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“You can’t be what you can’t see”

Hughes Hall Fellow, Professor Tamsin Ford, recognised as BMA Women in Academic Medicine role model

The British Medical Association’s Women in Academic Medicine Group has published a book of inspirational women to celebrate International Women’s Day 2021. The book celebrates achievements, career highs, great advice and opportunities, and recognised Professor Ford for her supportive, generous and encouraging approach in offering junior colleagues opportunities to develop their profile and take on leadership roles.

The trigger for this book was a growing realisation that, despite the progress made in increasing the number of academic training places, there remains a significant gender disparity in academic medicine – particularly in more senior roles. This difference becomes apparent at the post-PhD stage and the gap widens with increasing seniority (number of female professors). This does not appear to be primarily a ‘pipeline problem’ – for over a decade, around half of early career fellowships have been women. Nor does it seem to be something that will improve solely by attracting women into clinical academic careers early on, as there has been little change in the gender diversity post-PhD.

The BMA publication is clear: “academia is not a diverse field, especially at senior levels. Not only in gender, but in the intersection of other ‘protected characteristics’ such as ethnicity and disability. 0.1% of professors in the UK are black women. 3% of UK professors (of all genders) are disabled.”

As the introduction says, “You can’t be what you can’t see” and the BMA’s Women in Academic Medicine Group hope that this is another step in opening this world to as many people as possible. Professor Dame Parveen Kumar, BMA Board of Science chair, reflects: “Inspiration can come from many aspects of a person’s life: from their work or achievements, their leadership, communication skills, and interaction, or from being just themselves showing leadership, humility, hard work and a high moral standing.”

The interview with Professor Tamsin Ford is reproduced here with the kind permission of the BMA.

 Current post, speciality and area of research

Professor Tamsin Ford

I have been Professor of Child and Adolescent Psychiatry at Cambridge since October 2019 and before that was at Exeter Medical School. My research focuses on the interface between mental health and education, childhood psychiatric epidemiology and the effectiveness of clinical services and interventions. We study the full continuum of mental health, including well-being, rather than restricting our focus to children who meet somewhat arbitrary diagnostic criteria. Similarly, our focus extends to all services, practitioners and interventions that relate to child mental health rather than just those confined to specialist mental health services.

What is your current role in education, training and/or research?

My primary focus is research, but I have always taken on additional roles. In Exeter, I was the lead for clinical academic careers within the medical school for many years, including setting up and leading the INSPIRE programme for students, the ACF and ACL programmes and being the Exeter director of the Wellcome GW4CAT clinical PhD programme. I have been on the Board of the Association of Child and Adolescent Mental Health for nearly 10 years and was selected to be Vice-Chair in June 2019. My initial involvement was as one of the editors of their journals. The first year of my arrival at Cambridge has focused on regrouping the Child and Adolescent Resilience and Mental health research group (ChARM) and dealing with a lot of Covid-19-related research. However, I am beginning to build links across the wider university and to take on additional responsibilities, including being selected to be Head of the Department of Psychiatry.

What inspired you to become a clinical academic/take up your current role?

I am unusual as a clinical academic in that I completed all my clinical training before starting as a clinical research worker on the first National Child Mental Health Survey. I completed my specialist training at the Bethlem and Maudsley, where I was surrounded by excellent research and nationally renowned researchers. This environment created an interest that the actual experience of working on research crystallised. This is why I am keen to create experiences for trainees to join research projects.

Have role models informed your career development? If so, how?

I have been very lucky to benefit directly from the wisdom and support of a great many senior clinicians and peers in my training and subsequent career. The common theme is that they all encouraged me to do things that I thought I could not. My chemistry teacher, Mrs Wilson, changed the course of my life by encouraging me to take chemistry A level. The decision to do so opened up the possibility of the medical career that I had not even considered. As a core trainee and beyond, Alison Hall and Navina Evans encouraged me to be a child and adolescent psychiatrist, while Isobel Heyman, Anula Nikapota, Robert Goodman and Eric Taylor have been important sources of advice and support during my research and senior clinical training. More recently Linda Gask has been a hugely important and patient source of wisdom.

What importance would you place on mentors and supervisors in ensuring a successful clinical academic career? Are there any particular personal mentors or supervisors you’d like to mention and why?

Over the years, I have been extremely lucky to have trainers and colleagues who provided excellent role models, many of whom I am still in contact with. The support and advice of ‘critical friends’ is essential for all of us, whether in a formal supervisory or mentorship relationship or informally. But there is also much to learn from observing and talking to others in your clinical and research fields.

What motivates you most in your current role?

I am privileged to get up every day and do a job that I enjoy. Every contact with a child or young person represents an opportunity to identify distress and to intervene to improve a child’s developmental trajectory. My research is very much applied; and is often quoted in policy documents. It gives the sense that our work is contributing to improvements in services and interventions and ultimately the mental health of children and young people. This is hugely important to me. I also love the intellectual challenges thrown up by research in such a complex area. Study design, analysis and writing are my favourite aspects of the research process.

What features of the roles that you have undertaken do you enjoy most? What are the features that you like the least?

There is a constant battle to protect time for ‘actual work’ – it can appear that endless administrative documents and meetings swallow the working day. However, nothing beats a well-functioning multi-disciplinary project: the discussions that emerge from the different perspectives, skills sets and knowledge bases are truly fabulous to be involved in. I also love the thrill of seeing others develop in their ideas, skills and confidence over time.

What do you feel have been your best, and worst career decisions?

My best decision was to #ChoosePsychiatry. I have never regretted doing so, and have had an interesting and varied career. My worst career decision was to drop Physics at O level (we could not do all three sciences). This resulted in having to take Physics O Level with my A levels and to take the A level in a year while all my friends were starting university or travelling. That said, I also learned to type and to dance, did a creative writing course, and took a psychology and sociology open access course. I was at 5 different FE colleges across South and West London and it was quite an experience. The typing and psychology have been very useful.

What advice do you wish you could have given your past self?

I would tell myself not to worry so much what other people think. You cannot please everyone all of the time however hard you try.

What are the main challenges that you have faced, and how have you approached them?

I have always worked full time, but my family is also hugely important to me. My twin daughters were born during my Wellcome Clinical Training Fellowship. More recently, my mother who lived alone and 150 miles away was increasingly failing to cope. Being a large character, she had little insight into her condition, and being an only child, this was a hard situation to manage. I have a hugely supportive partner, and some extremely good friends and cousins who helped out. We got through these pressured times with ruthless prioritisation and chunking of tasks, regular yoga and more recently, running.

Do you feel that you had to make sacrifices to pursue your chosen career path? If so, what were they?

There are lots of things to do in life and lots of ways of being. Some in my generation were told you can have it all, but I think you have to prioritise. For me the focus has been work and family, and so my social life has suffered a bit. I would have loved to have kept in closer contact with old friends, been more actively involved in music – and I am the world’s worst cook. But there are only 24 hours in the day and I know my skill set.

What advice would you give to women considering a career in academic medicine?

Try it out to see if it suits you. Find a research team that are working on questions that you find interesting and important and get involved. Don’t be shy about asking questions and talking to people. Most of us have more data than we know what to do with and will be glad to have an interested person to work with their team.

Do you think that there are challenges that women particularly face in pursuing a career in academic medicine?

One of the issues that women face is the tendency to underrate their competence, which may lead to others overlooking their expertise and interest. The early career of a clinical academic involves passing membership exams, meeting clinical competences and getting your research career off the ground simultaneously. It is hard and demanding work for all, and often coincides with childbearing. This is tough for all new parents, but women often struggle more with guilt about working, and bear more of the household duties. I think attitudes are often more problematic than the actual logistics of juggling it all.

What advice would you give on managing these challenges successfully?

Try to become aware of the internal voice that undermines your confidence in yourself and test that against the evidence. Encourage yourself to take opportunities that present themselves to you. In terms of family life, flexibility, a supportive environment and efficient time management are essential. It is fine to work part time for a while if you want to.

What do you think are the most significant measures that have aided progress for women in medicine or academic medicine?

Maternity leave is essential and having more women in medical school and most medical fields is important. There is nothing like personal experience to shift attitudes. The gender divide at PhD level for GW4CAT has been fairly equal in terms of applicants and appointments so I think we will see the proportion of senior medical academics who are female increase over the next few years.

If you could improve one thing for women in medicine or academic medicine tomorrow, what would it be?

Teaching and pastoral support are important, but grossly under-recognised academic roles – if they were accorded the respect due to them, they would not tend to be pushed towards women. A more even gender allocation in these roles would also lead to a more even gender allocation in research.

8th March 2021