focus, you are on the right track.