Colleen M. Schmitt, MD, MHS, FACG, on “Leadership for Women in GI”
by Jill Gaidos, MD, FACG
Dr. Colleen Schmitt & Dr. Jill Gaidos
I had the opportunity to meet Dr. Colleen Schmitt at the ACG “Bridging the Leadership Gap in GI” conference in January 2020. Dr. Schmitt was one of our amazing faculty members for the conference and presented a talk on “Developing Your 5-Year Plan in Academics and Private Practice.” We had planned to meet up at the next GI society meeting for her interview, however, due to COVID, the interview was postponed. We were finally able to catch up this summer and talk about her experience being a leader in GI.
Jill Gaidos (JG): You were previously the Chief of the Gastroenterology division and the Director of Clinical Research at the University of Tennessee College of Medicine Chattanooga Unit. You are now the President of the Galen Medical Group (https://galenmedical.com/schmitt-2/), which is a multi-specialty private practice group in Chattanooga, Tennessee. You have leadership experience in both academic and private practice settings. What lead to you to transition from academics to private practice?
Colleen Schmitt (CS): My first academic position was at Duke after finishing my fellowships. The move to Chattanooga was a deeply personal decision. My husband and I wanted our children to grow up near their grandparents as we are both originally from this area. We both looked at a lot of opportunities. Clint is a musician and I’m in medicine. We looked at both academic and private practice positions in different cities that we had enjoyed and loved living in, like Boston and Durham as well. But what took us back home, if you will, was this personal decision. And we both had to give up something to do that, but in the end that was the wisest, best decision I think we could have made for ourselves and our family.
You know you don’t have a perfect crystal ball, but my career has been very satisfying and enriching. The nice thing about the move to Chattanooga was that I was able to take on a hybrid position, where our group straddled both private practice and academics. For individuals who still want to have an opportunity to teach while working out of a private practice setting, those opportunities do exist. Our group eventually had to leave the teaching hospital behind due to system changes, so made the decision to give up our faculty positions there. The decision to close that door was a decision I made jointly with the rest of my partners.
JG: You also have quite extensive research experience. You were the Director of Clinical Research at the University of Tennessee College of Medicine Chattanooga Unit and then the founding Medical Director for Chattanooga’s first multi-specialty clinical trials unit.
CS: So, this is one of those situations where you just take what you have and use it and see what kind of doors and opportunities will open for you. When I was at Duke, my mentors there, Scott Brazer, and Jack Feussner, who was the chief at the Durham VA, encouraged me to do a joint fellowship in health services research. During that experience, I had accumulated enough academic hours to complete a master’s degree in Biometry and Informatics. So, when I came to Chattanooga there were a couple of single-specialty clinical trials groups. I became friends with them, and with folks in industry and asked about starting to do clinical trials. I went to my partners and asked if they had interest in doing clinical trials. I believe this is a kind of situation where, if you enjoy the work, you can make what you want to out of the job. It’s been a job that has allowed us to continue to be cutting edge, has crossed several different clinical areas, has been tremendously rewarding, and really just plain fun.
JG: With all of your leadership experience, did you ever have any formal leadership training through leadership conferences or classes?
CS: Never. It was a real eye opener to me. I can tell you exactly how and when it happened. I remember when Sheryl Sandberg’s book Lean In was published, and there was a lot of pushback against that book. I don’t know if you remember it. But I thought, “I’m going to read this just because she’s gotten so much flack. Judge for yourself about who she is as a person or her personal wealth, whatever you want, but I want to know what this says so I can be part of that conversation.” At the same time, I read a book called Women Don’t Ask by Linda Babcock. I think I read them both the same month. I found Linda Babcock’s research to be so compelling and then juxtaposed that with the personal experience and observations that Sheryl Sandberg made.
We knew then how many women were going into our field and yet really were not rising to the level of leadership positions that you would naturally think that they would be getting to by that point. And this is 20 years into women going into GI as a specialty. It’s not an original observation, by any means, but I think all of our societies were looking internally at ourselves and wondering what is going on and what can we do to change it.
I believe what differentiated the experience of someone my age or anyone around the time we trained is that we felt very fortunate to actually be in an era where there was a serious focus on the development of clinical research skills in training. And what we have seen happen over the last few years is considerable education and thought around how to develop professional leadership skills. We have had to borrow from the business community to do that effectively because they were so far ahead of academia in terms of what kind of resources brought to bear on this problem. So, that is what we did. I was very lucky. I don’t think it would have happened, Jill, if I didn’t have a Board who all had daughters in the 18 to 25-year-old range and women leadership in the society administrative staff who were completely behind the idea. They all arrived at the same conclusion I did. So, no, no formal training. I went through the Leadership, Education, and Development (LEAD) program with the LEAD classes for the first three years. I actually attended all of those.
What we have seen happen over the last few years is considerable education and thought around how to develop professional leadership skills. We have had to borrow from the business community to do that effectively because they were so far ahead of academia in terms of what kind of resources brought to bear on this problem.
What we have seen happen over the last few years is considerable education and thought around how to develop professional leadership skills. We have had to borrow from the business community to do that effectively because they were so far ahead of academia in terms of what kind of resources brought to bear on this problem.
JG: The hard part is that our GI Societies seem so siloed. I have met with women on different committees or task forces for various GI societies and all the women are saying, “We need leadership training.” That is one of the reasons that Dr. Amy Oxentenko and I worked so hard to develop the “Bridging the Leadership Gap in GI” conference—because of this need for leadership training for women in GI. Do you see any way we can expand these training opportunities?
CS: First of all, it was a really good course. My observation is that it’s an expensive endeavor. The people who really teach these topics well teach it professionally at places like the Kellogg School of Business or Stanford and they are expensive. The other thing that I believe is very different is, in medicine in particular, we are taught to learn in bite-size lectures. In fact, that has gotten more obvious over time. When was the last time you sat through a 45-minute lecture at the postgraduate course? They are usually 15 or 20 minutes with Q & A, at most.
Leadership training can’t be taught in bite-size snippets. These are deep dives. So, you have to be invested for coming in for more than a day and be willing to spend two days with a speaker and come out on the other side of that tangibly and functionally changed. Minimum for some of these lectures is going to be four hours. And there are so many nuances to what we are talking about that are still going to be impactful for the development of one skill set. We learned that before we launched LEAD at ASGE and incorporated that model into the development program. Pooled resources and opportunities to share that kind of substantive content would be of benefit to women in all of these groups.
JG: When we were developing the curriculum for the conference, I had several conversations about this with Jean Gasen, the executive leadership coach who gave the keynote speech at the conference. She looked at the agenda and said, “How can you process this information in 20 minutes? When do you reflect on what you’ve learned?” But when you look at a business school leadership course, these topics are covered over hours, not minutes.
CS: Yes, and there is a lot of role playing that occurs and the commitment to developing these skills is time consuming. You have to allow time for introspection and feedback. Any of us are smart enough to go sit and learn something about a biopsy protocol or diagnostic criteria for certain disorders. That’s memorization work and something you can write down and put in your back pocket. But practicing, I’ll pull this out, practicing an elevator speech is not something that comes naturally to us, by any means, much less the opportunity to use it. It’s important to really be still, and sit, and think. I think my talk at your course was developing your career path. To really have time to ponder that, and then think about where your gaps are, and where you want to invest time and learning—this is not a 20-minute thought process by any stretch.
JG: Right!
JG: Back to your talk at the ACG “Bridging the Leadership Gap in GI” conference, you spoke on developing a 5-year career plan to identify steps to take to develop and achieve future career plans. Throughout your career, did you have a career plan? Do you encourage others that you mentor to create a plan?
CS: Yes, although I did not have the point-by-point plan that I outlined in my talk. I don’t know if that was even a thing back then. I’m not sure if you remember, but one of the points I made for me personally was that mine was more of a crooked path and part of that was because there were two people to think about—I believe that’s true for many women. We did not set out for our family to say “OK, we’re going to take turns,” but that’s basically what we did. One would make a decision to help put the other one forward for education or for whatever purpose and then the other person would put that person forward.
It’s easier to see that in retrospect but in real life, if you’re not willing to do that, I don’t think the end result is going to be happy. I believe, first of all, leadership is about creating opportunity for other people. Truly, that has been the best part of any leadership position I’ve been in. Of course, the downstream benefit of that is that I get to surround myself with people who are extremely talented and gifted. I would say that our career plan was, maximum, five years.
When we came to Chattanooga, it was not my career plan to be a division chief or lead a clinical trials group. I kind of looked around and thought “You know there is an opportunity to do this and I’ve got this person who works with me that would be really good at this,” and we would explore that and more opportunities would come from that. I hate to tell you that’s what I did, but in truth it is. So, if my partners read this article and saw anything else, they’d start laughing. (Laughing).
JG: In reality, I don’t think I’ve ever made a 5-year career plan. I hadn’t ever really considered it until I listened to your talk. It’s funny because I’ve just moved to Yale University for the Director of Clinical Research in IBD position and my husband asked me, “So, is this it or are we going to be moving again for a Chair position?” And I said, “You know what, I haven’t even thought about that.”
CS: I think that’s an honest question and an honest answer.
JG: It’s certainly not in the 5-year plan.
CS: I would be interested to hear what your 5-year plan is.
JG: I’ll let you know when I come up with it. (Laughing)
CS: (Laughing) Oh, that’s funny! I think the next most important point from my talk is for folks not just to “give and get” but the “try, rinse, and repeat.” Understanding that the trajectory is not going to be just a straight arrow. It’s going to wind, it’s going to curve, and may require iterations of your plan. Honestly, it’s taking advantage of those curves, taking advantage of those unexpected opportunities, that’s where the magic happens. And I’m sure the same thing is true for people who do research primarily. It’s the accidental discoveries. It’s not just the deliberate, intentional discoveries, it’s the ones that you take advantage of that you didn’t expect that are really the amazing part of that.
JG: That’s something that is hard for women to do. I listen to a podcast called, “The Brave Enough Show” (https://www.becomebraveenough.com/podcast) by Dr. Sasha Shillcutt. On the podcast she talks about how women get on these trajectories and we continue to do what we are good at, but not necessarily what we love. And it becomes hard to switch from the things that we are good at to the things that we love but we may not be as good at yet.
CS: That takes courage and it also takes a significant amount of insight. That is the big decision maker for someone who is leaving one type of position and going to another type of position, like leaving academics. You are taught certain things about what that means, but for everyone in a position like yours where you have to juggle or balance the administrative responsibilities, which, let’s face it, some people love, and the research responsibilities, teaching and clinical responsibilities, it may even be a moving target. You may love the clinical part of it for a period of time or the research part and want to maximize something else. There may be no door that you want to close. But if you do have the insight and then the courage to say, “OK, I’m committed to this path,” you do realize that you may close doors. It’s not a small decision.