Welcome to Our Voices Our Future, the podcast
where we amplify the voices driving change and
equity within medicine and beyond. Brought to
you by the Gender Equity Task Force, a committee
of the American Medical Women's Association.
We're here to challenge norms, break barriers,
and ignite conversations that matter. I'm Megan
Etsy, and in each episode, we'll bring you candid
discussions with leaders, changemakers, and advocates
working to create a more inclusive and just world.
No more silence, no more waiting. You're listening
to Our Voices Our Future. Today we're welcoming
Dr. Grace Gilbert. Dr. Gilbert is a PGY3 orthopedic
resident in the Philadelphia area. She began
her career as an operating room nurse before
earning her MD from St. George University in
2022. Dr. Gilbert is passionate about orthopedic
education, health policy, and advocacy work.
She also shares widely through her growing social
media presence, which is linked in the description
below, where she blends medicine, storytelling,
and accessible public health education. Thanks
for being here, Dr. Gilbert. Well, thank you
for having me. This is awesome. Yeah. So can
you just start by sharing a little bit about
your journey into medicine and what drew you
into your specialty? Yeah. So I'm, you know,
what we would call a non -traditional student
in that I didn't... Really grow up wanting to
be a doctor or even interested in health care
at all a lot of my childhood. I wanted to be
a teacher and a lot of people here and there
would be like, oh, you should be a nurse, blah,
blah, blah. And I'd always be like, ugh, that's
gross. I could never do that. So when I went
to college, I was pretty young. But I started
out as a math major. And I wanted to be an algebra
teacher. That was my life goal, which should
be awesome. Turns out, I'm horrible at calculus.
So that was very quickly. changed and I kind
of ended up in nursing because I wanted a stable
career and I wanted to help people. And by that
point, I had started being a caregiver for my
grandmother. So I knew that it wasn't so gross
and that I could handle it. So I went to nursing
school and kind of junior year of nursing school.
You know, I had fallen in love with nursing school
and I had loved the science behind it and all
these things. But I kept on asking questions
and being told, you don't need to know that.
Oh, yeah. And I was like, but I want to know.
And they're like, no, that's not going to be
on the exam. That's a doctor's job. And they
were right, right? It was not going to be at
all on the exam. They were just trying to be
like, listen, you don't need to know that. But
I was like, but I'm curious. And so maybe the
4 ,000th time that happened, I was like, maybe
I want to be a doctor. And so senior year, I
started taking all these pre -med rec. classes,
and then I went and became an operating room
nurse, studied for the MCAT, worked for two years,
and then went to medical school. So that's the
short and the long version of how I ended up
in medicine. While I was in the operating room
as a nurse, I fell in love with orthopedics.
And I was like, well, surely by the time I finish
medical school, I'll have talked myself out of
that crazy idea. But I didn't. And so here we
are. Yeah. So That's a pretty quick transition.
I think I didn't recognize that it was just like
two years in nursing and then you were right
back to school. How did that feel kind of going
like you're working, making money, and then you
go back to school, not making any money anymore.
How was that transition back? It was good, I
think. You know, I didn't have that. traditional
college experience, because I was commuted from
home and I grew up in a really strict kind of
background. And so actually going to medical
school and going to medical school in a different
country was really like the college experience
for me. It was getting away in a lot of ways.
And I think for me, a lot of that was very exciting.
The loss of salary was really tragic, though,
like not having a paycheck, not being able to
work overtime. struggling with money. That was
hard. That's still hard because I still make
less money now as a doctor than I did as a nurse.
So that was an adjustment for sure. I like school.
I know I'm one of those weird nerds who like
school. So it wasn't so hard to go back. And
I was able to, like during COVID and kind of
my fourth year of medical school, I was able
to do some travel nursing, which was really fun.
I got to kind of go back and remind myself about
all my skills and make some money. And I really
enjoyed that. That's awesome. So can you kind
of tell us how your experience in residency has
been so far, both of the rewarding parts and
the challenging parts equally? yeah so i think
you know when i talk to medical students about
residency um there are a lot of amazing things
about residency but it really is a means to an
end for most people you know you residency is
not a good time no matter where you go no matter
what you're doing it is really freaking hard.
And I did a prelim year, which I did one year
of general surgery in the Midwest in Minnesota.
And then I did a second intern year in orthopedics
when I made my transition. And I'm now, you know,
three years into orthopedics. So kind of seeing
and being in two very different programs as well,
you can really see that. The most amazing parts
of it is like not to be really cheesy, but is
the patients like when you have a patient you
like cry with or talk to or can make a change
in. There's nothing like that. And working with
your colleagues, especially because I do love
teaching, you know, like I started wanting to
be an algebra teacher and now I'm teaching like
our interns this year and helping them walk through
the process, I think for me is most rewarding
when I teach them something or when they're having
a bad day and I'm able to like talk about my
experiences and support them. Like that makes
it all worth it to me, like talking to my patients
and through it all. Like everything about residency
that's good is people based. Whether it's my
colleagues or my students or my patients. Everything
about residency that's hard and awful is the
healthcare system's difficulties, the hours,
the salary, and medical hierarchy. In a surgical
specialty, there's a lot of that. There's a lot
of extra hoops and things to jump through. Also
being on the East Coast, I kind of got I'm from
the East Coast, but when I was in Minnesota,
I got really spoiled. People are really nice.
Yeah. And that's not what I'm used to. But I
got used to it real quick. And then I came back
to the East Coast and I was like, this is my
people. But also, man, we're mean. We're not
nice. Even when we're being nice, we're very
gruff and like hard. And I'm a very sensitive
soul. So that, you know, that's always hard as
well. Yeah, so talking about these hoops and
the hierarchy and all the things that come with
residency, can you kind of tell us how this has
impacted your mental health and were there any
like particular stressors or turning points in
this stage of your life that has stood out to
you so far? Yeah, so mental health has always
been a part of my life and a battle. I've suffered
from anxiety and depression since I was like
six years old. I can remember my first panic
attack at six years old, even though me and my
family had no idea what that was. And it really
wasn't until medical school when I was on the
island at St. George when I got therapy for the
first time. And then during my clinical years,
when I got on Lexapro or SSRI, anti -anxiety,
antidepressant medicine for the first time, which
both of those things absolutely changed my life.
Like literally a week into medication, I was
like, oh, I should have been on this at six years
old. This makes a lot of sense. I also had ADHD,
so I'm a little neuro -spicy or neurodivergent
there. And I'm on Ritalin. I like to talk about
my medications a lot because I'm really pro treating
your symptoms and trying new things. So all of
those things, although when I started residency,
I was at a pretty good place in my mental health
because I had found therapy and I had found medications
through medical school. Thank goodness. It's
still been hard. My first residency was hard.
for different reasons than my second. I think
my mental health has struggled a lot more in
my second for some of the reasons that I mentioned.
I think when I did general surgery, it matched
a lot of my skill set a little bit better, which
general surgery is a lot more general, a lot
more whole, you know. holistic and whole body
and big picture and you know those kind of things
and orthopedic is very focused and very detail
oriented and that just goes against my personality
so i have to work a lot harder to be that person
and i think i make it a lot more holistic and
i have a bigger picture i think that's good but
it I still struggle to push on that other side
and be exactly who I need to be as that type
of clinician. And the hours are definitely longer
and the support is different. It's a lot more
independence, a lot less teamwork based things.
And this is all comparable, right? Like you compare
it to another specialty and maybe my specialty
or this hospital has way more teamwork and everything.
But those are just some changes for me that really
made it hard. You know clashes with people or
different seniors or whatever those things be
like I started having a lot of panic attacks.
In my second intern year and I started orthopedics
which I hadn't had for years and so that was
a struggle because I I kind of entered. My second
intern year being like, Oh, I've already done
an intern year. The second one will be easy.
Like I've already learned Epic. I've already
learned the EMR. Like I'm going to do great.
Like this is going to be awesome. All I'm going
to have to worry about is like brushing up on
my orthopedic knowledge and boy was I wrong in
every way, shape and form so much harder. My
mental health took a drastic dip. My anxiety
became horrific. Um, and I'm kind of slowly climbing
back up from that. Um, you know, reestablishing
therapy, reestablishing. and medication and care
in the new city and all of those things. And
I think we're on a better side now, but I really,
really struggled with that first year and I thought
about quitting a lot. So I know that there's
medical students and residents who feel the same
way and people who do. And I think I just want
everybody to know that you're not alone. Residency
sucks. It's supposed to suck, unfortunately.
And it's a means to an end. You do it for the
people. and for kind of the goal at the end of
the tunnel. Very fair. So a little more broad
than talking about you, what would you say more
unique challenges mental health wise for women
in medicine that there are compared to their
male colleagues? I mean, and I think I can fairly
say, especially in surgery, I think you're in
a great spot to talk about this. But yeah, what's
your kind of perspective on that? Yeah, especially
as an orthopedic. Like I'm lucky we have a couple
girls in my program, but I often interact with
other female orthopedic residents who are like,
oh my God, I don't have any women in my program.
It must be so nice to have a woman to talk to.
And it's true. The relationship I have with my
other female residents and my female attendings
is drastically different than the men. Like there
is a different... emotional awareness, emotional
intelligence, and there are men who are much
more that way, who I can talk about those things
with. I don't want to exclude all men from that
conversation. But there is just a comfort level
and a different dialogue that happens with most
women that I'm really lucky to have amazing females
in my group. And we're all at different levels,
but we all still connect in like a very similar
way. So it's hard. It's hard being one of the
only girls. It's hard being one of the only women.
It's hard having people make comments about that,
no matter where you go. It's hard always having
to clarify that you're not the nurse, which for
me, I was also a nurse, so no shade to nurses.
And I still have my nursing degree, so I am still
a nurse. I still have my license, although I
don't use it. So when people are like, are you
the nurse? And I'm like... Well, not your nurse.
I'm a nurse. I'm the doctor. I'm your doctor.
And I don't usually explain all that to the patients.
I usually just like, if someone's asking for
water, sure, I'm the nurse. If someone's saying
they want a clarification on their surgery, I
will clarify that I'm the doctor, you know, just
kind of situation specific. But we know that
across the board in medicine. We have higher
suicide rates, higher depression rates, higher
rates of alcoholism, and even some more like
other drug uses. We also know that women out
proportionally have issues with those things
and are treated differently, are paid less, et
cetera, et cetera. Unfortunately, in my first
residency, although I wasn't close with the people
I had two colleagues who worked in the hospital
who attempted suicide, one of them successful
the first year. And, you know, they were in different
specialties, but it was close to where you were
experiencing it. And you saw it and you heard
about it. And that's hard. Even not being close
to those people or not being personally affected,
like professionally, you're just aware of how
hard this can be, even at a great institution,
even somewhere that recognizes duty hours. You
know, when we talk about mental health and wellness
in residency, it's not because we want to be
like more butterflies and rainbows. It's because
people die. this isn't a little deal. This isn't
people being weak and just wanting to work less.
People literally die. People say, this is so
hard. It is incompatible with life. And obviously,
those things don't happen without some sort of
mental health issues, but we have to focus on
those things. to the people out there, like one
of the things that I've done is I've really fought
for change in my own program and been able to
make some changes that are better for our hours
and for our wellness. And I could have probably
made less waves by just dealing with the things
as they were. And when I came in, I decided that
I wasn't going to do that. I was willing to make
waves to make things safer and better for people.
And I'm really happy with that because now I'm
seeing my younger interns kind of see the benefits
of that and still struggle and still it's hard.
And I'm able to say like, I'm glad we changed
this. I'm glad we changed that. But fight for
change in your program. Don't sit idly while
you're struggling. Find people you can trust.
Find people you can talk to. If there's nobody
there, you can talk to. Reach out to the internet.
You know, like TikTok, I found so many great
friends through TikTok of people and similar
experiences. I'm meeting you today, which is
really nice. I think you can always find somebody
who's going through the same thing you are. You
don't have to be alone with the age of technology.
So if your hospital doesn't have somebody you
connect with, reach out. You can reach out to
me. You can follow me. If you're struggling,
reach out to me. I will talk to you. Because
this is hard. It's not something easy. And doing
it alone is, I would say, impossible. So I'm
going to blend the next two questions together,
because you've kind of hit on them. But I think
they kind of go together. So have you found kind
of mentorship, peer support, or any resources
that have helped you? And you have you felt kind
of the culture of medicine evolve any to support
residents? Or where do you still see like those
bigger gaps that exist? Yeah, I think it's it's
a process. I think especially orthopedics is
a little behind on all of that. And I think they
would tell you that too. You know, that's I think
it is Been such a isolated part of medicine for
so long, and it is the least diverse part of
medicine in so many, so many ways. And so the
patterns tend to perpetuate for a little bit
longer. And some of this diversity breaking in,
even having women or people of color or people
whose physically aren't third generation orthopedic
surgeons come in, kind of shake things up a little
bit. And so I think that we see. A lot of that,
but through it, I've yes, I found mentors. They
have amazing female attendings who really invest
in me and the other girls. And that's really
special. You know, I think that's what part of
the important reason diversity is important.
Like, yes, the male attendings invest in us,
but it's not it's not the same. And not that
they couldn't, but they just don't know. How
to invest us in us in the same way that those
female attendings who have been to the exact
same experiences of us do and I have an amazing
female attending who has given us books on confidence
and has sat down and talked to us about how to
handle the complex situations and not just teaching
us orthopedics but teaching us how to navigate
medicine as a woman and the extra jumps that
that takes and being very intentional with that.
And I think that's something that women really
strive at is we're very intentional. We're very
good at planning and being intentional with fixing
problems and helping in situations and helping
people. And that's what I've noticed about the
people who really invested in me. And my program
director, who is not a female, has also really
spent the time to... Talk to me about my mental
health and I think at one point I was struggling
and I mentioned my ADHD with to him just kind
of like casually and He followed up on that and
he's like I want you to tell me about your age
What does it make it harder to do? What does
it make it easier to do? Like show me and he
even was willing to do like the ADHD self -assessment
like myself And I think all of those things are
really special like If you care about me, if
you invest enough about me to learn about things
that you don't know about to teach me, like that's
exceptional. That's wonderful. And those things
motivate you at your core to work harder and
be better. If someone's willing to invest in
you, you want to invest back into them. Does
that kind of answer the question that I go off
to? of tangents. No, I think it was great. I
think it was great. So kind of like the conversation
we're having right now, like what role do you
think these open conversations about mental health
play kind of in reducing the stigma in the medical
practice and training? I think it's essential.
Every important conversation I have had with
those mentors is because I opened up about struggling.
It's because I opened up about my mental health.
Because they can't help if they don't know what's
going on. And a lot of people are uncomfortable
going, you know, it seems like you're struggling.
Are you depressed? And you're like, no, I'm not
depressed. Like, yeah, you are. Yes, you are.
You are sad. You are depressed. You are struggling.
Like, you're not being lazy. It's not that you're
not trying, or maybe you're not. But maybe you
have a reason, you know, and I think The more
I am open about myself, so many other people
have begun being open with me and with them because
of it, right? When I was trying to enact some
of the changes about some of the things that
were really hard, like our hardest shifts or
our longest shifts, I reached out to like every
resident and was like, how was your mental health
during this time or situation when you were doing
this? And I was able to present that to my program
director. And none of those people had ever been
asked that question. And none of those people
had ever discussed it. Most of them said, oh,
I didn't tell anybody. Oh, I wasn't telling anybody.
And some of those people even admitted to having
suicidal ideations and things during that time
or really severe depression or really severe
anxiety. And so like, Me being so open to that
with them when I was going through those experiences
I told them what I was struggling with and Asking
them like we all started dialogue and then I
was able to use that and make an actual physical
change in my program that My administration was
really happy to do because I had a plan and I
had the data to support it and we just changed
it right now if you don't have a supportive,
you know program director and administration,
you are going to struggle a lot more. But if
I had just come and said, this is hard, I don't
like it, that would have been the end of the
conversation, right? But I talked with people,
I had a plan, and we'll see if all those changes
help, but I think that they are, and I'm seeing
that with some of the interns. So it's essential.
You do not make change without communication,
and people can't help you if they don't know
what's going on. Very fair. I think that's super
encouraging just to know that you were able to
take like this data from your residence and have
change made because I think that's the issue
with a lot of people is they don't realize that
there can actually be fruit from it. You know,
a lot of people are like, I'm not going to say
anything. Nothing's going to change anyways,
but then just have the conversation. Yeah. And
like I said, I made a lot of waves and a lot
of made a lot of people unhappy with what I was
doing because it made some things more complicated
and like there was consequences for what I was
doing. It was not all easy. And a lot of times
when I have new interns and they're struggling
with something, I kind of always present them
with two choices. And I say, listen, if you want
to go with the flow, that's your choice. Like
if it brings you more anxiety and stress to try
and fight this and change it, that's fine. I'm
not saying you need to do that. Like you need
to do what's right for you. And some people will
choose that road. And some people will say, I
don't care how hard this is for me. I need to
make this better. It's fine, whichever one you
choose, but just know that if you choose that
harder road, it is literally going to be harder.
It is going to suck, but there may be some benefit
on the end for a lot of people. And you have
to do what's right for you and your mental health
and your career. But just because people are
frustrated or upset or their waves does not mean
you're doing the wrong thing. You have to know
your values. You have to know what's worth it.
And you have to fight for what you believe in.
And that's a lot of what my social media is about,
and a lot of what I talk about is, you know,
standing up for what you believe in no matter
what. Very fair. What advice would you, other
than that, give to all students or residents,
particularly women, who may be struggling with
these pressures that we go through during training?
I think, you know, this is probably The most
obvious thing ever and we don't have a lot of
time for it, but I don't know what I do without
therapy. I'm also lucky enough that I've also
had some career coaching, which a lot of people
don't know about, but it's basically just like
therapy for your job, where they talk about where
we talk about like, I'm struggling with this
part of my job and these social communications
and this person and like, how do I navigate that
and how do I talk about this? And it's really,
really helpful. Not everybody has access to that.
Not everybody has access to therapy. But medication,
if you haven't tried medication and you're struggling,
I have so many friends who I talked into trying
medication and it didn't work. I talked them
into trying medication again and it didn't work.
And I talked into trying medication a third time
and it has changed their life. And it doesn't
work for everybody, right? And you're not always
going to find the right thing, but it has made
such a... I cannot even describe the difference
it has made in my life. I think those are some
very tangible things that you have to do on your
side that have nothing to do with residency,
but just have to do with you. Maybe you didn't
struggle with anxiety and depression since you
were six years old like I was, right? Maybe yours
is more adjustment disorder or situational, but
that doesn't mean it's not real. It doesn't mean
that other interventions can't help with it.
I think finding a support system is essential.
You know, teaching yourself about imposter syndrome,
learning that no one has it figured out, learning
that everyone is faking it, and not comparing
yourself to other people. All of these things
are things you hear, but doing them is really,
really hard. Like really, really, really hard.
So however you learn best, if you're in residency
or in medical school, you know at this point
how you learn best. Is it by listening to podcasts
like this? Is it audio? Is it reading books about
it? Is it through communication? Do you learn
best with a therapist or with studying with a
partner? However you learn best, you have to
think about your mental health as a skill. It
doesn't just get better. You have to study it.
You have to learn about yourself. Again, when
you're working 90 hours a week, it's kind of
hard to do that. But if you're working 90 hours
a week, you're not going to survive however many
years of that. if you can't figure it out. And
so take your wellness days, take your vacation,
do those things and try and take care of yourself
best you can. Do not turn to alcohol. Do not
turn to my big one is food binging. That's how
I deal with a lot of my stress. And all of the
other maladaptive behaviors like that people
do, especially in medicine, like you have to
find a way to recharge and reset for me. I have
a lot of rules. I'll share a couple of my rules
with you. So one of the rules is if I'm at the
hospital later than 11 p .m., I don't go home.
I sleep in the call room because I can get like
two hours extra sleep if I don't go home. And
for me, that makes a huge difference on my mental
health and it's a little bit safer. So when I
was like on call a lot and wouldn't get done
until late, I would just stay in the hospital.
Another rule I have is if I fall asleep at my
desk, I'm not allowed to drive home until I take
a nap because it's literally unsafe. But that
is a rule I have that protects myself. So a lot
of rules like that that protect yourself and
protect your mental health and your sleep and
your personhood. You're like literally being
alive and not crashing and dying, I think can
help because you have such decision fatigue and
you're so exhausted that making some of those
choices can be really hard. Sorry, my dogs are
listening in. They're big fans of the show. Oh,
that's awesome. So as you think about your own
future in medicine, how do you hope to carry
forward what you've learned about supporting
yourself and others in their mental health journey?
It's a hard question. I think I'm a big dreamer.
And so I'm like, oh, I just want to change the
world. I just want to change health care policy.
And I want to get the duty hours reduced. And
I want to do everything. I don't know how grand
scheme of things will be, but I do want to be
a program director. And I do want to work on.
The mental health of my students. One of the
things that my PB does is he talks to us a lot
about values and he even takes every year one
of our education blocks and just sits down and
talks to us about our values and how to like
apply that to our life and how to be like a good
person. And I think that's really inspiring that
you know we have all this time devoted to education
and a lot of people don't educate us on like.
things other than textbooks. And so I want to
focus on that. I want to continue using my TikTok
to, you know, bring change and talk to people
and advocate for people. I don't know, honestly,
all the things I want to do, because a lot of
this is still relatively new. You know, I've
only been TikToking and sharing my story since
June. And I've kind of been really lucky in that
I've hit some virality with it, but I think that
that was something that I was just like, let
me just try this. And it exploded. And now I
have this new path. So I know that what I plan
is probably not that it's going to happen. What
I planned was to be an algebra teacher and not
an orthopedic surgeon. What I planned was to
maybe make some money on TikTok, not to be on
multiple podcasts and interviewed by people and
be advocating for mental health. But I think
when your values are aligned and my values are
to help people, both in medicine and patients,
And my values is to be authentic about my mental
health. And when you are authentic to those,
everything you touch is going to explode with
that. Everything that you try and do, you're
going to incorporate that. So when I'm teaching
my medical students or my residents, my interns,
not just teaching them orthopedics, I'm teaching
them those values. I'm making TikToks. I'm teaching
those values. So whatever it is that you are
passionate about, if you insist on bringing that
to everything you do, it is going to make a change
and it is going to be impactful. And I have no
idea how that is going to turn out over the next
10 years, but I'm excited that it is going to
turn out. I know that it is going to make a difference
because I'm not going to let it not. I love it.
Yeah, that's great. Thank you so much for your
advice and this talk today. It's been amazing.
Yeah. I'm happy to talk about it and people can
absolutely reach out to me. People reach out
to me all the time when they're struggling. And
honestly, it's nice for me too to hear other
people struggling. It's hard. It does get easier,
but it's really hard. And I'm sure being an attending
is also hard. I'm sure being a medical student
was also hard. I'm sure being a nursing student
was also hard. Our lives are hard and we're choosing
more. really difficult path. So if you're struggling,
it's because you chose something really, really
hard. You're not doing anything wrong. You are
struggling because it is hard. And that's a very
reasonable response. Yeah, it's a great way to
look at it. Love it. So that's a wrap on this
episode of Our Voice is Our Future. We hope today's
conversation inspired you, challenged you, and
reminded you of the power of raising your voice.
The fight for equity doesn't stop here. Join
us in the movement. Subscribe wherever you get
your podcasts and if you love this episode, share
it with someone who needs to hear it. Until next
time, stay bold, stay vocal, and keep the conversation
going. This is Our Voices, Our Future.